The two most common eating disorders, especially among young American women, are bulimia and anorexia nervosa. Both disorders stem from psychological issues, which result in the sufferer’s depriving his or her body of essential nutrients. Dental offices are one of the few places where the physical damages that may accompany these disorders can be detected.
Bulimia is characterized by compulsive overeating (binging) followed by self-induced purging, whereas anorexia nervosa is marked by extreme weight loss usually achieved through a severely restricted caloric intake. Yet both diseases produce signs and symptoms that can be detected in the mouth during a routine oral exam, with manifestations, such as dry mouth, reddening of the palate, and dry, chapped lips.
In addition to these symptoms, repeated vomiting, a common characteristic of both disorders, exposes teeth to gastric acids which erode tooth enamel, the hard protective covering of the tooth. Teeth may become rounded and soft and/or amalgam fillings may start to protrude above a tooth’s surface. Eating disorders often can be successfully treated when detected early and when those patients with eating disorders are encouraged to seek oral healthcare.
People suffering from an eating disorder are often able to hide their problem from family and friends. However, many bulimics and anorexics are finding it difficult to hide the disorder from their dentists. In fact, 28 percent of all bulimic cases are first diagnosed by dental professionals.
Tooth decay is normally found on the biting surface of the back teeth. Continuous vomiting, however, causes erosion primarily on the inside of the front teeth, which can be detected during a routine dental exam. In addition to eroded teeth, dental professionals may discover that patients with eating disorders suffer from eroded fillings and dry mouth.
The damage caused by continuous purging is what may ultimately bring a bulimic patient to the dentist. If the erosion is caught early enough and the patient is seeking treatment for the eating disorder, then something as simple as a fluoride rinse may help. But if the damage is severe, the next step may be a more comprehensive treatment, such as placing a crown on each affected tooth. However, if the patient has not sought treatment for the bulimia, any reconstructive efforts may prove ineffective because additional acid will destroy any new restorations.
Dr. Courey recommends that anyone suffering from an eating disorder seek medical treatment immediately. Many hospitals now have facilities and/or programs that treat people with bulimia and anorexia nervosa.