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.
