Lots of people, especially young people, feel the pressure to look thinner. In some cases, they develop eating disorders to keep up with these social expectations. Unfortunately, not only is this bad for their health, but it can also damage their teeth.
The 2 most common of these eating disorders are anorexia nervosa (where one restricts the food intake) and bulimia (where one has compulsive eating episodes). At times, patients interchange these behaviors, as well as suddenly tame steps to stop gaining weight like making themselves sick, using some laxatives, fasting, or working out too much. Because those with eating disorders suffer from a distorted body image, they can lose so much weight that they become too thin and have an unhealthily low BMI. At the same time, they can suffer hormonal disruption.
Patients with an eating disorder can hide it for a long time, however, it will start to manifest in the mouth, where the first signs tend to show up. The lack of proper nutrients, as well as the harmful activities that accompany an eating disorder, will start to have serious consequences on the health of their teeth.
Without treatment of the eating disorder, this damage can be long-lasting or permanent. It is important to identify and treat these issues to allow the teeth and the rest of the body to recover.
How Do Eating Disorders Affect Your Oral Health?
When the body is not receiving the right nutrients, the gums and soft tissues inside the mouth, including the glands that are responsible for saliva production, tend to bleed quickly. Dry mouth is also noticed due to the lower saliva production.
Effects of Nutritional Deficiency
In anorexia, food intake is restricted and this leads to extreme nutritional deficiency. Some of these nutrients, like calcium, B vitamins, and iron are vital for good oral health. Without enough calcium, patients have higher instances of tooth decay and gum disease. Even if they have enough intake of calcium, without vitamin D, it is not absorbed by the body.
Lack of sufficient iron in the diet will lead to sores in the mouth. On the other hand, with low levels of vitamin B3, patients have bad breath and develop canker sores. Signs of gingivitis, like red and swollen gums, can be observed. Lastly, dehydration can make the mouth dry and the lips look red, cracked, and dry.
Effects of Frequent Vomiting
Patients with bulimia will tend to pig out and then force the food out of the body. This frequent vomiting will also affect oral health, specifically because they are exposed to strong stomach acid. After a while, teeth enamel will be eroded and lost. This will manifest in teeth that look different in shape, color, and length as they slowly become weak, brittle, and translucent.
They will start to find eating food at either high or low temperature quite uncomfortable. Finally, patients with eating disorders will experience loss of tissue and lesions on the mouth’s surface. Some parts of the teeth will thin out and start to break off.
In more serious cases, the pulp becomes exposed and infected, discolored and even die. Many patients who brush or rinse their teeth a lot after vomiting will also notice advanced tooth decay.
This type of arthritis in the temporomandibular joint of the jaw is one common problem that is normally linked to eating disorders. This joint is located at the point where the lower jaw is hinged to their skull. When they suffer from arthritis in this joint, patients will experience pain in the location, as well as have chronic headaches and issues with chewing and simply even opening or closing the mouth.
Soft Palate Damage
This kind of damage is a telltale sign of bulimia, as the upper surface called the soft palate is rarely damaged by normal day-to-day activities. But purging will cause redness, cuts, and scratches in this area. Moreover, physical evidence of purging can also be observed in bruises and cuts on the knuckles whenever the teeth put pressure on their skin during purging.
Enlarged Salivary Glands
Those suffering from eating disorders will frequently shift between binging and purging. This can eventually lead to enlarged salivary glands. This is very painful and visible to other people, leading to extreme emotional distress.
Treating Patients with Dental Damage Due To Eating Disorders
The most important step to avoid more damage is to treat the eating disorder. However, for some with extreme body image issues, treatment will take some time. Some patients might also struggle on the way to full recovery.
However, they can already take some steps to improve their oral health.
- It is important to keep good oral habits like tooth brushing and flossing. They should also visit the dentist often, being open with their struggle with eating disorders. This can help the dentist monitor their case carefully.
- At times, patients will continue purging, and it is vital for their good oral health that they disclose this. After all, their dentist is bound by patient-and-doctor confidentiality. Their dental professional can help maintain oral care while they are struggling to stop these behaviors. For example, they can rinse their mouth with water or a sugar-free mouth rinse immediately after purging. Due to the acids present in the mouth after the purge, brushing teeth can lead to more acid damage.
- Dry mouth due to frequent vomiting and poor nutrition should be addressed. They should keep the mouth moist with water or other products so that they will reduce tooth decay.
- Fluoride rinses may also help desensitize or re-mineralize.
Dentists will observe signs of eating disorders even if patients will not admit having one. However, being honest is the first step in treating these issues and taking steps to maintain good oral and overall health. At times, patients suffer from psychological issues like body dysmorphic disorder and will need therapy.
Support and treatment can change their lives for the better and help them stop these damaging behaviors.