Dental Tribune USA

Dentists are often able to spot eating disorders in patients

By Fred Michmershuizen, DTI
March 30, 2009

Bad breath, sensitive teeth and eroded tooth enamel are just a few of the signs that dentists use to determine whether a patient suffers from an eating disorder. Other signs include teeth that are worn and appear almost translucent, mouth sores, dry mouth, cracked lips, bleeding gums and tender mouth, throat and salivary glands, according to the Academy of General Dentistry (AGD).

Studies have found up to 89 per cent of bulimic patients have signs of tooth erosion due to the effects of stomach acid, according to the National Eating Disorders Association. Over time, this loss of tooth enamel can be considerable, and the teeth change color, shape and length. They can also become brittle, translucent and sensitive to temperature. The salivary glands may swell, causing the jaw to widen and appear squarish. Lips may become reddened, dry and cracked, and the patient may also experience chronic dry mouth.

In a recent press release, Delta Dental Plans Association, a national network of independent dental service corporations specializing in providing dental benefits programs, said it recognizes eating disorders as a serious health care concern and it wants to increase awareness of the potential oral health problems that can be caused by eating disorders.

“Eating disorders have serious implications for oral health and overall health,” said Max Anderson, DDS, a national oral health advisor for Delta Dental Plans Association. “Stomach acids can damage teeth with repeated exposures during purging for those individuals with bulimia nervosa. For those individuals with anorexia nervosa, which is characterized by self-induced starvation, poor nutrition can affect oral health by increasing the risk for periodontal diseases.”

An eating disorder is a complex compulsion to eat in a way that disturbs physical, mental and psychological health. The three most common eating disorders are anorexia nervosa, bulimia nervosa and binge eating disorder. The eating may be excessive (compulsive overeating); restrictive; or may include normal eating punctuated with episodes of purging (such as self-induced vomiting, use of laxatives, fasting, diuretics or diet pills). The eating may include cycles of binging and purging, or it may encompass the ingesting of non-foods (such as dirt, clay or chalk). Each of these disorders robs the body of adequate minerals, vitamins, proteins and other nutrients needed for good health and may cause injury to teeth, muscles and major organs, according to the American Dental Association. As many as 35 million men, women and children in the United States are said to suffer from eating disorders.

The frequent vomiting and nutritional deficiencies often associated with eating disorders can severely affect oral health.

Dentists are becoming the first line of defense when it comes to spotting eating disorders in patients, according to the AGD. For example, although parents may not recognize that their child is anorexic or bulimic, they are often still taking the child to a dentist on a regular schedule and the dentist may spot the oral signs of the disease.

“Delta Dental Plans Association supports providing appropriate referral for those individuals with signs and symptoms of eating disorders and encourages those with eating disorders, or those who are caring for individuals with eating disorders, to seek care from a dental professional to manage the dental consequences of these disorders,” Anderson said.

For further information, contact Delta Dental Plans Association at or the National Eating Disorders Association at



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