It is estimated that almost 10% of the population in the U.S. will have an eating disorder at some point in their lives. Anorexia nervosa, bulimia nervosa, and binge eating disorder can have far-reaching consequences that extend beyond simply physical and psychological health. Among these seldom acknowledged impacts is the profound damage on the dental health of those suffering from these conditions. Understanding the intricate relationship between eating disorders and oral health is critical for those affected and their caregivers.
The Link Between Eating Disorders and Oral Health
Nutritional deficiencies associated with these disorders can contribute to weakened teeth and cavities, as well as gum-disease and inflamed oral tissues. Frequent vomiting associated with certain conditions can also expose the mouth to damaging acids, which can induce long-lasting damage. Appropriate dental care is an important part of the recovery process for these individuals.
Specific Dental Issues Stemming from Eating Disorders
1. Tooth Erosion and Sensitivity
Self-induced vomiting associated with certain eating disorders, mostly Bulimia Nervosa, frequently exposes the teeth to stomach acid. This results in the gradual but inevitable erosion and breakdown of tooth enamel (hard outer layer of teeth), leading to weaker, brittle teeth that are sensitive and prone to decay.
2. Cavities and Tooth Decay
Dietary changes and poor oral hygiene (common in those with eating disorders) leads to a significant change in the oral flora in the mouth. Decreased consumption of essential nutrients like vitamin D and calcium leads to weakened tooth enamel that is more susceptible to cavities. An increased presence of plaque layers from lack of adequate hygiene leads to higher numbers of cavity-causing bacteria.
3. Gum Disease and Recession
Malnutrition associated with eating disorders often leads to a deficiency in vitamins and minerals, namely Vitamin C, Vitamin D, and Vitamin B – all of which are vital for the maintenance and support of healthy gum tissues. A lack of these nutrients also results in a weakened immune system and healing response and leaves the body susceptible to the effects of gum-disease causing bacteria. This can result in gingivitis and eventually progress to periodontitis which can lead to tooth loss.
4. Dry Mouth and Reduced Salivary Flow
Our salivary glands rely on us to keep ourselves hydrated in order for them to function properly. The dehydration that is often coupled with eating disorders leads to a decrease in salivary production. Saliva is absolutely critical to neutralize acid and wash away food particles. Without it, the occurrence of tooth decay increases drastically.
5. Oral Lesions
Because malnutrition leads to the decreased functioning of the immune system, the body is left more susceptible to oral lesions such as canker sores and ulcers. Frequent exposure of the oral cavity to acid can also negatively impact existing lesions and cause delayed healing.
The Role of the Dentist in Eating Disorder Recovery
Your dentist can provide not only direct dental care, but they can act as part of a larger support system. In addition to identifying early dental problems to mitigate damage, dentists can collaborate with nutritionists, therapists, and physicians to create a safe environment for those with eating disorders.
- Nutritional Support: Your dentist can help discuss adequate intake of vitamins and minerals and how to minimize malnutritions effect on dental tissues.
- Psychological Support: The health of our mouths impacts self-image tremendously, and dentists can work with patients to support their individualized needs and goals.
Prevention and Long-Term Dental Solutions
While dental complications are a common side effect of eating disorders, there are steps that can be taken to manage outcomes:
- Oral Hygiene: It’s important to maintain a good oral hygiene routine while battling an eating disorder – be sure to brush twice daily, floss, and use a fluoride mouth wash to strengthen enamel.
- Rinsing after Vomiting: In order to neutralize harmful acids after vomiting, it’s important to rinse with water or a baking soda solution (1/2 teaspoon baking soda, 1 cup water). Avoid brushing right after vomiting, as the abrasion of the toothbrush bristles can actually press the acid into the enamel, making matters worse.
- Regular Dental Visits: Frequent check-ups are important for someone struggling with an eating disorder. Catching and addressing dental problems early will prevent more serious complications down the line.
- Restorative treatments: Fillings, crowns, and gum-disease treatment can repair teeth and support healing of the gum tissue.
Personal Stories
The following are stories from patients that have gone through eating disorder recovery. The quotes have been edited for length and clarity, and names have been changed to protect individual privacy.
Emma’s story: “I struggled with anorexia for a long time, and I didn’t notice how much it was impacting my teeth until I went to the dentist. My teeth were weak, and I had multiple cavities. She gave me a special toothpaste and helped me create a routine to take better care of my teeth. Because my teeth are so important to me, I felt like this was a big step toward healing my body and mind.”
Miles’ story: “I went through a period where I was binge eating and not taking care of my mouth. My gums bled easily and were always sore. When I went to the dentist, I was able to get treatment for my gum-disease and my dental health improved a lot. I started to feel more in control of my recovery.”
Additional Resources
Here are some valuable resources for those seeking help:
- National Eating Disorders Association (NEDA) supports those and their families affect by eating disorders.
- National Association of Anorexia Nervosa and Associated Disorders (ANAD) Helpline offers emotional support and program referrals. Call 1-888-375-7767.
- The Body Positive offers resources to help individuals embrace body positivity and challenge harmful societal norms on body image.
Final Thoughts
The dental fallout of eating disorders is an important yet often overlooked part of these conditions. By understanding the real impact on dental health, individuals are able to take proactive steps to mitigate long-term consequences as they work towards recovery.
If you or someone you know is struggling with an eating disorder, reach out to a healthcare professional to begin your recovery journey – your overall health, and your dental health, deserve attention and care.
Have you or someone you know suffered from an eating disorder? What has helped you on your healing journey?
~Dr. Lee