The Effects of Eating Disorders on Your Oral Health

The Effects of Eating Disorders on Your Oral Health
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The Effects of Eating Disorders on Your Oral HealthClinical Content Reviewed by Dr. Jay Khorsandi, DDS
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Table of Contents

  1. Eating Disorder Specifics
  2. The Impact on the Mouth & Teeth
  3. Dental & Oral Signs
  4. What to Do If You Spot the Signs
  5. Prevention
  6. Treatment Options
  7. Resources
  8. Frequently Asked Questions
  9. References

Eating disorders can cause nutritional deficiencies and impact multiple parts of the body, including your oral health.

Eating disorders are serious illnesses that involve issues with eating behaviors and related emotions and thoughts, the National Institute on Mental Health (NIMH) explains. This includes disorders such as anorexia nervosa, binge eating disorder, and bulimia nervosa.

Dentists are often some of the first to spot the warning signs of an eating disorder, as they can cause damage to your mouth and teeth.

Early treatment can help to minimize and even potentially reverse some of the damage before it becomes permanent.

Eating disorders require specialized and comprehensive treatment methods to prevent irreversible oral health damage and promote overall health and well-being. Untreated eating disorders can be fatal.

Eating disorder specifics

Eating disorders are one of the deadliest mental illnesses, impacting 9 percent of the population in the United States. This is close to 30 million Americans, the National Association of Anorexia Nervosa and Associated Disorders (ANAD) reports.

Eating disorders can impact anyone at any age, but they are most common in young women.

These are some of the most common eating disorders:

Anorexia nervosa

This disorder causes an unhealthy view of self, making people feel that they are overweight when they are often actually underweight.

A person with anorexia will typically view themselves as “fat” and will severely restrict calories, exercise excessively, misuse laxatives or enemas, or force vomiting to lose weight. This disorder has a high mortality rate, both from complications related to starvation and from suicide.

Bulimia nervosa

This disorder also involves a fear of being overweight, but it also includes periods of hidden binge eating. These periods of overeating may happen a few times a week or even multiple times per day.

During binge eating, a person will be out of control and consume large amounts of food, often ones that are also high in fats and carbohydrates, and more than a person typically will eat in one sitting. After a binge eating session, someone with bulimia will often seek to purge the food through forced vomiting, the misuse of laxatives or enemas, fasting, or excessive exercising. The overeating and forced release is called bingeing and purging.

Binge eating disorder

With this disorder, a person will not have control over their eating and will often consume excessive calories and food in a sitting. Unlike with the other disorders, there is no attempt to control this after the fact.

This is the most common eating disorder in the United States. People with binge eating disorder are often overweight.

Eating disorders commonly impact people during adolescence or early adulthood, although they can develop at any point in life. They are likely a result of multiple factors, such as genetics, social, psychological, behavioral, and biological ones.

Eating disorders involve a distorted sense of body image and an unhealthy relationship with food. This can wreak havoc on the entire body, causing malnutrition, deficiencies, and oral health issues.

The impact of different eating disorders on the mouth & teeth

Eating disorders can cause significant damage to the mouth and teeth. The longer the disorder goes untreated, the greater the damage.

Nutritional deficiencies and harmful habits can cause oral health issues, such as these:

  • Bleeding gums: Nutritional deficiencies can cause the gums and soft tissue in your mouth to bleed more easily.
  • Swollen salivary glands: A cycle of bingeing and purging can cause the salivary glands to become enlarged.
  • Chronic dry mouth: Deficits in nutrients in the body, as well as bingeing and purging, can lead to recurring dry mouth, dehydration, and decreased saliva production.
  • Tooth decay and gum disease: Not enough calcium, or vitamin D to process it, can elevate the risk for gum disease and tooth decay, as these nutrients are vital for oral health. Brushing your teeth too often after a purging session can also exacerbate tooth decay.
  • Bad breath: Deficiencies of vitamin B3 (niacin) can cause chronic bad breath, as can regular vomiting.
  • Tooth sensitivity and enamel erosion: Vomiting regularly causes stomach acid to pass over the teeth, which can cause the enamel (outer layer) to erode. This can lead to sensitivity to hot and cold, discoloration, and weakened/brittle teeth.
  • Arthritis in the jaw: The temporomandibular jaw is the joint connecting the lower jaw to the skull. Eating disorders can cause degenerative arthritis here, which includes joint pain, headaches, and difficulties chewing and opening/closing the mouth.
  • Cracked and dry lips: Dehydration from insufficient nutrients and frequent vomiting can cause the lips to become red, dry, and crack.
  • Damage to the soft palate: Sores in the mouth can form from lack of iron in the body. Purging can also cause redness, cuts, and scratches inside the mouth, particularly the top, or soft palate, area. It can also cause tissue loss around the mouth.

Eating disorders can lead to potentially permanent damage to the mouth and teeth. The sooner treatment starts, the better the recovery potential for your oral health.

Dental & oral signs of eating disorders

Dentists and dental professionals can often be the first to notice signs of an eating disorder related to damage to the teeth and mouth. Some common dental and oral problems with an eating disorder are:

  • Burning tongue.
  • Dental erosion.
  • Dry and cracked lips.
  • Gingival bleeding.

The dental team will do a thorough check of your mouth during a routine dental exam. This can include checking the inside of the mouth for injuries, which can be caused by putting objects into the mouth to force vomiting.

They will check for signs of tooth erosion and decay. They will be able to notice if there is evidence of nutritional deficiencies as well.

Individuals with bulimia will usually have more extreme oral health issues faster. Continual vomiting and compulsive teeth brushing can quickly damage the teeth. It can take longer for signs of nutritional deficiencies related to starvation to show.

What to do if you notice the signs

Eating disorders don’t just impact your physical and oral health; they also affect your emotional well-being and relationships. They can detract from your overall quality of life, affecting your self-image, relationships with families and friends, and your ability to continue to do your job (or schoolwork) to the best of your abilities.

If you think you might have an eating disorder, it is important to seek help. Your medical, mental health, and dental providers can all provide you with resources for treatment options.

The sooner you reach out for help, the better. An eating disorder is a serious illness with potentially life-threatening consequences.

If you suspect a loved one has an eating disorder, find time to talk to them in a nonconfrontational manner. Remain loving, understanding, sympathetic, and free of judgment.

It can often take more than one conversation to get them to agree to seek professional help. Remain calm and patient. Remind them that you love them and want to help them live their healthiest life.

Prevention

Eating disorders can stem from social, physical, and social issues. All of these potential stressors and triggers should be addressed to help prevent eating issues.

Model positive body image and healthy eating habits. Practice a good relationship with eating and food. Reducing potential negative risk factors and increasing protective ones can help to prevent eating disorders.

Try these steps to decrease the likelihood of an eating disorder:

  • Find positive things to appreciate about your body.
  • Treat depression by seeing a therapist.
  • Appreciate body functionality.
  • Replace dieting with intuitive eating.
  • Define yourself by talents and strengths that are not related to physical appearance
  • Educate yourself on healthy eating habits and unhealthy patterns.
  • Consider prevention programs aimed at decreasing the rate of eating disorders.

Eating disorders commonly co-occur with other mental illnesses. Depression, anxiety, post-traumatic stress disorder (PTSD), obsessive-compulsive disorder (OCD), and substance abuse can be risk factors for also developing an eating disorder. Treating and managing the mental health issue can help to reduce the odds for a concurrent eating disorder.

Treatment options

To treat oral issues related to an eating disorder, maintain a regular brushing and flossing schedule. If you purge, consider a baking soda rinse instead of brushing too much, to help neutralize the acid in your mouth.

See your dentist regularly, be honest with them, and consult them about specific dental needs. They will best be able to assess the right approach for your teeth.

Professional help for an eating disorder can be lifesaving. Early intervention and diagnosis are optimal.

Treatment is highly individual and will depend on the type of eating disorder, the severity and longevity of it, your support system, and if there are any other co-occurring mental health or medical conditions to manage at the same time.

Treatment should be comprehensive. It may include:

  • Group and individual therapies.
  • Medications.
  • Medical care and monitoring.
  • Nutritional counseling and support.

Treatment can be delivered in both inpatient and outpatient settings, depending on needs and circumstances. Therapies may include both family-based and behavioral options, which can help increase self-esteem and a healthy relationship with food. These approaches can also help you learn how to spot and manage potential stressors and triggers.

Medications such as mood stabilizers and antidepressants can be helpful when treating an eating disorder, particularly if a comorbid mental illness is also present. Medications are best used in conjunction with therapeutic methods.

Resources for eating disorder treatment

When looking for help for an eating disorder, your medical care team can help you to find resources and referrals for support in your local area. Here are other resources:

Frequently Asked Questions (FAQs)

What happens to your teeth when you have an eating disorder?
An eating disorder can cause your body to lose vitamins, leading to tooth decay. Purging can cause the enamel to wear faster. This can cause your teeth to become discolored, brittle, and thin, which can mean they break easier.
Can dentists tell if you have an eating disorder?
In short, yes. Dentists are often the first to notice the signs of an eating disorder based on the resulting decline in oral health.
Does not eating affect your teeth?
Not eating, or not eating enough of the right things, can cause your body to become deficient in nutrients, which can increase your risk for tooth decay.
Are the side effects of an eating disorder on your oral health permanent?
If you get treatment for an eating disorder early enough and maintain your oral hygiene, you can often manage and reverse the negative effects.
Should you talk to your dentist about a potential eating disorder?
If you think you have an eating disorder, it is important to be honest with your dentist so you can minimize the damage to your teeth. They can offer you support and come up with a workable plan to keep your teeth and mouth as healthy as possible.

References

Eating Disorders. (February 2016). National Institute of Mental Health (NIMH).

Eating Disorder Statistics. (2021). National Association of Anorexia Nervosa and Associated Disorders (ANAD).

Dental Complications of Eating Disorders. (2021). National Eating Disorders Association (NEDA).

Eating Disorders and Oral Health: A Matched Case-Control Study. (February 2012). European Journal of Oral Sciences.

Prevention. (2021). National Eating Disorders Association (NEDA).

Co-Occurring Conditions and Special Issues. (2021). National Eating Disorders Association (NEDA).

Contact the Helpline. (2021). National Eating Disorders Association (NEDA).

Get Help at ANAD. (2021). National Association of Anorexia Nervosa and Associated Disorders (ANAD).

Behavioral Health Treatment Services Locator. Substance Abuse and Mental Health Services Administration (SAMHSA).

National Suicide Prevention Lifeline. Substance Abuse and Mental Health Services Administration (SAMHSA).

Disclaimer: This article is intended to promote understanding of and knowledge about general oral health topics. It is not intended to serve as dental or other professional health advice and is not intended to be used for diagnosis or treatment of any condition or symptom. You should consult a dentist or other qualified healthcare provider with any questions you may have regarding a medical condition or treatment.

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