The Explorer Winter 2018 Explorer Winter 2018 | Page 10

DENTAL PROBLEMS COULD BE A
SIGN OF AN EATING DISORDER
By Andrea K. McDaniels, The Baltimore Sun
healing of oral injuries, loss or
distortion of taste and predisposition to
gum disease. Nutritional deficiencies
may also contribute to dry mouth
(xerostomia). Unfortunately, most
people are not aware that persistent dry
mouth encourages tooth decay.
CAN A DENTIST DETECT AN EATING
DISORDER?
People with eating disorders often mask
their disease, making it hard for a
primary physician to detect. But the
dentist can see telltale signs, such as
redness and ulcers, that patients can't
hide. Dr. Gigi Meinecke, a practicing
dentist and president of the Maryland
Academy of General Dentistry,
discusses how dentists can help treat
people with eating disorders.
WHY ARE DENTISTS ABLE TO
DETECT EATING DISORDERS?
It might surprise some people that a large
number of diseases and conditions of the
body have symptoms that can appear in
the mouth. Some of these manifestations
are disease-specific and help to raise a
degree of suspicion in the alert
practitioner. Eating disorders are among
those conditions which present with very
classic appearances on the teeth as well as
the soft tissues inside the mouth.
Patients suffering from these disorders
often attempt to keep their food-related
problems a secret and will avoid their
medical practitioner. It's not uncommon
for the dentist to be the first
practitioner to diagnose these disorders.
According to the National Institute of
Dental and Craniofacial Research, 28
percent of patients with bulimia are first
diagnosed during a dental exam.
What are some of the oral health
symptoms for someone who might have
an eating disorder?
The dentist will often identify one or
more of the following in patients with
eating disorders: specific wear-patterns
on the teeth in characteristic locations,
redness and/or ulcerations in the
mouth, lesions on the soft palate,
irritations in the corners of the mouth,
decreased saliva production and
enlarged parotid glands, the large
HOW ARE DENTAL PROBLEMS
CAUSED BY EATING DISORDERS
TREATED?
salivary glands located between the ear
and jaw. Additionally, the patient may
present or complain about dry mouth,
burning tongue and sensitive teeth, or
they may notice that their teeth appear
shorter.
WHICH EATING DISORDERS CAUSE
THESE PROBLEMS?
Eating disorders are commonly
classified in two groups: anorexia
nervosa and bulimia nervosa. Both have
subtypes, and many patients often
present with a combination of
symptoms which may blur the
distinction between anorexia or bulimia.
Generally speaking, these disorders may
involve the following: severe calorie
restriction, binge eating, purging and
self-induced vomiting. Each of these
behaviors will produce harmful or
destructive effects in the mouth which
become detectable to the dentist.
HOW CAN MALNOURISHMENT
CAUSED BY EATING DISORDERS
CONTRIBUTE TO DENTAL
PROBLEMS?
Nutritional deficiencies will typically
manifest themselves first as the soft
tissue complications that I've described.
Here are a few that come to mind:
chronic ulcerations in the corners of the
mouth (angular cheilitis), painful
inflammation of the tongue (glossitis),
fungal infections of the mouth
(candidiasis), burning sensation in the
mouth or tongue (glossodynia), poor
Identification of the problem with a
proper medical referral is a dentist's first
priority. Then, patient education
regarding the oral effects of their
disorder with a compassionate,
nonjudgmental approach is often key to
enlisting the patient as a partner in their
treatment. I've personally watched
patients become highly motivated in
preventing further damage to their teeth
once they understand the link between
their eating disorder and their dental
problems. Sadly, many of the effects on
teeth may require placement of caps
(crowns) or other filling materials, with
some advanced cases needing root
canals or even removal of the tooth.
IS THERE A WAY TO PREVENT THESE
DENTAL PROBLEMS WHILE
TREATING THE EATING DISORDER?
Simple strategies, such as rinsing with
plain water and not brushing your teeth
for an hour after vomiting — which
contradicts what most people are
inclined to do — will decrease the
damage caused by stomach acids.
Additionally, using a fluoride containing
toothpaste and home fluoride
treatments prescribed by the dentist can
decrease decay as well as decrease tooth
sensitivity. Regular dental visits to check
for problems before they become large
and expensive is also something
everyone should do. 䡲
Los Angeles Dental Society Explorer