Anorexia And Bulimia Damage Your Teeth: 10 Dental Complications Of Eating Disorders

Dental health is important to quality of life. Bad teeth interfere with social acceptance as well as ease in eating. Dental problems detract from self-confidence and self-esteem.

There are a few dental problems that are common in the general public but are among people who have eating disorders. It’s relatively rare for someone who has anorexia, bulimia, binge eating disorder, or EDNOS (eating disorder not otherwise specified) to have a problem with sensitivity to cold, sensitivity to sweets, erosion of the lining of the throat, or swollen salivary glands—although all of these problem can occur in people who have eating disorders.

On the other hand, most studies of people who live with eating disorders find that almost none of them maintains good oral hygiene. Dental problems and oral health concerns are universal among people who have anorexia, bulimia, binge-eating disorder, and EDNOS (eating disorders not otherwise classified).

Let’s take a look at 10 of the most common dental complications of eating disorders.

Angular cheilitis

Irritation at the corners of the mouth is common in anorexia and bulimia patients who purge by vomiting. Many doctors are on the lookout for eating disorders when they observe angular cheilitis in young, thin patients, especially when there are other diagnosed nutritional deficiencies.

Burning mouth syndrome

Burning mouth syndrome is a continuous sensation of burning on the tongue that may extend to theoral membranes lining the mouth and the lips. The mouth may also feel dry, and there may be a loss of the sense of taste (dysgeusia or parageusia). The sensation may be burning, scalding, tingling, or numbness. Eating and drinking may relieve the pain, or make it worse. There are no obvious changes to the tongue, oral membranes, or lips. The condition seems to result from damage to the nerves in the tongue, mouth, and lips.

Cavities (caries)

Cavities are found in about 90 percent of people who have eating disorders. About 35 percent of people who have anorexia, bulimia, or a binge eating disorder have cavities bad enough to require a root canal extraction.

Cracked lips

Dry, irritated lips may be caused by vomiting, or by dehydration, or by nutritional deficiencies. Addiction to lip balm can also cause this problem. Addiction to lip balm is not unusual in anorexia. Using lip balms with cinnamon flavoring, lemon oil, jojoba wax, or red or yellow dyes can make the problem worse.

Damage from abrasion

When the enamel is weakened by repeated exposure to stomach acid, brushing with a hard toothbrush or eating “scratchy” foods can further damage the teeth. The damage to the teeth from poor brushing practice becomes permanent.

Dry mouth

People who have either anorexia or bulimia who purge food by vomiting are at increased risk for xerostomia, or dry mouth. They experience decreased salivation, and increased mouth irritation when eating acidic, spicy, crunchy, or dry foods.

Erosion of dental enamel

People who purge by vomiting damage their teeth by repeated exposure to stomach acid. Loss of tooth enamel occurs in about 20 percent of people who have anorexia or bulimia. It is not a significant problem in binge eating disorder. Erosion of dental enamel is concentrated on the backside of the teeth and in the center of the mouth.

People who have binge-eating disorders can develop gastroesophageal reflux disease (GERD). They often have problems with stomach acid when they are lying down at night asleep. They may not even know they have GERD when they develop dental problems and/or hoarseness. They will tend to develop damage on just one side of the jaw if they typically sleep on one side, or in the center of the mouth if they sleep on their backs.

Keratinization

Repeated exposure to stomach acid can result in the formation of a tough, scar-like material on the tongue and in the mouth. This material makes the mouth and tongue less flexible and can interfere with both eating and speech. If the irritation that is causing the accumulation stops, this tough tissue may break down on its own, or it can be removed by an oral surgeon.

Thrush

Thrush is a yeast infection of the oral mucosa, the membranes lining the mouth. The presence of a small number of yeast cells in the mouth is normal. But when they grow too rapidly, they can “unglue” the cells in the lining of the mouth, leaving dead tissue that invites bacterial infection. Thrush starts as tiny white patches in the mouth. These patches aren’t easy to scrape away, and if they are disturbed, they may expose bleeding tissue beneath. Thrush is usually a self-limiting condition, but if the immune system is weak, it can spread to the lungs and/or cause inflammation of the esophagus.

Tongue coating

Mucus vomited up from the stomach may stick to the tongue. This is a removable coating of the tongue. When the tongue coating is thrush, it is necessary to treat the yeast overgrowth. Trying to scrape the coating of yeast off the tongue would result in bloody injury and possibly additional, bacterial infections.