Eating disorders can affect anybody, and can manifest in many different ways, from extreme calorie deprivation to binge eating. Genetics, psychological problems like depression, substance abuse, ADHD, anxiety, and trauma can contribute to their development, as can certain diseases related to the stomach and intestines.
They are most commonly found in teenagers and young adults. Females also tend to suffer from such disorders more than men, but to think it is only women that suffer from them is plain wrong. Social media pressure and a societal bias towards certain body types often fuel eating disorders, and men are exposed to these pressures, as well.
Understanding the root problem and treating that is essential to the healthy remodeling of eating habits.
How can eating disorders impact oral health?
Eating disorders, especially anorexia and bulimia, can lead to severe dental problems.
Bulimia is a disorder where a person first eats uncontrollably, then purges by vomiting to rid themselves of the guilt of overeating and the extra calories. Such patients suffer from multiple deficiency diseases which commonly have an effect on dental health. The teeth can be more prone to developing decay, since they are not being sufficiently remineralized after an acid attack produced by the harmful bacteria.
Frequent starving can lead to a deficiency in B complex vitamins and minerals such as zinc, which are important in maintaining good oral health. A shift in the microbial population from a healthy one to a disease-causing one is seen, as well as an increase in the tendency to develop ulcers.
A deficiency of calcium and vitamin D can increase the risk of cavities and arthritis, which can affect the joints of your jaw. Chronic problems of the jaw can be very difficult to treat and often remain unresolved for life.
The gums of patients with eating disorders usually tend to be inflamed, red, and bleed easily. The absence of any other local factors such as plaque and tartar should point in the direction of something less common including eating disorders.
Frequent vomiting can cause an acidic environment in the mouth. This causes the enamel on the teeth to dissolve over a period of time and lead to increased sensitivity and yellowing of teeth.
Patients who binge on sugary foods are more prone to cavities.
What can dentists do to help identify patients suffering from eating disorders?
A large percentage of patients suffering from eating disorders are in denial about their condition or want to hide it from their family. People around them play an important role in identifying the issue and managing the underlying cause.
The dentist can be the first person to identify a person suffering from eating disorders due to apparent dental symptoms. After identifying an eating disorder, it is necessary to counsel the patient and their family to undergo psychological treatment in order to prevent the underlying condition from worsening. Dentists should make sure to talk to patients they suspect of having an eating disorder in a manner that doesn't make the patient feel uncomfortable in any way.
How to prevent oral problems from eating disorders
Regular regurgitation and vomiting lead to an acidic environment in the mouth, which slowly leads to dissolving of the upper layer of the tooth (enamel). An approach similar to that taken for patients suffering gastric reflux can be taken. Patients should use a mouthwash containing fluoride and get topical fluoride treatment, which can help make the teeth stronger and more resistant to cavities and an acidic environment.
Acidic foods, foods containing high amounts of sugar, and carbonated drinks should be avoided as they can make the already bad condition worse.
Regular tooth brushing and tongue cleaning will help reduce the formation of cavities and also prevent bad breath.
Some medicines used during psychiatric treatment can cause a dry mouth. In such cases, sugar-free chewing gums or artificial saliva can be used to keep the mouth lubricated. This will prevent redness and soreness in the mouth.
Regular for vitamin and mineral deficiencies should be done, and supplements should be taken as and when needed. This will help reduce or avoid problems like bleeding gums, swollen gums, and repeated ulcers.
Treating patients with eating disorders
As eating disorders point toward deeper underlying psychological problems, it is important for the dentist to treat such patients with utmost care and patience.
Simple procedures like scaling can be difficult for patients to bear because of the sensitivity in their teeth. Regular application of fluoride varnishes will help in preventing the formation of cavities. Early identification of cavities will help in cleaning it with minimum use of abrasives and prevent further sensitivity.
Conclusion
Dentists may well be one of the first healthcare providers to come across patients with eating disorders, and they have a responsibility to help identify the problem. With proper guidance and management, such conditions are readily managed. People around patients suffering from such conditions should take an empathetic view and provide the supportive environment needed to break out of a difficult cycle.
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