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Eating Disorders

Oral Effects

Anorexia nervosa, bulimia and binge eating disorder are the most common types of eating dis-orders. People who restrict what they eat or force themselves to vomit can affect the health of their teeth and mouth, as well as overall health.

Dentists often can see oral changes in people with eating disorders. These changes include:

  • The wearing away of tooth enamel
  • Changes in the color and shape of teeth
  • Swollen salivary glands
  • Dry mouth
  • Cracked lips
  • Small bruises on the roof of the mouth
  • Tooth sensitivity

The stomach acid from frequent vomiting can wear away tooth enamel. This puts the teeth at risk for decay. They also can be sensitive to cold or heat. Enamel is most likely to dissolve from the acid right after vomiting. Brushing right away can make the damage worse. Rinsing first with a fluoride rinse, water mixed with baking soda or plain water may reduce the damage.

Enamel wears away most often on the tongue side of the upper front teeth. If the enamel ero-sion gets bad enough, it can change the way your upper and lower teeth come together. Some teeth can even be lost as a result of constant exposure to acid. Tooth erosion can take about three years to become obvious. Not all people with bulimia will have it.

Many people with eating disorders don't get all of the nutrients they need. This can increase their risk of developing gum disease.

At the Dentist

Your dentist may apply fluoride varnishes during your dental visits and prescribe a fluoride gel for you to use at home. Your dentist also can prescribe saliva replacements for dry mouth.

Dental visits can be an important part of treating an eating disorder. Your dentist will work with your health care team. If you have severe tooth damage and are being treated for bulimia, your dentist may give you an appliance that covers your teeth and protects them from stomach acids.

Several other conditions tend to occur with eating disorders. They include depression, anxiety disorders and drug or alcohol addiction. These conditions, and the medicines used to treat them, also can affect your oral health. Let your dentist know which medicines you are taking, as well as their dosages.