How Your Dentist Can Detect an Eating Disorder

With as many as 35 million men and women suffering from eating disorders in the United States, more dentists are becoming the first line of defense when it comes to spotting eating disorders in patients, according to the May 2005 issue of AGD Impact, the newsmagazine of the Academy of General Dentistry (AGD).

Bad breath, sensitive teeth and tooth erosion are just a few of the signs that dentists use to determine whether a patient suffers from an eating disorder.

"Purging episodes bring stomach acids up through the mouth. The damage from purging mostly occurs inside the upper front teeth in the form of erosion of the tooth's enamel, sensitivity, thinning and chipping," says AGD spokesperson Maharukh Kravich, DDS, AGD.

The National Eating Disorders Association (NEDA) estimates that nearly 10 million women and 1 million men are affected by anorexia nervosa and bulimia nervosa. Another 25 million suffer from binge-eating disorders.

Dentists who detect patients with eating disorders may recommend therapists and teach the patients how to minimize the effects of purging (a clear indicator of bulimia). For example, patients should immediately rinse their mouth with soda water or use a sugar-free mouthrinse. Patients should swish water around their mouth if nothing else is available and brush with a soft toothbrush and fluoride toothpaste.

"This is especially helpful if the signs of eating disorders are caught early," says Dr. Kravich.

Sometimes, eating disorders may not be discovered until too late, after irreversible damage has been done to the body as well as the teeth. According to NEDA, early detection of the disease may ensure a smoother and successful recovery period for the body and the teeth.

Although parents may not recognize that their children are anorexic or bulimic, they are often still taking the child to a dentist on a regular schedule.

"Parents that suspect a child suffers from one of these disorders should consider visiting a dentist," says Julie Barna, DMD, MAGD. "He or she should be able to spot the warning signs and help point you in the direction to get help."

Signs of an eating disorder:

• Bad breath
  
• Tender mouth, throat and salivary glands
• Eroded tooth enamel
  
• Teeth that are worn and appear almost translucent
  
• Mouth sores
  
• Dry mouth
  
• Cracked lips
  
• Bleeding gums
  
• Sensitive teeth

 

Pregnancy Cravings Can Harm your Oral Health

Pregnant women may often make ice cream runs to calm their cravings as they wait for their baby's arrival. Other women suffering from an eating disorder called pica, will have cravings for ice, freezer frost, or even soil.

Pica combined with bulimia can have adverse effects on an individual's oral health during pregnancy and also can be hard to diagnose and treat during those nine months, according to a study published in the May/June 2006 issue of General Dentistry, the Academy of General Dentistry's (AGD) clinical, peer-reviewed journal.

Pica, usually a secretive behavior, is a compulsive eating disorder in which sufferers have a constant appetite for non-nutritious substances. Bulimia is a condition in which patients overeat and then purge due to a fear of gaining weight. While the conditions' association and cause during pregnancy are not known, many suggest cultural and physiological factors are to blame. Others believe depression or iron and zinc deficiencies during pregnancy could be a factor.

"Eating disorders can cause serious erosion of the tooth's enamel, as well as sensitivity, thinning, and chipping," says Paula Jones, DDS, FAGD, AGD spokesperson. "Dentists can detect the signs and provide patients with treatment options."

While women often believe they should avoid dental care during pregnancy, it is very important for those suffering from eating disorders to continue with their dental visits. "Dentists are often the first to witness the physical effects of an eating disorder on an individual's oral health," says Dr. Jones. "Many of those who suffer will not self-report the problem."

If the problem is not reported, eventually the medical and dental complications will force the patient to seek help. In these cases, the dentist will work with other health care professionals to make the appropriate referrals and manage the patient's care.

Substances that pica sufferers will crave:•Clothes •Ice•Paper •Plants •Cornstarch•Soap •Ashes•Paint•Soil

You Are How You Eat: A Look at Pica

Pop, candy, coffee—you've heard the countless number of things that will cause dental erosion, abrasion, and tooth loss, but eating habits matter just as much as what you consume. According to a study published in the September/October 2007 issue of General Dentistry, the clinical, peer-reviewed journal of the Academy of General Dentistry (AGD), eating disorders play a major part in dental erosion, abrasion, and tooth loss, as the consumption of foods or beverages that contain acids cause damage to tooth structure.

The study focuses on pica, an eating disorder that is described as "the hunger or craving for non-food substances," explains Betty Shynett, DDS, FAGD, one of the authors of the study. It involves a person persistently mouthing and/or ingesting nonnutritive substances for at least a period of one month at an age when it is considered developmentally inappropriate. These nonnutritive substances include things that most would consider repulsive, such as coal, laundry starch, and plaster, but also includes substances that most are guilty of nibbling on, such pencil erasers, ice and fingernails. Pica itself is considered to be connected with mineral deficiencies, cultural practices, depression, stress and anxiety.

A common time for this disorder to occur is during pregnancy, explains Carolyn Taggart-Burns, DDS, spokesperson for the AGD. "Pregnant females can more easily experience iron deficiency, thus increasing the chances and desire for nonnutritive substances," she says.

Pica isn't the only eating disorder connected to dental erosion, abrasion and tooth loss; bulimia nervosa and anorexia nervosa are also culprits. But, unlike bulimia nervosa and anorexia nervosa, pica doesn't receive mass media coverage and therefore the public is less aware of this particular eating disorder. Additionally, few symptoms are related to the eating disorder and it is hard to diagnose. However, management of the eating disorder simply includes behavioral and dietary modifications.

Side effects of pica and other eating disorders:

• Pica, like many other eating disorders, introduces abrasive and highly erosive components into the oral cavity. Chalk, dirt and other agents wear enamel and all tooth structures at a faster rate.
• Pica is usually caused by iron deficiency, but when sufferers consume materials like clay, the components will bind with the iron receptors in the GI tract. This will make it more difficult for any iron to get absorbed, thus worsening the deficiency and furthering the eating disorder.
• If this or other disorders are not caught early and intervened, tooth loss is most certain due to the fact that eating disorders occur continually.