Eating disorders: their prevalence, complications, and role in oral health

Abstract

Eating disorders fall within the top nine health ailments affecting young people today. These illnesses such as Anorexia Nervosa, Bulimia Nervosa, and Eating Disorders Not Otherwise Specified affect a large number of people, particularly female adolescents. The disorders can further cause complications in one’s health, systemically and orally, sometimes resulting in death.

The purpose of this paper is to closely examine published studies examining the link between eating disorders and oral health. Multiple studies have found that patients suffering from eating disorders are more likely to develop tooth erosion. Behaviors often found in eating disorder patients such as self-induced vomiting and ingestion of highly acidic diets can lead to such enamel loss, a condition that is irreversible. Other researchers disagree about whether eating disorders can lead to an increase in dental caries, with some finding amplification and others finding no significant results. Parotid gland swelling is another side effect of eating disorders but this complication often recedes once the unhealthy behavior is halted. Most studies have not yet found a link between these illnesses and increased periodontal disease. However, they do seem to lead to decreased unstimulated salivary flow rates. Furthermore, it also appears that the disorders lead to augmented levels of S. mutans and Lactobacilli. One’s oral mucosa can also be affected via angular cheilitis and oral candidiasis. Additionally, eating disorders may serve as a risk factor for bone and joint disorders such as osteoporosis and temporomandibular joint disorders, respectively. The illnesses may show effect outside the oral cavity through Russell’s sign on one’s knuckles and oral function may be impaired.

With all these possible oral complications being some of the first to indicate the presence of an eating disorder, dentists may be integral to identifying and stopping the progression of the disease. However, it has been suggested that eating disorder patients may have greater dental anxiety keeping them from visiting the dentist in the first place, let alone divulging their disease to their dentist. Furthermore, oral health professionals may not be adequately prepared to notice the presence of an eating disorder. Dental schools must do more to teach future oral health professionals about eating disorders, especially in the clinic, as simple suggestions like avoiding brushing one’s teeth immediately after participating in self-induced vomiting may help to reduce the likelihood of enamel erosion.

Through this analysis it was determined that while sufficient baseline research has been done, there is still a great deal more to learn about how eating disorders affect one’s oral health. There are multiple forms of diagnostic criteria that could possibly prevent patients from receiving the best treatment possible. Furthermore, more research needs to be done on disorders other than Anorexia Nervosa and Bulimia Nervosa as not every patient falls under these two categories. Since it has been shown that certain types of medication can decrease one’s salivary flow rate, future studies need to also consider any medication that patients may be on. In order to really aid those affected by eating disorders, men should be considered as future subjects too, since most studies have currently only focused on women. By completing more research on eating disorders and their consequences on oral health, health care professionals will be better able to serve those affected.