Eating Disorders and Oral Health: An Overview

Introduction

Eating disorders have a detrimental effect on a person's self-image, relationships with family and friends, performance in the workplace or education, and overall health and quality of life. Eating disorders can majorly affect dental health, and dietary habits substantially impact oral health. Nutritional deficits resulting from eating disorder-related hazardous behaviors, such as extreme dietary restriction or frequent purging, can have a direct impact on oral health.

What Are the Various Eating Disorders?

1. Anorexia - It usually involves a severe fear of gaining weight or a dislike of being overweight. These people consider themselves to be ‘fat,’ although they may be exceedingly underweight or even very skinny. Individuals who experience this may overeat or starve themselves in an attempt to reach their desired weight because they believe they are overweight. Some people binge eat and then eliminate it by forcing themselves to throw up or abusing laxatives or enemas to get rid of the excess calories in their bodies. Extreme weight control practices resulting from a distorted body image and anxiety about gaining weight are symptoms of this disease.

2. Bulimia - Bulimia, like anorexia, is characterized by worries about being overweight. However, it also includes instances when overeating stays hidden like binge eating, and this can happen on multiple occasions during the week or even multiple times a day. People may feel uncontrollable when they are overeating. They may consume quantities of food that are larger than what a normal person usually consumes in one sitting, often consuming thousands of calories that are heavy in fat and carbohydrates. When someone overeats, they often attempt to ‘undo’ the excess food as soon as they can by compelling themselves to ‘throw up’ or by misusing laxatives or enemas.

3. Binge Eating or Overeating - This disorder is characterized by binge eating; however, the person suffering from bulimia does not constantly attempt to get rid of the food. Thus, this behavior differs from usual bulimic patterns in that it does not involve a consistent attempt to throw up food shortly after consumption through laxatives, vomiting, or enemas (fluid injections that lower the bowel through the rectum). Continued instances of overeating are frequently sustained by guilt feelings.

How Eating Disorders Can Be Prevented?

A focus on physical, mental, and social elements is necessary for the prevention and treatment of eating disorders, which are rooted in these factors. Family and friends should set a good example for their loved ones by eating healthily and supporting them. Even though food, weight, and body image seem to be the primary focus of these diseases, they frequently relate to more general problems. The likelihood of recovery is greatly increased when people are sent to medical specialists and encouraged to seek treatment as soon as possible.

What Are the Dental Effects of Eating Disorders?

• Inadequate nourishment can lead to easy bleeding of the gums and other soft tissues of the mouth. There may be swelling in the salivary glands. This may result in constant suffering from dry mouth in people suffering from eating disorders.

• Nutritional deficiencies frequently occur as a result of food limitations. Iron, calcium, and vitamin B are some of the nutrients that support dental health. A patient with an eating disorder must also take adequate vitamin D to aid in the body's absorption of calcium, as insufficient calcium can lead to gum disease and tooth decay. Mouth sores might develop as a result of low iron intake. Bad breath and the emergence of canker sores (a small and shallow sore in the oral cavity) can be caused by inadequate levels of vitamin B3, commonly referred to as Niacin. Gingivitis is frequently indicated by swollen, red gums that have an almost glossy aspect. Dehydration can cause the lips to become red, dry, and cracked. It can also cause the mouth to get very dry.

• A person with an eating disorder vomits frequently. Strong stomach acid flows across teeth regularly as a result of frequent vomiting. Teeth can alter in length, color, and shape. Teeth can also lose their enamel, which makes them brittle, transparent, and weak. It could become uncomfortable to eat or drink anything hot or cold. There may be erosive lesions and tissue loss on the oral mucosa. Teeth frequently get thin at the edges and break easily. Severe circumstances may expose the pulp, which could result in infection, discoloration, or even pulp death. Brushing the teeth too much or rinsing them immediately after vomiting can make dental decay worse.

• Purging (an act of cleaning) may result in internal bleeding, scratches, and wounds, particularly on the upper part of the mouth known as the ‘soft palate.’ Since healthy everyday actions rarely cause harm to this area, this kind of harm is a warning sign for dental specialists. Since the teeth press on the skin during a purging effort, soft palate damage frequently results in knuckle cuts or bruises.

• It is well known that salivary gland enlargement results from the recurrent cycle of bingeing and purging. This enlargement frequently causes mental distress for the person experiencing it and can be both physically uncomfortable and evident to others.

How Are the Oral Health-Related Effects of Eating Disorders Managed?

• The patient must be encouraged to maintain good oral hygiene habits, such as regular brushing and flossing. It is crucial to have regular dental checkups in addition to open and frequent communication. Ensuring a confidential environment is crucial in creating a secure space for patients to discuss their eating disorder (ED) issues and recovery process while in the dental office. To promote the patient's general well-being, the dentist and patient must maintain this private relationship.

• Some patients may still force themselves to throw up while receiving treatment. They must communicate this information to their treatment team. They should immediately rinse their mouth with water or a mouthwash without sugar after spitting. Throw-up is highly acidic, so it is best to use only water. Additionally, it is advised to wait an hour before brushing teeth to prevent stomach acid from spreading and worsening enamel erosion.

• Vomiting or inadequate diet may cause xerostomia or dry mouth. Tooth decay is also often a result of xerostomia; therefore, using water or other specific treatments to moisturize the mouth can help minimize repeated decay.

• Desensitizing or re-mineralizing medications may be recommended in addition to fluoride rinses by some of the dentists.

Conclusion

Early detection and intervention are crucial since eating disorders can have permanent or long-lasting effects on oral health. It is essential to have thorough therapy for the eating issue and assistance from oral health professionals. Also, to lessen the impact on teeth and work toward restoring oral health while the patient receives treatment for the underlying condition; dentists can offer invaluable advice and support. To address the issues with oral health that are related to eating disorders and assist people in their recovery, medical and dental experts must work together collaboratively.