Dental Issues in Eating Disorders

Woman feeling shame from her eating disorder

Eating disorders are serious illnesses affecting an estimated 30 million people in the United States alone [1]. While many people know that eating disorder behaviors can lead to numerous health complications like malnourishment, heart problems, and osteoporosis (just to name a few), many are unaware of one of the most common (and sometimes irreversible) side effects of eating disorders–dental issues.

A recent study published in the Journal of Eating Disorders revealed that individuals with an eating disorder (regardless of ED subtype) are five times more likely to suffer from tooth decay and tooth erosion than the general population [2]. Other dental issues commonly found among individuals with eating disorders include bad breath, weakened jawbones (which can lead to tooth loss), and sensitive teeth.

Why Do Eating Disorders Cause Dental Issues?

Eating disorders impact dental health for several different reasons. First, purge vomiting causes acid from the stomach to travel through the mouth, where some of it sticks around and begins to eat away at your teeth (specifically the backside of the front teeth).

Erosion of the tooth’s enamel (the protective covering on your teeth) can lead to thinning, sensitivity, chipping, and, ultimately, tooth decay. And while you may think brushing your teeth directly after purging will get rid of harmful stomach acid and protect your teeth from erosion, it can actually do the opposite.

“When you vomit, stomach acids are coming in contact with your teeth and coating them,” says ADA dentist Dr. Gene Romo in a Mouth Healthy article [3]. Dr. Romo goes on to say, “If you brush too soon, you’re just rubbing that acid all over the hard outer shell of your teeth.”

So instead of removing the acid when you brush, you’re simply pushing it deeper into your teeth and gums. Dr. Romo tells patients to rinse their mouth out with tap water, a diluted mouthwash, or a mixture of 1 tsp. of baking soda and water directly after vomiting. After about 30 minutes, it’s safe to brush your teeth.

But you don’t have to have bulimia or actively purge to be at risk of developing dental issues from your ED. A lack of nutrients (which can result from restriction, excessive exercise, use of laxatives, etc.) can also lead to severe dental issues like a weakening of the jaw bone, weakened teeth, and tooth loss.

Furthermore, the Journal of Eating Disorders study mentioned above also found that those with mental health issues like an eating disorder often fail to seek dental intervention due to perceived barriers like anxiety, distrust of dental providers, decreased energy, and uncertainty around oral hygiene [4].

Unfortunately, if left untreated, ED-related dental issues can lead to serious oral health complications, which, in turn, can perpetuate body image problems, low self-esteem, and a decline in psychosocial functioning and quality of life. Finally, dental issues may even disrupt ED treatment and exacerbate ED behaviors like food avoidance and food intake.

Signs of Decay and Other Issues

Woman upset with her dental issues during eating disorderA routine check-up at the dentist should reveal if you or a loved one are suffering from any ED-related oral health complications. Additionally, if you think a loved one may be purging, restricting, or otherwise engaging in ED behaviors, a trip to the dentist can help reveal if an eating disorder is present and may help your loved one realize they need professional eating disorder help. Here are some of the common signs of ED-related dental issues:

  • Dry mouth
  • Tooth decay
  • Sensitive teeth
  • Bleeding gums or gum pain
  • Inflamed esophagus
  • Tooth enamel erosion
  • Reduced saliva production
  • Chronic sore throat
  • Tender mouth, salivary glands, and throat
  • Cracked lips
  • Worn or translucent-appearing teeth
  • Jaw alignment abnormalities
  • Palatal hemorrhages
  • Enlarged parotid glands
  • Mouth sores
  • Problems swallowing

Dental issues are a common (sometimes irreversible) side effect of eating disorders. If you or a loved one are currently suffering from an eating disorder, talk to both your eating disorder specialist and dental provider to address any dental issues you may be experiencing.


References:

[1] Caceres, V. (2020, February). Surprising Eating Disorder Statistics. U.S. News & World Report. https://health.usnews.com/conditions/eating-disorder/articles/eating-disorder-statistics.

[2] A. Aranha, C. D. P. E., Nielsen, S., S. McManus, H. M., JI. Hudson, E. H., D. Grange, S. A. S., TD. Wade, J. L. B., … A. George, M. S. S. (1970, January 1). Eating disorders and oral health: a scoping review on the role of dietitians. Journal of Eating Disorders. https://jeatdisord.biomedcentral.com/articles/10.1186/s40337-020-00325-0.

[3] Cold and Flu Season: 5 Ways to Care for Your Mouth When You’re Sick. Mouth Healthy TM. https://www.mouthhealthy.org/en/az-topics/c/cold-and-flu-season.

[4] A. Aranha, C. D. P. E., Nielsen, S., S. McManus, H. M., JI. Hudson, E. H., D. Grange, S. A. S., TD. Wade, J. L. B., … A. George, M. S. S. (1970, January 1). Eating disorders and oral health: a scoping review on the role of dietitians. Journal of Eating Disorders. https://jeatdisord.biomedcentral.com/articles/10.1186/s40337-020-00325-0.


About the Author:

Sarah Musick PhotoSarah Musick is a freelance writer who specializes in eating disorder awareness and education. After battling with a 4-years long eating disorder, she made it her mission to help others find hope and healing in recovery.

Her work has been featured on numerous eating disorder blogs and websites. When she’s not writing, Sarah is off traveling the world with her husband.


The opinions and views of our guest contributors are shared to provide a broad perspective on eating disorders. These are not necessarily the views of Eating Disorder Hope, but an effort to offer a discussion of various issues by different concerned individuals.

We at Eating Disorder Hope understand that eating disorders result from a combination of environmental and genetic factors. If you or a loved one are suffering from an eating disorder, please know that there is hope for you, and seek immediate professional help.

Published November 6, 2020, on EatingDisorderHope.com
Reviewed & Approved on November 6, 2020, by Jacquelyn Ekern MS, LPC

About Baxter Ekern

Baxter is the Vice President of Ekern Enterprises, Inc. He is responsible for the operations of Eating Disorder Hope and ensuring that the website is functioning smoothly.