How Eating Disorders Impact Oral Health

Dr. Christopher Li Etobicoke - Li Family Dental

By Dr. Christopher Li

December 3, 2023

dental care, health and wellness, how eating disorders impact oral health, oral health

Eating disorders can present themselves in different ways. Whether you suffer from an eating disorder yourself or have a child or loved one living with one, it is important to understand what happens to teeth as a result of eating disorders. Here we look at how eating disorders impact oral health, with tips to help keep teeth healthy. 

What Are The Different Types Of Eating Disorders?

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The most common eating disorders include:

  • Anorexia nervosa: This disorder tends to impact young women in their teens and early adulthood, causing patients to believe they are overweight despite their size. As a result, calorie intake is restricted, and weight becomes dangerously low. Patients either purge after eating or restrict what they eat, and/or exercise excessively to help reduce their weight.
  • Bulimia nervosa: Bulimia also impacts young women. In this case, large amounts of food are eaten all at once, followed by purging via vomiting or using products like laxatives. Some people also use excessive exercise.
  • Binge eating disorder (BED): This illness is common in adolescents but does not use purging or exercise to control weight. Instead, binges of obsessive eating, often on unhealthy food choices, lead to dangerous weight gain.
  • Pica: Patients with Pica eat non-food items that can range from ice to dirt and soap to hair. It depends on the individual and impacts people of all ages.
  • Rumination disorder: This disorder has only been recognized as an eating disorder in recent years. People with this disorder eat food, regurgitate it and then rechew it or re-swallow the food and spit it out. It can develop as early as 3 months.
  • Avoidant/restrictive food intake disorder (ARFID): This disorder relates to disturbed eating habits such as not wanting to eat or being impacted by different aspects of food, such as the temperature, the colour, the smell, the taste, or even the texture. 

3 Common Eating Disorders In Children Under 12

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The three most common eating disorders in children are:

  1. AFRID: Children might develop an aversion to certain foods, a fear that eating foods might make them sick, or simply not enjoy the feeling of certain food textures when they eat or swallow.
  2. Pica: Although most children will put non-food items in their mouth, children with Pica continuously eat non-food items and usually the same item, such as chalk, dirt, or hair.
  3. Anorexia nervosa: An obsession with feeling overweight can impact both boys and girls under 12, leading to severe weight loss and malnutrition that impacts growth.

How Eating Disorders Impact Oral Health

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Dietary habits, both good and bad, contribute to oral health. Eating disorders can create changes in the mouth related to nutritional deficiencies or harmful substances that impact the teeth and tissue in the mouth in many different ways. The impact of eating disorders on oral health includes:

  • Bleeding gums and soft tissue in the mouth
  • Chronic dry mouth
  • Bad breath
  • Enamel loss from the acids related to frequent vomiting
  • Changes in tooth colour, shape, and length
  • Tooth weakening
  • Brittle teeth
  • Teeth appearing translucent
  • Tooth sensitivity
  • Tissue loss
  • Erosive lesions in the mouth
  • Easy chipping
  • Tooth damage leading to tooth pulp infections
  • Tooth decay due to weakened enamel
  • Gum and tooth damage from excessive brushing after vomiting
  • TMJ and degenerative arthritis in the jawbone
  • TMJ symptoms including pain, headaches, earaches, difficulty opening and closing the mouth
  • Problems chewing
  • Redness, scratches, and cuts on the soft palate
  • Enlargement of the salivary glands 

How Different Eating Disorders Affect Teeth And Gums

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Different eating disorders affect oral health in different ways:

  • Purging disorders create excess acid in the mouth that leads to enamel damage, tooth discolouration, brittleness, tooth weakening and decay, erosive legions in the mouth, and more.
  • Binge eating disorders increase the risk of weight gain and diabetes. Diabetes and increased blood glucose levels create dry mouth that allows plaque to form and increases the risk of tooth decay. Even if individuals do not develop Diabetes, tooth decay and gum disease occur, often related to higher intakes of sugar content and unhealthy carbs.
  • Pica can include eating hard, harmful items that can increase the risk of chipping and broken teeth, which in turn increases the risk of infection. 

Can Oral Health Issues Related To Eating Disorders Be Reversed?

Yes, however, ongoing chronic eating disorders continue to create oral health issues. Your dentist can provide an assessment and recommend dental restorations. However, restorations such as crowns are damaged by acid erosion related to purging. As a result, your dentist will likely only perform essential restorative work to alleviate pain and avoid further damage. Once a patient recovers from their eating disorder, the rest of the treatment plan can be completed. Meanwhile, special interventions should be used to limit further damage. Dental hygiene appointments should also be maintained to reduce the risk of further decay and gum disease, with special considerations for tooth sensitivity. 

Can People With Eating Disorders Protect Their Teeth?

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Yes — because of the oral health risks associated with eating disorders, patients should try to protect their teeth with the following steps:

  • Maintain a strict oral health care regime, brushing and flossing every day
  • Avoid brushing more than twice a day, especially following purging, as the acids in your mouth can penetrate the teeth with brushing and cause even more damage
  • If you vomit, do not brush your teeth for at least one hour
  • Do not rinse your mouth with water after vomiting — instead rinse your mouth with one teaspoon of bicarbonate of soda in 1 cup of water
  • Visit your dentist at least twice a year
  • Be honest about your condition with your dental team so they can provide proper care and offer advice to help counteract the damage caused by purging behaviours
  • Report dry mouth to your dentist for advice on how to keep your mouth moist to help combat infection, sores and decay
  • Ask your dentist about fluoride rinse prescriptions and desensitizing or re-mineralizing agents
  • Wear a mouthguard when vomiting to protect your teeth

Honesty about your condition and symptoms is essential to help reduce the damage caused by eating disorders. Speak to your dentist about your or your loved one’s condition to ensure you receive an effective preventative and treatment plan.

Give us a call at 416-232-2033 or request an appointment by clicking here.

Dr. Christopher Li

About the author

Doctor Christopher Li, DDS
Dr. Chris, as he is affectionately known, is a licensed dentist with over 20 years experience. His caring personality makes even the most tentative person at ease. Patients are constantly commenting about how Dr. Chris is incredible at delivering pain-free freezing, and how he has an amazing chair-side manner.  Dr. Chris loves sharing information with his patients and everyone who has teeth about how to care for their teeth, avoid tooth decay, and the treatments available to help them overcome their tooth pain or other dental issues so they can enjoy life and food to its fullest!

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