Dr O Dadashian
Eating disorders are often viewed as psychological conditions that primarily affect body weight and mental health. However, what many people don't realise is that these serious conditions can wreak havoc on your oral health, sometimes causing irreversible damage to your teeth and gums. Understanding this connection is crucial, especially as eating disorders continue to rise among young people worldwide.
The Scope of the Problem
Recent comprehensive research involving nearly 1,700 patients across 17 countries has revealed alarming statistics about eating disorders and dental health. The study found that 42.1% of people with eating disorders experience tooth erosion – a condition where acids literally dissolve the protective enamel coating on teeth. Even more concerning, individuals with eating disorders are more than seven times more likely to develop dental problems compared to healthy individuals.
This isn't just a minor cosmetic issue. Dental erosion can lead to severe tooth sensitivity, permanent tooth damage, and the need for extensive dental treatment that can cost thousands of pounds and take years to complete.
Who's at Risk: Understanding the Demographics
Eating disorders predominantly affect young women, with the vast majority of research participants being female. However, it's important to note that these conditions can affect anyone, regardless of gender or age. The typical profile includes:
The research shows that eating disorders are becoming increasingly common in university populations, where academic pressure, social expectations, and lifestyle changes can trigger these conditions.
The Main Culprits: Types of Eating Disorders and Their Dental Impact
Bulimia Nervosa - The Biggest Threat to Your Teeth
Bulimia nervosa poses the greatest risk to dental health, with 54.4% of patients experiencing tooth erosion. This eating disorder involves cycles of binge eating followed by compensatory behaviours, most commonly self-induced vomiting. The repeated exposure to stomach acid (with a pH as low as 1.5) creates a perfect storm for dental destruction.
People with bulimia are more than 10 times more likely to develop dental erosion than healthy individuals. The damage typically appears on the inside surfaces of upper front teeth, where stomach acid makes direct contact during vomiting episodes.
Anorexia Nervosa - A Different but Serious Risk
Anorexia nervosa affects 26.7% of patients with tooth erosion. While the percentage is lower than bulimia, individuals with anorexia still face approximately 12 times higher odds of developing dental problems compared to healthy people.
The risk varies significantly depending on whether vomiting behaviours are present. Those who engage in purging behaviours show much more severe dental damage than those who restrict food intake without vomiting.
Other Eating Disorders
The research also examined other eating disorder categories, including EDNOS (Eating Disorders Not Otherwise Specified) and ARFID (Avoidant/Restrictive Food Intake Disorder). While less studied, these conditions still showed elevated rates of dental problems, particularly when vomiting behaviours were involved.
The Contributing Factors - Why Eating Disorders Destroy Teeth
Stomach Acid Exposure
The primary culprit is gastric acid from frequent vomiting. This acid has a pH similar to battery acid and literally dissolves tooth enamel with repeated exposure. The longer someone has been vomiting, the more severe the damage becomes.
Compromised Saliva Function
People with eating disorders often experience:
Saliva normally acts as the mouth's natural defence system, helping to neutralise acids and repair early damage. When this system is compromised, teeth become sitting ducks for erosion.
Dietary Factors
Many individuals with eating disorders consume large quantities of acidic foods and beverages, including:
While these might seem like healthier choices, their high acid content can contribute to enamel breakdown over time.
Behavioural Factors
Well-meaning but harmful behaviours can worsen the damage:
The Warning Signs: What to Look For
Dental erosion from eating disorders follows predictable patterns that both patients and healthcare providers should recognize:
Early warning signs:
Advanced damage:
Management and Prevention Strategies
Immediate Protective Measures
If you're struggling with an eating disorder, these steps can help minimise dental damage:
• After vomiting: Rinse immediately with water, wait 30-60 minutes before brushing • Daily care: Use fluoride toothpaste, stay hydrated, avoid acidic foods when possible • Professional care: Regular dental checkups, professional fluoride treatments
Comprehensive Treatment Approach
Effective management requires addressing both the eating disorder and its dental consequences:
Medical team approach: Effective treatment requires a comprehensive team that includes mental health professionals who specialise in eating disorder treatment to address the underlying psychological aspects of the condition. Medical doctors play a crucial role in monitoring overall health and managing any physical complications that may arise. Dental specialists focus specifically on oral health management, providing expertise in treating and preventing further dental damage. Nutritionists provide essential dietary guidance to help patients develop healthy eating patterns while supporting both recovery and oral health.
Dental interventions: The dental component of treatment involves regular monitoring and early intervention to catch problems before they become severe and irreversible. Fluoride treatments and remineralisation therapy help strengthen weakened tooth enamel and can reverse early stages of erosion. For teeth that have already sustained significant damage, restorative treatments such as fillings, crowns, or veneers may be necessary to restore function and appearance. In some cases, custom protective appliances like night guards or special mouth guards may be recommended to protect teeth from further acid exposure during the recovery process.
The Path to Recovery
The good news is that with proper treatment, both eating disorders and their dental consequences can be managed effectively. Early intervention is key – the sooner treatment begins, the more tooth structure can be preserved.
Modern dental techniques can repair much of the damage caused by eating disorders, but prevention is always preferable to treatment. If you or someone you know is struggling with an eating disorder, seeking help early can save both your overall health and your smile.
Remember, dental professionals are often among the first to recognise signs of eating disorders, as oral symptoms may appear before other physical manifestations. This makes regular visits to our Croydon dentist particularly important for young people at risk.
Hope for the Future
While eating disorders can cause serious dental damage, recovery is possible. With comprehensive treatment that addresses both the psychological and physical aspects of these conditions, individuals can regain their health and preserve their smiles for years to come.
If you're struggling with an eating disorder, please know that help is available. Your teeth – and your life – are worth fighting for.
References:
Bartlett D, Ganss C, Lussi A. Basic Erosive Wear Examination (BEWE): A New Scoring System for Scientific and Clinical Needs. Clin Oral Investig. 2008;12(Suppl 1):S65-S68.
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