By Sarah-Ashley Robbins, MD and Rachel Barone, DDS, FAGD, FICOI
While it’s well known that eating disorders affect your overall health, one facet that may be overlooked is the impact an eating disorder has on your oral health. In addition to your physician and healthcare team, partnering with a dentist throughout eating disorder recovery efforts can greatly increase the likelihood of long term oral health and stability, as well as preservation of the teeth and gums.
To start, it may be helpful to have an understanding of what happens to the mouth and oral cavity when purging occurs. When vomiting is induced, acid and bile from the stomach are regurgitated into the mouth, coating the gums, tongue, and teeth. Stomach acid is very acidic, and repeated exposure to it can cause myriad issues with your mouth, including thinning and shortening of the teeth, a higher likelihood of developing dental decay, drying of the gums, swollen salivary glands, a sensitive gag reflex, chronic dry mouth, and problems with acid reflux affecting the throat. The connection between your oral health and your overall health is well established and it is commonly understood that oral health issues impact your systemic health, and vice versa.
One of the biggest challenges with diseases related to your teeth and gums is that they very often don’t hurt until the disease is advanced. This means that you could have dental decay or gum disease, but won’t feel it until the cavity is so big it impacts the nerve and blood supply of the tooth. If you are inconsistent with your routine dental care and check-ups, and you suffer from an eating disorder, you are at an increased risk of decay and rapidly occurring tooth breakdown. Unfortunately, just because your teeth and gums were healthy at the last dental visit doesn’t mean they will be the next time you’re seen. Prevention is key when it comes to your dental health, and it’s important to see a dentist a minimum of every six months, and get standard check-up x-rays once a year. This will enable your dental hygienist and dentist to catch any decay or disease early, when it’s easier to treat, and allow them to partner with you to create a plan to keep your teeth and gums healthy throughout the disease and recovery process.
Some dental complications that arise from repeated self-induced vomiting can lead to thinning of tooth enamel, increased likelihood for dental decay and damage to gum tissue, chronic dry mouth, and increased tooth sensitivity. Treating eating disorders is challenging and can often take many years to achieve full recovery; it’s important to partner with your dentist, physician, and healthcare team to stay healthy in all phases of disease and recovery.
One of the most significant dental conditions caused by recurrent vomiting is erosion, or thinning, of tooth enamel. The enamel covering the outer surfaces of our teeth is the strongest substance in the human body, but when subjected to repeated, prolonged acid exposure it thins and wears away, exposing the softer inner portion of the tooth. Not only does the loss of enamel lead to an increased risk for tooth decay, it also removes the protective layer of the tooth, making them much more prone to sensitivity with cold or hot foods. Additionally, loss of enamel makes teeth wear more quickly, causing them to chip, break, or lose height over time.
Repeated self-induced vomiting also traumatizes the tissues of the mouth, and can lead to dry mouth and gums that bleed easily. When your mouth is dry, the saliva cannot do its job, which is to protect the teeth from decay by neutralizing acid, sugars, and other erosive substances in the mouth. Without its ability to buffer those harmful conditions, teeth become much more susceptible to dental decay that spreads rapidly. Repeated acid exposure can also weaken existing dental work, again leading to a higher risk for cavities to form. If you’re suffering from dry mouth, sip on water throughout the day and use lozenges that will minimize additional decay.