Dentists can raise warning signs about eating disorders
Your dentist can often do more than fill cavities, perform root canals and undertake teeth whitening and cosmetic procedures.
He or she can also raise important warning signs to patients about other health issues. For instance, oral cancers are among the illnesses we currently check for during a patient’s regular oral-health check-up.
Another set of illnesses we have the potential to suspect are eating disorders.
Anorexia nervosa (the conscious restriction of eating in a deliberate effort to lose weight) and bulimia (binge-eating and purging through self-induced vomiting, mainly, and sometimes through laxative use) can often be suspected by a quick search of the mouth. Tooth decay, enamel wear-down from increased stomach-acid presence due to vomiting, gum problems such as swelling, tooth discolouration and even bad breath are sometimes symptoms of these serious health issues.
Anorexia’s self-imposed extreme calorie restriction makes the body compensate to save nutrients for the rest of the body that would, under normal healthy circumstances, be directed towards the teeth.
Mouth health can only worsen over time as the eating disorders continue so it’s important to identify a cause as soon as possible.
That’s easier said than done. Eating disorders are, by their nature, a secretive set of behaviours, so raising the possibility of their existence with the patient can be highly sensitive. Denial might be the first response a dentist gets. Yet it is important to determine if an eating disorder is going on. Anorexia and bulimia are serious health issues that can sometimes lead to death.
Depending on the relationship the dentist has with the patient, the matter could be raised directly. I have had several patients tell me they suffered from bulimia in the past, which explained the condition of their teeth. At this point, the dentist might gently ask if the practice is continuing, and if so, suggest the patient seek out help from the family doctor or other health practitioner.
If a dentist feels a direct conversation with a patient is not appropriate, the patient can be referred to his or her family physician for suspected eating disorders. Since many with eating disorders are young, it might also be advisable to raise the issue with the parents in a caring and sensitive way. Say that you “suspect” an eating disorder and are concerned about the patient.
Eating disorders can cause serious and sometimes irreversible oral-health problems. That’s why it’s so important for dentists to be aware of the “mouth signs” and take action as early as possible.