How Eating Disorders Are Damaging to Teeth

Eating disorders are serious mental health conditions, but they also have a serious impact on physical health. And poor oral hygiene is one of the ways these conditions can physically manifest.

If left untreated, these issues can lead to severe consequences for oral health, some of which may be irreversible. [1] But with the right kind of care, many dental health problems for patients with eating disorders like anorexia and bulimia can be treated.

Anorexia Nervosa and Oral Health

Anorexia nervosa (AN) is an eating disorder characterized by a pathological fear of gaining weight, a distorted body image, and extreme food restriction. It has serious consequences for overall physical health and poses a particular risk to oral health.

One study found that the nutritional deficiencies involved in AN played a role in changing the biochemical composition of people’s saliva. Higher levels of certain hormones were reported in these patients’ saliva, which was found to contribute to deteriorating oral health. [3]

Individuals with anorexia nervosa may also develop periodontitis, a severe gum disease that damages the soft tissue around teeth. [4] This condition occurs when the gums become inflamed and recede from the teeth, creating pockets where bacteria can accumulate and cause infections.

And another study examining patients with AN found that they were more likely to participate in excessive tooth brushing, leading to dental erosion and other issues. [5]

Bulimia Nervosa and Oral Health

Bulimia nervosa (BN) is a prevalent eating disorder characterized by frequent episodes of binge eating and purging. The self-induced vomiting often used as a purging method is particularly damaging to dental health. [6]

Frequent vomiting exposes teeth to strong stomach acid, which can lead to a suite of oral health problems and wear away tooth enamel, leading to sensitivity, discoloration, and cavities. [6] In extreme cases, it may lead to tooth decay.

In addition to tooth erosion, bulimia nervosa can cause enlargement of the salivary glands. [7] This may in turn lead to a feeling of fullness in the mouth, chronic dry mouth, and difficulty swallowing.

Individuals with bulimia nervosa are also at a higher risk of developing gum disease. Repeated purging can cause irritation and inflammation of the gums, leading to gum recession, tooth sensitivity, and an increased risk of tooth loss.

Some people with anorexia nervosa also participate in binge-purge behavior, and they incur similar risks raised by self-induced vomiting. [2]

Other Impacts of Eating Disorders on Teeth

It’s not just AN and BN that impact oral health. All types of eating disorders affect this area, including binge eating disorder (BED) and the variety of disordered eating behaviors clustered under the description other specified eating and feeding disorders (OSFED).

Some other impacts of these eating disorders and others on teeth include: [9, 10]

• Mouth sores: Frequent purging can cause trauma to the mouth, resulting in sores and ulcers, leading to pain and discomfort.
• Sensitive teeth: When tooth enamel is weakened, teeth can become more sensitive to temperature and pressure, leading to pain when eating or drinking.
• Halitosis: Halitosis, or bad breath, can occur due to bacteria buildup in the mouth. Eating disorder linked-problems such as reduced saliva production and stomach acid from purging play a huge role in developing this condition.
• Tooth sensitivity to hot and cold temperatures: When the enamel on teeth is eroded, teeth can become more sensitive to temperature, leading to pain and discomfort when eating or drinking hot or cold foods.
• Jaw pain: Frequent purging can cause strain on the jaw muscles, leading to pain and discomfort. In extreme cases, degenerative arthritis of the jaw can develop.

Treatment for Oral Health and Eating Disorders

Oral health plays a special role in eating disorder treatment. Often, the oral cavity is among the first areas of the body impacted by these conditions, and dental professionals may be the first—or only—people to see the signs of an eating disorder.

This also puts these professionals in the place to catch these conditions early. As early detection can play a crucial role in recovery, many professionals are trained to look for these signs, and are given help on how to direct patients to proper care.

For oral health problems caused by eating disorders, treatments will vary, based on the issue and the severity of symptoms. Dental treatment options generally include surgical procedures, sensitivity treatments, and dry mouth remedies. Many patients are also instructed in better ways to promote oral health. [10]

How to Seek Help for an Eating Disorder

If you or a loved one are struggling with an eating disorder, it’s important to seek out help. These conditions don’t get better on their own, and often get worse with time. When it comes to dental problems, in particular, damage caused can eventually become irreversible. [1]

There are many resources available, including therapy, support groups, and medical treatment. Finding a qualified professional who specializes in eating disorders and makes you feel comfortable is crucial. Building a strong support network of loved ones can also play a significant role in the recovery process.

You can speak with your primary care physician or therapist to start. These professionals can help you secure an official diagnosis or direct you to treatment programs. A number of eating disorder hotlines offer additional resources and information, often allowing callers to remain anonymous and providing these services free of charge.

Regardless of where you look for health, the most important thing is looking. It is often the first step on the journey toward a healthier and happier future.

Resources

1. Patterson-Norrie T, Ramjan L, Sousa MS, Sank L, & George A. (2020). Eating disorders and oral health: a scoping review on the role of dietitians. Journal of Eating Disorders; 8(49).
2. Paszynska E, Dutkiewicz A, Osinska A, Mozol-Jursza M, Smalc N, Tyszkiewicz-Nwafor M, Dmitrzak-Weglarz M, Slopien A, & Jenerowicz D. (2020). Anorexia Nervosa with Vomiting Episodes: Dermatological and Oral Complications. European Journal of Dentistry; 14(1):180–185.
3. Mascitti M, Coccia E, Vignini A, Aquilanti L, Santarelli A, Salvolini E, Sabbatinelli J, Mazzanti L, Procaccini M, & Rappelli G. (2019). Anorexia, Oral Health and Antioxidant Salivary System: A Clinical Study on Adult Female Subjects. Dentistry Journal; 7(2):60.
4. Rangé H, Colon P, Godart N, Kapila Y, & Bouchard P. (2021). Eating disorders through the periodontal lens. Periodontology 2000; 87(1):17–31.
5. Pallier A, Karimova A, Boillot A, Colon P, Ringuenet D, Bouchard P, & Rangé H. (2019). Dental and periodontal health in adults with eating disorders: A case-control study. Journal of Dentistry; 84:55–59.
6. Uhlen MM, Tveit AB, Stenhagen KR, & Mulic A. (2014). Self-induced vomiting and dental erosion–a clinical study. BMC Oral Health; 14, 92.
7. Vavrina J, Müller W, & Gebbers JO. (1994). Enlargement of salivary glands in bulimia. The Journal of Laryngology and Otology; 108(6):516–518.
8. Hasan S, Ahmed S, Panigrahi R, Chaudhary P, Vyas V, & Saeed S. (2020). Oral cavity and eating disorders: An insight to holistic health. Journal of Family Medicine and Primary Care; 9(8):3890–3897.
9. Dental Complications of Eating Disorders. (n.d.). National Eating Disorder Association. Accessed August 2023.
10. How Do Eating Disorders Affect Your Mouth? (n.d.). Colgate. Accessed August 2023.

The opinions and views of our guest contributors are shared to provide a broad perspective of eating disorders. These are not necessarily the views of Eating Disorder Hope, but an effort to offer 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.

Last Updated & Reviewed on August 14, 2023
Published on EatingDisorderHope.com

Eating Disorder Hope Staff

The EatingDisorderHope.com editorial team comprises experienced writers, editors, and medical reviewers specializing in eating disorders, treatment, and mental and behavioral health.