Identifying early signs of eating disorder in dentistry

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Eating disorders and dentistry: Identifying early signs in the dental office

According to the Oral Health Foundation, dental teams can play a crucial role in identifying and acting on early signs of eating disorders. (Image: Paradise studio/Shutterstock)

RUGBY, UK: According to some eating disorder organisations and charities, between 1.25 and 3.40 million people in the UK are affected by an eating disorder. The condition can have a tremendous effect not only on a person’s mental health and body image but also on his or her oral health, and a patient’s mouth can thus serve as a major indicator of disordered eating. In this regard, the Oral Health Foundation has recently highlighted the role of dentists, dental hygienists, dental therapists and dental nurses in recognising the warning signs and symptoms of eating disorders.

According to various studies, eating disorders are among the deadliest mental illnesses. In the UK, around 275,000 people have binge eating disorder, 235,000 bulimia and 100,000 anorexia. Purging through vomiting often leads to enamel erosion, whereas binge eating may increase the risk of dental caries and tooth loss caused by excessive sugar consumption. Additionally, people with eating disorders often absorb insufficient vitamins and other nutrients, and malnourishment too can be reflected in the mouth. Other dental problems related to eating disorders include sensitive teeth, dry mouth, halitosis and enlarged salivary glands.

Dentists have an important role

In light of the National Smile Month campaign aimed at championing the importance of having good oral health, the Oral Health Foundation has recently stated that dental professionals are well placed to identify eating disorders early during regular dental check-ups.

Brooke Sharp, a clinical advice coordinator at Beat, an eating disorder charity based in the UK, stated that eating disorders often go undetected for a long time, since it is difficult to identify the disorder by just looking at a person. However, since there are physical indicators of an eating disorder that are visible in the mouth, she believes that dentists may be among the first to observe these.

As noted by Chief Executive of the Oral Health Foundation Dr Nigel Carter, OBE, it is already the case that dental professionals examine the hard and soft tissue of the mouth and look for signs of tooth erosion during routine dental examinations. They also have the opportunity to spot possible injuries to the mouth from the insertion of foreign objects to cause the person to vomit.

“The UK needs a far better strategy for diagnosing eating disorders early”
— Dr Nigel Carter, Oral Health Foundation

Commenting on the issue, Dr Carter said in a press release: “The UK needs a far better strategy for diagnosing eating disorders early. The sooner an eating disorder is suspected or recognised, then the more effective treatment will be.”

Sharp stated that the charity is already taking action to provide dental professionals with the necessary tools for recognising eating disorders and advising patients on the next steps: “At Beat, we are currently working on a webinar series to educate different health sectors about health, which includes dentists, dieticians, and pharmacists. The aim of this training will be to help professionals identify the signs of an eating disorder and understand how to support their patients.”

However, she noted that, although dental teams may encounter patients with eating disorders, it is not their responsibility to treat the condition. Instead, they should direct patients to professional help: “Whilst it’s important to increase awareness of eating disorders, it is never the role of dentists to diagnose or treat the eating disorder, and patients must always be signposted to specialist support,” she concluded.

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