Eating disorders and dentistry
Eating disorders are expressions of a range of weight and food issues
that both men and women can experience. They can include a complex combination
of both psychological and physical problems. Different forms of eating
disorders exist and all are serious.
The different types of disorders are:
- Anorexia Nervosa - a person has the intense fear that fat and weight
gain will occur. They often have drastic weight loss.
- Bulimia Nervosa - a person binges and eats an enormous amount of food,
then purges (vomits), through self-induction, the food they have just
eaten. The prevalence of bulimia amongst adolescents is 1 to 3 percent
of the population according to the American Psychiatric Association. Females usually outnumber males 10 to 1.
This disorder is of most importance to dentists, due to the excessive
amount of enamel wear the person may have. This results from the excessive
vomiting, where the gastric contents, which are highly acidic, erode the
enamel surfaces over time. This leads to thinning of the enamel and eventual
chipping of the teeth.
The most notable areas where tooth structure is lost is on the lingual
(or tongue surface) part of the upper anterior teeth. What parents may
notice is shorter than normal incisor teeth. The teeth may also have
color changes, most notably from a whitish color to a brownish or grayish
color. Fillings (amalgam type), may also begin to appear more prominent
on the back teeth due to the enamel wear surrounding the fillings. People
are urged to monitor other signs, some of which include a marked increase
or decrease in weight, not due to any other medical problem, withdrawn
behavior, excessive, compulsive exercising, irritability, and intense
preoccupation with body and weight image.
Other eating disorders exist that may not necessarily fit anorexia or
bulimia nervosa. If one suspects that this condition exists, medical consultation
is very important due to the possible life threatening results.
Dentists and hygienists can help diagnose if excessive wear or abnormal
oral pathology exists, especially with the enamel damage that can occur
with excessive vomiting. They can help the patient minimize further oral
complications until further medical and psychological therapy has brought
the condition under control.
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