Eating Disorders and Oral Health Challenges

In another dynamic session of Grand Rounds, Dr. David Clark, a Dentist at Ontario Shores Centre for Mental Health Sciences (Ontario Shores) highlighted some potentially devastating consequences for individuals living with mental illness and their oral health.

An individual’s oral health can reflect a record of the peaks and valleys in their life, as there is usually a correlation between when they are well and when they stop caring for themselves and the condition of their oral health. “When you are unwell you may not spend as much time on your dental hygiene, and the effects will be visible,” explained Dr. Clark.

In particular, Dr. Clark highlighted the impact of eating disorders on an individual’s oral health.   “Individuals with an eating disorder usually control the intake of food and this manifests itself in physical changes in the body as well as compromised oral health,” adds Dr. Clark.

These changes usually include teeth erosion and other manifestations in the mouth of equal magnitude affecting the oral cavity, the tongue, gums, supporting structures and salivary glands.  In addition, persons with eating disorders may delay getting treatment or do not access treatment at all as well as they may have medical complications that affect treatment, thus making the problems worse.

“Complications that result for the person may include impaired oral function, oral discomfort and pain, and deterioration of aesthetics, all of which will impact the overall quality of their life,” Dr. Clark says.

These problems are often caused because of metabolic impairment, lack of regular and effective oral hygiene, side effects from medications, altered nutritional habits and physical changes caused by methods of purging.

“The dental treatment team may be the first people to become aware of an eating disorder through the detection of the erosion pattern in the teeth, discoloration or staining of teeth and they should be prepared to discuss and refer individuals to a proper medical diagnosis and treatment,” Dr. Clark suggests.

The recommended response from the dental team is to reduce the frequency of acid exposure on the teeth, enhance salivary flow and neutralize acids in the mouths as well as to increase resistance of the enamel to demineralization.

However, these might not be able to be implemented in a timely manner, if the eating disorder persists. “Definitive dental treatment may be discouraged or delayed until the individual with an eating disorder is stable and the behaviour has ceased,” adds Dr. Clark.