Eating disorders are notoriously tricky to spot. The person suffering with the eating disorder generally wants to hide it from those around them and so the fact that they are ill often isn’t spotted until severe symptoms have begun to manifest.

Dental professionals are in a unique position to spot some signs of eating disorders when they are carrying out routine examinations. Keeping an eye out for these signs could mean that a patient gets help much earlier and therefore has a much better chance of recovery.

Dental Erosion

A common side effect of the eating disorder Bulimia, is dental erosion. People with Bulimia will binge on large amounts of food as a way to deal with emotional unrest. They then feel intense guilt about their eating and so they make themselves vomit as a way to get rid of the extra calories. 

As vomit is acidic, over time this can cause erosion of the teeth.

Damage To The Throat And Mouth

In order to induce vomiting, a person pushes their fingers or another object into the back of their throat. This can cause damage to the palate or the oropharynx, so lesions in these areas are a sign of possibly purging.

In addition a dental professional may notice that the salivary glands have swollen as a result of vomiting, causing redness on the inside of the throat or swelling just below the ears.

Tooth Decay And Gum Disease

One of the side effects of not getting enough nutrients, is that tooth decay and gum disease may set in. You may also notice ulcers and canker sores developing, as well as soreness and redness inside the mouth.

Over Brushing

If you notice that your patient’s mouth is otherwise healthy, but they have gums that are red and sore or are beginning to recede, this can be a sign of over brushing.

People with eating disorders, particularly Bulimia, often become aware that they are developing bad breath from being malnourished or from vomiting. In order to combat this, they may start brushing their teeth very often or with too much force, causing damage to their mouth.

What Should You Do?

Firstly it’s a good idea to learn as much as you can about eating disorders so that you know the sorts of things you can expect. A specialist treatment center like is a good place to go for advice.

If you have noticed signs of an eating disorder in your patients then it’s important that you talk to them about it. This is a sensitive conversation and needs to be approached as such. 

  • Make sure you have enough time to have an in depth conversation – it’s not something you can just casually mention.
  • Close the door and ensure privacy. Your patient is unlikely to want to talk if they think they will be overheard.
  • Approach the conversation from a dental perspective. Tell the patient what you have spotted and ask them if they have any idea what might be causing it. If they don’t, you can hint that sometimes eating disorders are the cause.
  • Be sure that you ask open ended questions, make your patient feel as though you truly care about their answers. If they get the sense you are merely checking questions off of a list, they are not likely to be truthful with you.

You can provide referrals and advice if asked for, but it’s likely that it will take a few conversations before this happens. Be sure that you note what you have found in your patients notes and keep an eye on it at future appointments. You could even book in the next appointment sooner than you normally might.