What’s In a Smile? The Impact of Eating Disorders on Dental Health.
Eating disorders (EDs) affect every part of a person’s being—often in ways we don’t immediately see. One of the most overlooked is the serious toll they take on oral health, namely for individuals who experience bulimia and long periods of undernutrition due to disordered eating. The resulting lasting oral effects of eating disorders serve as daily reminders for those with eating disorders of the struggles they have faced.
In high school, I took several dental science courses. When we got to the section on eating disorders and how the oral cavity was affected, the brief mention made it feel like an afterthought. Years later, that “afterthought” continued to stick with me, so I took this as a call to action. As an aspiring dental practitioner and someone who has personally experienced disordered eating, I felt that there was a gap in research and literature that, if filled, could help many struggling individuals. Over the last few years, I learned as much as I could about the intersection between dental health and eating disorders.
Dental professionals are uniquely positioned to identify the oral manifestations of eating disorders. For example, in disorders like bulimia, the repeated purging of stomach acids can erode tooth enamel, leading to long-term damage in the oral cavity. Eating disorders can also cause dry mouth, enlarged salivary glands, cracked/dry lips, mouth sores, tooth decay, and sensitive teeth.
When it comes to eating disorders and dental health, the literature mainly focuses on the impact eating disorders have on the oral cavity. There is also some literature on educational interventions in oral health professional education for eating disorders, but there is little evidence showing that eating disorder training and guidelines are being implemented and enforced in training programs.
Dental practitioners might not be the ones to officially diagnose or treat eating disorders, but they can most definitely identify the signs and offer support and a safe space for their patients.
As a future dental practitioner, I urge practicing professionals to understand this positionality and act on it. Start by creating a comfortable, nonjudgmental environment where patients feel safe enough to open up and leave space for them to share their experiences at their own pace. Conversations regarding eating disorders can be difficult, so it’s important to use empathetic, non-stigmatizing language. Never underestimate the importance of your voice in advocating for the well-being of your patients. You could also develop a list of local resources—therapists, dieticians, doctors, and clinics—that patients experiencing an eating disorder can reach out to. Even small gestures, such as expressing concern in a compassionate manner or offering resources, can have a lasting impact on someone's journey toward recovery.
For those who have experienced an eating disorder, the effects extend far beyond just the physical—they touch every aspect of life, both mentally and emotionally. The isolating nature of these conditions makes them particularly difficult to navigate, but if we can better equip personnel in different areas, it may not be so isolating. I believe dental professionals and future dental professionals including myself have a responsibility. Not only to educate ourselves on the oral impacts of eating disorders and to provide compassionate support where possible, but also to advocate for a better implementation of educational interventions in training programs. This is more than just a professional challenge—it’s a call to action.
