Eating disorders: knowing the signs – Julie Deverick – BSDHT

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  Posted by: Dental Design      4th June 2019

Eating disorders are not only damaging to general health, but heavily impact oral health too. As a dental hygienist or dental therapist it’s a good idea to be aware of how these conditions affect the oral cavity and be able to identify them. This way, if you are faced with patients who may potentially have an eating disorder, you can give them the care and advice they need.


What defines eating disorders?

When we hear the term eating disorder it’s easy to quickly jump to the most extreme examples such as anorexia nervosa or bulimia, but eating disorders actually cover a far wider range of behaviours. For example, an eating disorder may be characterised by someone obsessively counting calories and then exercising until they know they have burned off that amount. Another example may be periodic binge eating triggered by emotions or people using food as a comfort when they are going through a tough time and forming an unhealthy reliance.


A common problem in the modern age

It is estimated that as many as 15% of young girls have an eating disorder of some degree, and this is the most highly affected segment of society. Despite this, these conditions can strike people of any gender and age at any point in their lives.[i]

So what are the causes of eating disorders? Much like many mental health issues, there is no single cause for eating disorders. It is generally agreed that pressures to be thin and beautiful are the main cause behind teenage girls developing these conditions, but such reasons are not age or gender exclusive and may go some way towards explaining eating disorders in other segments of society too.

Other reasons that people may develop eating disorders can include big changes such as bereavement or moving countries, existing psychological disorders, abuse and many others. As such, it is almost impossible to tell what may trigger someone to develop one of these disorders, and therefore being able to identify the signs of these disorders and working from there is incredibly important.[ii]


Anorexia Nervosa

Anorexia is an eating disorder characterised by individuals restricting their diet or not eating at all in order to avoid any weight gain. There are varying degrees of anorexia, and in some cases individuals may aggressively exercise in order to lose weight, quickly becoming unhealthily underweight as a consequence.

Whilst this may have very little effect on the mouth in the short term, once a person has reached the point of malnutrition, a number of problems may begin to arise. Gums and other soft tissue will bleed easily and salivary glands may also become swollen. Furthermore, a lack of B vitamins will quickly have noticeable effects, such as the development of canker sores. Lack of calcium can also quickly lead to decay, and a deficiency of vitamin D will prevent individuals from being able to absorb any calcium they do consume effectively.[iii]

In addition, people suffering from anorexia may show signs of tooth erosion as a result of drinking excessive amounts of diet fizzy drinks. As these drinks have no calories, they are a popular choice for people who are restricting calorie intake or who want to fill their stomachs without eating, but they are highly acidic and will weaken and destroy enamel.



Unlike Anorexia, bulimic individuals are likely to binge eat and then purge these meals by forcing themselves to vomit. This often turns into a vicious cycle, meaning that people suffering from the worst cases are likely to vomit multiple times per day.

Due to the strength of our stomach acid, this can very quickly have noticeable effects on the teeth. Enamel can quickly become thin or weakened, and teeth can change in colour shape and size as a result. Tooth decay may also be aggravated as a result of too much rinsing or ferocious brushing after vomiting.

Other signs may manifest in the soft tissue. Purging behaviours can lead to damage such as scratches on the soft palate, and as this damage is rarely caused by anything else it is a reliable sign of someone suffering from an eating disorder.


What can you do to help?

The key to helping people with these conditions is to act fast. If you see signs that are pointing towards someone suffering from an eating disorder, it is a good idea to have resources to hand such as leaflets or useful web links that will help inspire them to seek help.

It’s also worth explaining the dangers of these disorders and how they will affect their oral health in both the short and the long-term.

Lastly, if you feel like you need help reaching out to these patients, you can join an organisation such as the British Society of Dental Hygiene and Therapy. Members have direct access to a helpline and can ask advice 24/7 if they are unsure about how to approach subjects such as these with their patients, giving them peace of mind that they have the support they need in all delicate matters.


For more information about the BSDHT, please visit

call 01788 575050 or email




[i]Milestones. Anorexia and Bulimia and the Effects on Your Teeth. Link: [Last accessed March 19].


[ii]Your Mind In Health. Eating Disorders. Link:[Last accessed March 19].


[iii]NEDA. Dental Complications of Eating Disorders. Link:[Last accessed March 19].

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