Yes, dentists can very well help in diagnosing eating disorders too! And sometimes we may be the only medical professional who notices the symptoms that are indicative of an eating disorder. The regular scheduled greater frequency of dental visits can also be cited as one reason.
Eating disorders are characterised by denial and even shame, so immediate and open discussions are not forthcoming. When eating disorders have the highest mortality rate of all psychiatric illnesses, we must take this opportunity to better support such patients. It is not just a simple binge-and-purge habit.
We are all aware of one classic sign of eating disorders - dental erosion caused by intentional vomiting seen in bulimia. We might also well identify the signs of malnutrition in the oral cavity, but there are many knowledge gaps to be bridged in order to tackle such a sensitive issue!
Basic Information about Eating Disorders
They are defined as compulsive psychological disorders affecting individuals’ perception and relationship with their body and food, which results in distorted eating behaviours and habits.
3 most common eating disorders
- Bulimia nervosa (binge-purge)
- Anorexia nervosa (starvation)
- Binge-eating disorder (binging without purging)
Identifying individuals with eating disorders can be a challenge in a dental clinic sometimes. In light of this, the Sick, Control, One stone, Fat, Food questionnaire (SCOFF) was designed to aid in the diagnosis of patients with potential eating disorders.
SCOFF Questions
- Do you believe that you are fat when others say you are thin?
- Do you worry that you have lost control over how much you eat?
- Do you make yourself vomit because you feel uncomfortably full?
- Would you say that food dominates your life?
- Have you recently lost more than 15 pounds over a three-month period?
If a patient responds “yes” to two or more of the five SCOFF questions, there is a strong likelihood that an eating disorder exists.
Oral Manifestations of Eating Disorders
- Erosion of dental enamel
- Increased sensitivity to temperature. In extreme cases the pulp can be exposed and cause infection, discolouration, or even pulp death
- Enlargement of the salivary glands
- Dry mouth due to decreased salivary flow
- Reddened, dry, cracked lips
- Redness of the throat and palate
- Changes in the color, shape, and length of teeth. Teeth can become brittle, translucent and weak
- Oral sores with injury on palate, due to things that are used to provoke vomiting
- Impairment of taste perception
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