Anorexia nervosa is an eating disorder with extensive physical consequences, including significant and sometimes permanent dental problems like tooth decay and loss. These issues arise from factors that harm the teeth and surrounding tissues. Addressing these oral health effects is a component of comprehensive care for recovery.
How Anorexia Impacts Oral Health
Anorexia damages oral health through several pathways. Severe food restriction deprives the body of nutrients needed for strong teeth, with deficiencies in calcium, vitamin D, and phosphorus being particularly damaging. Calcium is a primary building block of tooth enamel and the jawbone, making teeth weak and susceptible to decay without it. Vitamin D is necessary for the body to absorb and use calcium effectively.
Damage also comes from behaviors associated with the purging subtype of anorexia. Self-induced vomiting exposes teeth to powerful stomach acids, which have a very low pH. Frequent exposure to this acid dissolves the protective outer layer of enamel in a process called demineralization, leaving the softer dentin exposed. This erosion often affects the tongue-facing surfaces of the upper front teeth most severely.
Malnutrition and dehydration can lead to xerostomia, or chronic dry mouth, by reducing saliva production. Saliva is the mouth’s natural defense system, helping to wash away food debris, neutralize acids, and remineralize teeth. When salivary flow is low, acids remain on the teeth longer, and the mouth loses its ability to repair minor enamel wear.
Common Dental Problems Caused by Anorexia
Tooth decay, or cavities, is a frequent outcome. When enamel is weakened by mineral deficiencies and acid erosion, it can no longer protect the tooth from decay-causing bacteria. This decay can progress rapidly in the oral environment created by anorexia.
Enamel erosion causes noticeable changes to teeth. As the white enamel thins, the yellowish dentin layer beneath becomes more visible, making teeth appear discolored. The edges of the front teeth may look thin, uneven, and almost translucent. Eroded teeth are also prone to chipping and cracking.
A sharp increase in tooth sensitivity is common. With the insulating enamel worn away, microscopic tubules in the dentin that lead to the tooth’s nerve become exposed. This causes sharp pain when teeth contact hot, cold, sweet, or acidic foods and drinks. Anorexia also affects the mouth’s soft tissues, leading to:
- Swollen salivary glands
- Chronically dry and cracked lips
- Sores on the gums
- Sores on the palate
Managing Dental Health During and After Recovery
Managing dental health is part of the recovery journey, though it must be secondary to treating the eating disorder. For individuals who purge, immediate actions can reduce dental harm. Avoid brushing teeth immediately after vomiting, as this can scrub the softened enamel away. Instead, rinse the mouth with a neutralizing solution like water with baking soda, or a fluoride mouthwash to rinse away acid and strengthen teeth.
Seeking professional dental care is a step in recovery. While discussing an eating disorder can be difficult, dentists are health professionals who provide help without judgment and are often among the first to notice signs of the condition. A dentist can assess the damage and recommend treatments like prescription high-fluoride toothpastes, in-office fluoride treatments, or restorative procedures like bonding to protect eroded areas.
For more severe damage, crowns may be required to cover and save a tooth. Long-term management involves a gentle but consistent oral hygiene routine, using a soft-bristled toothbrush and non-abrasive toothpaste to prevent further wear. Regular dental check-ups allow a professional to monitor oral health, address problems early, and provide support for recovery.