The New Year sees an increase in people watching what they eat, which is all to the good. However, there are some for whom food can become a battle ground and develop into an eating disorder.
Eating Disorders Awareness Week (24 February – 2 March 2014) aims to raise awareness of the health implications of these disorders. One of the many impacts of an eating disorder is the potential for damage to the dentition.
For example, the extended periods of intentional vomiting instigated by bulimia can result in tooth wear, which can make dentists the first health professional to be privy to the problem.
Signs include of tooth wear as a result of an eating disorder can include one or all of the following:
• The teeth become rounded, smooth and shiny and lose their surface characteristics
• Incisal edges appear translucent
• Cupping forms in the dentine
• Cervical lesions are shallow and rounded
• Restorations tend to be unaffected by erosion and will therefore stand proud of the surrounding tooth tissue.
Advice rather than treatment features heavily during the initial stage of helping a patient suffering with bulimia. Diet analysis and general oral health guidance should be given, including:
• Issuing a fluoride rinse or gel and prescribing a high-fluoride toothpaste for daily use
• Not brushing immediately after vomiting or consuming acidic foodstuffs, but rinsing with a fluoridated mouthwash and chewing sugar-free, xylitol-sweetened gum afterwards.
In addition, it is recommended that the patient sees a doctor, who can assess their physical condition and refer them to available help. If the patient is uncomfortable seeing the doctor, in the first instance a nurse or health visitor from the same medical practice is an acceptable alternative.
To treat or manage extensive tooth wear, referral to a dental specialist may be recommended either for treatment planning advice only or for the provision of comprehensive care. London Tooth Wear Centre®, for example, offers an evidence-based and comprehensive approach to managing tooth wear.