Gerald S. Fine, D.D.S.

   Oral and Maxillofacial Surgery

Brookline Office
Tel: 617-731-6060

Our commitment is to provide you the highest standard of oral and maxillofacial surgery in a professional manner.

Anorexia and Bulimia: Medical and Dental Management

Anorexia and Bulimia: Medical and Dental Management

CAITLIN IS O.K. !!   Last Summer my neighbor asked me to examine her 17 year old daughter who had dental pain. Caitlin had labial tooth erosion, dental caries and parotitis, among other findings, and was preoccupied with her diet. I was concerned that Caitlin might have bulimia nervosa and suggested she see her physician as well. Caitlin is now under medical care and is doing well.

The eating disorders anorexia nervosa and bulimia nervosa are associated with serious morbidity in women. The cause is unknown, but may involve a variety of genetic, cultural and psychiatric factors. Dentists play an important role in recognizing cases of eating disorders and managing the oral manifestations and complications.

Clinical Findings and Medical Treatments—For women with anorexia and bulimia, being thin is the major objective of life. Those with anorexia achieve this goal by radically restricting their food intake, whereas patients with bulimia have binge eating followed by vomiting, excessive laxative use, or enemas.

Oral Findings Anorexia Nervosa Bulimia Nervosa

Labial tooth erosion No Yes
Tooth sensitivity No Yes
Xerostomia Yes Yes/No
Dry mouth (complaint) Yes Yes
Dental caries No Yes
Periodontal disease No Yes
Enlarged parotid glands Yes Yes
Atrophic mucosa Yes No
Poor oral hygiene No Yes

Dental Complications and Treatment - Both eating disorders, but especially bulimia can have serious complications. Patients with bulimia may have caries develop as a result of the types of food they eat and dental erosion caused by vomiting. Recognition of this dental erosion by the dentist may prompt initial referral and diagnosis of an eating disorder. Bulimic patients with dental caries need to improve oral hygiene, prevent further erosion, and reduce tooth sensitivity. Anorexia may be more difficult to identify in a dental practice.

Anorexia and bulimia are common conditions, especially prevalent in white, middle class girls and young women. Dentists must be familiar with the medical and dental manifestations of these eating disorders and their management. IS THERE A CAITLIN IN YOUR PRACTICE?

‍Gerald S. Fine, D.D.S.
Practice limited to oral & maxillofacial surgery‍