Dental Diagnosis and Dilemma

The dentist may be the first health-care professional to suspect a person has an eating disorder. When 123 male and female dentists and dental hygienists in North Dakota were surveyed, 79% reported that they currently had at least 1 or more patients in their practices whom they suspected or knew had bulimia nervosa. Their suspicions arose from the patients’ dental profiles, including appearance of abnormal dental erosion. Ninety-two percent of the dental professionals reported they might share their suspicions of an underlying eating disorder with the patient or parents; 42% note that they always do so. The two pieces of advice the dental professionals give to patients, before referring them for further care, are to rinse their mouths with water immediately after vomiting (52%) and to brush their teeth immediately after vomiting (46%). The vast majority of people with suspected eating disorders are referred to primary care physicians; only 3% of the dentists and dental hygienists refer such patients to a psychologist or psychiatrist. The survey results were reported at the Academy for Eating Disorders annual meeting in Boston last April.