Eating Disorders (and Oral Health)

Pop, candy, coffee—you've heard the countless number of things that will cause dental erosion, abrasion, and tooth loss, but eating habits matter just as much as what you consume. According to a study published in the September/October 2007 issue of General Dentistry, the clinical, peer-reviewed journal of the Academy of General Dentistry (AGD), eating disorders play a major part in dental erosion, abrasion, and tooth loss, as the consumption of foods or beverages that contain acids cause damage to tooth structure.

The study focuses on pica, an eating disorder that is described as "the hunger or craving for non-food substances," explains Betty Shynett, DDS, FAGD, one of the authors of the study. It involves a person persistently mouthing and/or ingesting nonnutritive substances for at least a period of one month at an age when it is considered developmentally inappropriate. These nonnutritive substances include things that most would consider repulsive, such as coal, laundry starch, and plaster, but also includes substances that most are guilty of nibbling on, such pencil erasers, ice and fingernails. Pica itself is considered to be connected with mineral deficiencies, cultural practices, depression, stress and anxiety.

A common time for this disorder to occur is during pregnancy, explains Carolyn Taggart-Burns, DDS, spokesperson for the AGD. "Pregnant females can more easily experience iron deficiency, thus increasing the chances and desire for nonnutritive substances," she says.

Pica isn't the only eating disorder connected to dental erosion, abrasion and tooth loss; bulimia nervosa and anorexia nervosa are also culprits. But, unlike bulimia nervosa and anorexia nervosa, pica doesn't receive mass media coverage and therefore the public is less aware of this particular eating disorder. Additionally, few symptoms are related to the eating disorder and it is hard to diagnose. However, management of the eating disorder simply includes behavioral and dietary modifications.

Side effects of pica and other eating disorders:

• Pica, like many other eating disorders, introduces abrasive and highly erosive components into the oral cavity. Chalk, dirt and other    agents wear enamel and all tooth structures at a faster rate.
• Pica is usually caused by iron deficiency, but when sufferers consume materials like clay, the components will bind with the iron    receptors in the GI tract. This will make it more difficult for any iron to get absorbed, thus worsening the deficiency and furthering    the eating disorder.
• If this or other disorders are not caught early and intervened, tooth loss is most certain due to the fact that eating disorders occur    continually.