Oral status in eating disorders

Both anorexia nervosa and bulimia nervosa are responsible for lesions that affect the dentition, oral mucosa, and salivary glands. Tooth surface loss is a result of acidic erosion of enamel and dentin as well as increased caries activity. Dry mouth can also increase caries activity. Mucosal lesions include traumatically induced ulcerations and subepithelial hemorrhage. In some cases, there can also be enlargement of the salivary glands. While a conclusive diagnosis of bulimia nervosa may be difficult to establish, due to a noncooperative patient, the dentist is in an advantageous, and perhaps singular, position to confirm the presence of this disease because of the distinctive pattern of tooth erosion.