Dentists can sometimes suspect or recognize signs that a patient may be bulimic, but they cannot definitively know for certain without the patient's disclosure. Bulimia nervosa is an eating disorder characterized by episodes of binge-eating followed by purging behaviors, such as self-induced vomiting, excessive use of laxatives, or other forms of compensatory behaviors to rid the body of calories.
Some of the signs and oral symptoms that may raise suspicion of bulimia in a patient include:
Erosion of tooth enamel: Frequent vomiting exposes the teeth to stomach acid, which can erode the enamel, leading to a distinct pattern of wear on the back of the front teeth.
Tooth sensitivity: As the enamel wears away, teeth become more sensitive to hot and cold temperatures.
Discoloration of teeth: The teeth may take on a yellowish appearance due to erosion of the enamel and exposure of the dentin underneath.
Dry mouth and cracked lips: Frequent vomiting can lead to dehydration and dryness in the mouth, which can cause cracked lips.
Swollen salivary glands: The salivary glands can become inflamed due to repeated vomiting.
Enlarged parotid glands: The parotid glands, located near the ears, can become swollen and noticeable in some cases.
Cuts or calluses on the knuckles: Some individuals with bulimia use their fingers to induce vomiting, leading to skin abrasions or changes on their knuckles.
It's important to note that these signs can also be indicative of other oral health issues, so dentists must approach the situation sensitively and without making assumptions about their patients. If a dentist suspects that a patient may have an eating disorder, they should approach the matter with empathy and encourage open communication. However, it is up to the patient to share such personal information voluntarily. Dentists are bound by patient confidentiality and must respect their patients' privacy. If a patient does disclose an eating disorder, the dentist can then provide appropriate support and referral to other healthcare professionals, such as dietitians or mental health specialists, who can help address the underlying issues.