Visit to Dentist May Reveal Bulimia, Osteoporosis

NEW ORLEANS, October 2002 --A person with bulimia may seem to have a regular smile, but look at the back of the patient's teeth with a dental mirror and a very different story emerges. The self-induced vomiting to prevent weight gain exposes the back of a bulimic person's teeth to powerful stomach acids. Over time, the back of the teeth may become smooth and glassy as the enamel and dentin layers of the bulimic person's teeth erode. It may even get to the point where the innermost layer of the teeth, the pulp, becomes visible. Without the protection of the enamel, a bulimic person's teeth will be extremely sensitive to hot and cold.

"One of the most important things a bulimic person can do for their oral health is to rinse with water immediately after vomiting. Rinsing will help neutralize the intense stomach acids that are so damaging to teeth," states Barbara J. Steinberg, D.D.S., clinical professor of surgery and medicine at Drexel University College of Medicine in Philadelphia. Dr. Steinberg is speaking here at a women's health seminar at the American Dental Association's 143rd Annual Session.

Swelling of the salivary glands may also occur in 10 percent to 50 percent of bulimics. Persistent salivary gland swelling causes the jaw to widen and appear squarish, frequently prompting bulimics to seek dental or medical attention.

Dr. Steinberg cautions fellow dentists to be alert to the oral health manifestations of bulimia in order to refer patients to appropriate health care professionals. Experts say more than 5 million people in the United States have an eating disorder. Most are women, but some men also develop eating disorders.

"The mouth reflects the body," Dr. Steinberg states. "Medical conditions can affect oral health as well."

Osteoporosis

According to Dr. Steinberg, when dentists observe bone loss in the jaw, it may be a sign of bone loss in other parts of the body, signaling osteoporosis. A dentist may be the first health professional to suspect a patient has osteoporosis based on the patient's medical history, including risk factors, and results of clinical and x-ray examination. If osteoporosis is suspect, the dentist can then refer the patient to his or her physician for medical assessment and any subsequent treatment.

A patient with osteoporosis who experiences bone loss in the jaw may also be at risk of bone loss around the teeth. Studies support the hypothesis that women with low bone mineral density tend to have fewer teeth.

In addition, if a post-menopausal woman frequently complains that her dentures do not fit properly, Dr. Steinberg points out that osteoporosis may be the culprit. Studies have shown post-menopausal women with osteoporosis needed new dentures three times more often after age 50 than women without osteoporosis. Bone loss may become so severe that it may be impossible to create functional dentures. Without the aid of dentures to chew many types of food, older patients may suffer severe nutritional deficiencies.

Please Note: The presentation described in this news release does not necessarily reflect the policies or opinions of the American Dental Association.

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