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Dentists can help spot early signs of eating disorders

November 01, 2017

By Jennifer Garvin

Washington — When it comes to the early detection of eating disorders, dentists are in a unique position for spotting the early warning signs and referring patients to the proper behavioral health professionals.

This was part of the conversation during the Nov. 1 briefing, Waiting on Cures: The role of Health Professionals in Early Detection of Eating Disorders, in the Russell Senate Building on Capitol Hill. Dr. Richard W. Gesker, spoke on behalf of the ADA at the event, which was hosted by the Eating Disorders Coalition. The goal of briefing was to explain to legislators the value of health care providers identifying eating disorders early as well as the need for implementing the 21st Century Cures Act by the U.S. Department of Health and Human Services.

Photo of Dr. Gesker
Dental role: Dr. Richard Gesker talks about the role dentists can play in helping patients with eating disorders during a Nov. 1 briefing in Washington.
"Dentistry isn't just about changing lives, today we are speaking about saving lives," said Dr. Gesker, who is the chief dental officer at Mary's Center, a federally qualified health center that provides dental, medical and behavioral health services at multiple locations in Washington, D.C. and Maryland.

For dentists who suspect they have a patient with an eating disorder, Dr. Richard Gesker and Dr. Jessica Yoo, also of Mary's Center, underscored the importance of making sure the patient is comfortable talking about the patient's condition and urged providers to consider all risk factors — from the social, demographic and psychiatric perspective — when making their assessment. They also stressed the need to help patients find behavioral health homes for treatment.

During his presentation, Dr. Gesker explained how certain changes in the mouth, including stains to tooth enamel and receding gums, can be key early warning signs a patient has an eating disorder. Other signs include reduced salivary secretions, dry mouth and gland enlargement.

One audience member inquired about tooth erosion and wondered if dentists could tell the difference between stains from purging or those from other sources such as citrus.

"The pH of a lemon is much less acidic than the pH of the stomach, which is almost equivalent to battery acid. However, lemon pH can also be damaging to the tooth enamel," he answered. "You can't trick your dentist if they're well trained."

The panel was moderated by Bryn Austin, ScD., president, Eating Disorders Coalition. In addition to Dr. Gesker, speakers were Jessica Luzier, Ph.D., clinical director, West Virginia University Disordered Eating Center; Alexis Duncan, Ph.D., associate professor of public health, Washington University's Brown School; and Gail Schoenbach, a patient in recovery and Eatings Disorders Coalition board member who also serves as the executive director of FREED — For Recovery and the Elimination of Eating Disorders — and the Start To Advocate Today Foundation.

In October, 65 members of the U.S. Senate and House of Representatives sent bipartisan letters of support to the Center for Disease Control urging the agency to include eating disorders surveillance questions within the CDC's national surveillance systems.