Childhood Eating Disorders and Oral Health

With childhood obesity and food allergies and sensitivities on a consistent rise among American children, parents are becoming more and more aware of how they feed their children and how often. Sometimes there is more to a child’s diet than merely monitoring and influencing positive choices and habits. Unfortunately, health professionals are seeing eating disorders develop in children even under the age of 12, which is most commonly seen as a prepubescent time when the body is changing. Understanding the cause of eating disorders among children is a complicated task, and even the most skilled and experienced experts cannot offer definitive reasoning or explanation as to why and how they tend to develop other than a collection of hypotheses. What we do know, however, is how certain eating disorders in children and young adults can affect dental health, and the signs to look for in order to prevent major oral hygiene issues in a parent’s and child’s future.

Most Common Childhood Eating Disorders

Many parents will deal with a child who is fussy about food or eating, but eating disorders are different from pickiness or dislike of certain foods. In fact, eating disorders are a form of mental illness, rather than just emotions or adverse thoughts towards food. The most common eating disorders found among minors are:

• Anorexia: eating very little food, attempting to achieve very low body weight, intense fear of body fat, obsessive thoughts about food and calories, distorted body image, or body dysmorphia disorder.
• Bulimia: uncontrollable overeating, binge eating for hours at a time, intentional purging by forced vomiting, taking laxatives, and over-exercising, obsession with body weight and shape.
• Binge eating: often called BED (binge eating disorder), overeating without the ability to control intake or stop, eating large amounts of food when not hungry, high bodyweight, guilt after eating.
• ARFID: stands for avoidant/restrictive food intake disorder, highly sensitive to certain foods due to texture, taste, or smell, not interested in food, often skip meals, not obsessed with body weight, and don’t have poor body image.

Children who develop these eating orders will all eventually face health issues as adolescence is a time when the body goes through many significant changes. Those with eating disorders are most likely to have one or more mental illnesses such as OCD, depression, and anxiety, along with stunted growth, malnutrition, heart health issues, abnormal blood panels, and much more.

Eating Disorders and Teeth

If the young developing body is not receiving the essential nutrients it needs, soft tissues in the body, including the gums and other parts of the mouth, can become inflamed and bleed easily. Some eating disorders can cause chronic dry mouth, which is particularly harmful to teeth and gums, giving way to cavities, gum disease, and even tooth loss.

Eating disorders that involve recurrent binge eating episodes can be harmful to teeth due to the amount of food that passes through the teeth and mouth. Since the foods that are chosen are often “junk food” choices, the sugar and acidity content will usually be higher than of typical, healthy meals. Long binges can also cause cracked or damaged teeth, as sometimes chewing on candy or crunchy and hard foods can feel satisfying physically, and they are unable to stop before they notice a tooth has been cracked.

Children who have bulimia are particularly at risk of harming their teeth permanently at a very young age. By vomiting frequently, sometimes many times in a single day, they are introducing potent stomach acids to the mouth regularly, washing it over their teeth. Many with bulimia will attempt to mask the smell of vomit or food on their breath by brushing very frequently, which, when coupled with constant vomiting, is the perfect recipe for permanent enamel damage.

Monitoring and Prevention Tips

No parent wants to experience seeing their child suffer or be in pain. Sometimes, illnesses like eating disorders are silent, and not always very noticeable even to the most doting parent. The most common ages for eating disorders are between 15 and 25 years old, but some children can develop them as young as 12 and younger. Most eating disorders arise from a combination of emotional, social, and physical issues that need to be identified in order to prevent them.

The first and most important goal for parents is to promote healthy attitudes and habits surrounding food and body acceptance. However, even with shining examples from their parents, children can still fall into disordered eating habits through outside influences or due to other personal issues. Sometimes eating disorders can manifest as a coping mechanism caused by different kinds of trauma, utterly unrelated to body image, as well. Parents should be on the lookout for specific changes in their children’s demeanor if they suspect they may be dealing with an eating disorder:

• Sudden change in diet, strong dislikes/likes
• Eating only certain foods
• Not eating with the family or in front of others
• Frequent trips to the bathroom during meals
• Changes in bodyweight
• Junk food wrappers are hidden away
• Wearing loose-fitting or unseasonal clothing
• Use of food scales or frequent weighing
• Fixation on a particular area of the body, thighs, stomach, or arms
• The smell of vomit in the bathroom
• Weak or thinning hair
• Dull complexion and bloodshot eyes
• Cracked lips and canker sores
• Withdrawal from social activities or hobbies
• Spending a lot of time alone
• Large sums of money spent on buying food

Dentists can also be allies to parents when it comes to recognizing signs of eating disorders. Not only are dentists able to spot signs of frequent vomiting or unusual wear and tear on the teeth and gums, but they can also offer some remedial efforts to curb the damage to the teeth while the child seeks therapy. There are specific fluoride treatments and enamel protecting gels that can aid in preserving the tooth health of children who are suffering from an eating disorder to help with harm reduction as they work to improve their health.