Confronting eating disorders in the dental chair: Advice from an eating disorder survivor

As dental professionals, you are placed in an awkward situation when you notice a patient with the clinical signs of an eating disorder. You may be unsure about how best to approach the issue without offending or scaring off your patient from your practice. You may also be hesitant to treat the patient until he or she has admitted to having a problem.

Regardless of how you are feeling, direct and honest communication is key. I can attest to this as someone who suffered from an undetected eating disorder for 15 years, from ages 12 to 27. As a result of my disorder, I suffered severe and irreversible damage to my teeth from purging.

Although I am not a dental professional, I believe that my experience from a patient’s perspective during my 15-year struggle with an eating disorder could be helpful to dental professionals who are likely to encounter patients like me at some point in their practices. I was fortunate to find an extremely skilled and knowledgeable dental professional to help restore my smile, but it took several years, a lot of dental work, and a lot of money to get to a place where I can finally say I am free from pain and confident about my smile.

There were times throughout my eating disorder journey when I encountered dental professionals who were ill-prepared to have a patient with an eating disorder in their dental chair. I say this not to criticize these dentists, but because I believe dentistry suffers from a lack of standard and effective protocol for confronting eating disorders, which leaves clinicians unprepared and unclear about how best to help their patients. As a result, some patients have fallen through the cracks—like I did—such that their teeth are irreversibly damaged.

Most importantly, I believe it is essential that the dental professional use direct communication and clear language to confront patients in a gentle way about the unusual damage eating disorders inflict on their teeth. When talking to patients, directly mention an eating disorder as a possible cause for the damage. Avoid terms such as bulimic or anorexic, because these words may make the patient feel stigmatized or defined by his or her eating disorder. Direct communication is so important, because you may be the only medical professional who notices the symptoms that are indicative of an eating disorder.