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What are the effects of anorexia on teeth and oral health?

Anorexia nervosa (AN) may be a mental health disorder, but it can have a number of physical consequences, including an impact on dental health.

Tooth loss, tooth erosion, and tooth enamel damage are all possible, and may be difficult to reverse. So it's important to take as good care of your oral health as possible, whether or not you struggle with AN.

 minute read
Last updated on 
June 9, 2023
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In this article

What are the effects of anorexia on teeth?

One of the biggest reasons anorexia nervosa and other eating disorders affect oral health is the lack of proper nutrients being received by the body. People with AN commonly restrict food, which can lead to a lack of key vitamins and minerals needed to promote oral health.

Calcium is often the most impactful of these minerals, as it plays a big role in building strong teeth. Without enough calcium, teeth are at risk of decay. However, to absorb calcium, the body also needs sufficient levels of vitamin D.

Those with anorexia nervosa also tend to have low levels of iron and vitamin B, which can lead to additional issues.

And those who struggle with purging-type anorexia nervosa, which involves purging behaviors such as self-induced vomiting, may encounter even more risks to their oral health, since this frequently introduces corrosive stomach acid into the oral cavity.2

Side effects of anorexia nervosa on teeth and gum health

Anorexia nervosa can promote poor oral hygiene, and is associated with many side effects and complications on teeth and gum health, including: 

  • Chronic dry mouth (xerostomia): Anorexia nervosa has been connected to xerostomia, or dry mouth. This could lead to issues with chewing and swallowing, as well as tooth decay and fungal infection in extreme cases.5,6
  • Tooth decay: Food restriction is also generally tied to nutrient deficiencies, including a lack of calcium, iron, and B vitamins. This can promote tooth decay. If someone struggles with purging-type anorexia nervosa, frequent vomiting, or brushing of teeth thereafter, can also contribute to this issue.1
  • Gum disease: The same type of nutritional deficiencies that lead to tooth decay can also contribute to gum disease in patients with anorexia nervosa.1 
  • Gingivitis: Gingivitis is a common type of mild gum disease which can cause tender gums that bleed easily, often when brushing or flossing. It’s also been linked to disordered eating behaviors.1
  • Angular cheilitis/exfoliative cheilitis: The continuous peeling of the lips, also known as exfoliative cheilitis, and the inflammation of the small cracks in the corners of the mouth, known as angular cheilitis, have both been connected to disordered eating behaviors.7
  • Degenerative arthritis within the jaw: Degenerative arthritis, also called osteoarthritis, is when the cartilage and tissues surrounding a joint wear down. People with anorexia can develop degenerative arthritis in the temporomandibular joint, also known as temporomandibular joint dysfunction (TMJ) where the lower jaw attaches to the skull.Signs and symptoms of this arthritis include pain, swelling, and stiffness of the jaw.1

How to treat oral problems associated with anorexia nervosa

Dental treatment for anorexia teeth will vary depending on the individual and the specific problem at hand.

The first step is often addressing the potential for any long-term damage, such as tooth decay or gum disease. In the early stages of tooth decay, a dentist may suggest a fluoride treatment to prevent further loss of the tooth’s enamel. If the teeth have more decay, the individual may need a filling or crown to replace the missing enamel and stop further damage.

If the tooth pulp is damaged, the dentist could perform a root canal to remove it and clear any infections. In rare situations, when a tooth is severely decayed, it may require a tooth extraction.

If the dentist needs to remove a tooth, dental implants can replace the missing tooth.3 Dentists will typically do a deep cleaning using special instruments to clean under the gum line to treat gum disease.4

Tips to avoid further damage during eating disorder recovery 

For someone struggling with AN or bulimia nervosa (BN), brushing the teeth and gums directly after purging can further damage the mouth. Instead, an individual can:8

  • Gently rinse with water and a sugar-free, alcohol-free mouthwash 
  • Wash the mouth with water or fluoride solution
  • Gargle with basic solutions, such as baking soda

If teeth must be brushed, it’s better to wait at least an hour before doing so, to avoid causing more damage. Using basic, alkaline toothpaste and avoiding sugary foods and drinks can also help cut down on potential damage.8

Dentists may also generally suggest using a fluoride rinse to use at home to help prevent further decay and strengthen enamel. And maintaining proper oral hygiene practices, such as brushing and flossing daily, is essential. 

Finding help for anorexia nervosa

Often, dental professionals are among the first people to notice signs of anorexia nervosa and other eating disorders. Individuals with AN who are experiencing mouth discomfort or noticing changes in their teeth and gums should consult with their dentist for treatment.

Help for anorexia is available

Within's remote treatment program is designed to help each individual with their specific needs, and give them a space to feel heard, understood, and start the healing process. Contact the Within Health admissions team to take the first step on this road to recovery.

Call (866) 293-0041

It’s essential for people to be honest with dentists if they struggle with an eating disorder. Anything discussed with a dentist remains confidential, and the dental office should feel like a safe resource during the healing process. 

But there are many other options for those looking for help, including comprehensive treatment plans that fold in different aspects of therapy, nutritional education, and medical support.

Disclaimer about "overeating": Within Health hesitatingly uses the word "overeating" because it is the term currently associated with this condition in society, however, we believe it inherently overlooks the various psychological aspects of this condition which are often interconnected with internalized diet culture, and a restrictive mindset about food. For the remainder of this piece, we will therefore be putting "overeating" in quotations to recognize that the diagnosis itself pathologizes behavior that is potentially hardwired and adaptive to a restrictive mindset.

Disclaimer about weight loss drugs: Within does not endorse the use of any weight loss drug or behavior and seeks to provide education on the insidious nature of diet culture. We understand the complex nature of disordered eating and eating disorders and strongly encourage anyone engaging in these behaviors to reach out for help as soon as possible. No statement should be taken as healthcare advice. All healthcare decisions should be made with your individual healthcare provider.


  1. Dental complications of eating disorders. (2018, February 22). National Eating Disorders Association. Retrieved January 2022.
  2. Uhlen, M. M., Tveit, A. B., Refsholt Stenhagen, K., & Mulic, A. (2014). Self-induced vomiting and dental erosion – a clinical study. BMC Oral Health, 14(1).
  3. Cavities/Tooth Decay. (2017, July 19). Mayo Clinic. Retrieved January 31, 2022.
  4. Reiff Ellis, R. How to know if you have gum disease and what to do about it. WebMD. Retrieved January 2022.
  5. Montecchi, P.P., Custureri, V., Polimeni, A. et al. (2003). Oral manifestations in a group of young patients with anorexia nervosa. Eating and Weight Disorders, 8, 164-167.
  6. Dental Health. National Institute of Dental and Craniofacial Research. Accessed June 2023.
  7. Lesar, T., Vidović Juras, D., Tomić, M., Čimić, S., & Kraljević Šimunković, S. (2022). Oral Changes in Pediatric Patients with Eating Disorders. Acta Clinica Croatica, 61(2), 185–192.
  8. Olliffe, K. Bulimia: Caring For Your Teeth. National Centre for Eating Disorders (UK). Accessed June 2023.


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