Screening for Eating Disorders in Dental Settings

Key Oral Warning Signs to Identify

Parotid gland enlargement presenting as swollen cheeks or jawline, caused by repeated self-induced vomiting stimulating salivary gland hypertrophy, is a sign of eating disorders 1
Dental enamel erosion particularly on lingual surfaces of maxillary anterior teeth, resulting from repeated acid exposure from gastric contents, is a common finding in patients with eating disorders 1
Russell's sign (calluses or scarring on the dorsum of the hand from self-induced vomiting) is a physical finding associated with eating disorders 1
Dental caries and poor gum health secondary to acid exposure and nutritional deficiencies are oral manifestations of eating disorders 1
Hair thinning or lanugo-like facial hair indicating malnutrition is a sign of eating disorders 1

The American Psychiatric Association recommends screening for eating disorders as part of initial evaluations, a principle that extends to dental settings 2
The American Psychiatric Association suggests assessing weight history patterns, including recent weight changes, maximum and minimum weights, when screening for eating disorders 2
Eating behavior patterns, including restrictive eating, food avoidance, or binge eating, should be assessed when screening for eating disorders, as recommended by the American Psychiatric Association 2
Compensatory behaviors, such as purging, excessive exercise, or laxative use, should be evaluated when screening for eating disorders, according to the American Psychiatric Association 2
Preoccupation with food, weight, and body shape as a percentage of daily thoughts should be assessed when screening for eating disorders, as recommended by the American Psychiatric Association 2
Psychosocial impairment secondary to eating or body image concerns should be evaluated when screening for eating disorders, according to the American Psychiatric Association 2

Adolescents aged 12 and above should receive routine screening for eating disorders at initial visits and periodic intervals, as recommended by Clinical Nutrition 4
Patients with Type 1 diabetes require particularly careful screening for eating disorders, as they carry substantially higher mortality risk, according to Diabetes Care 5
Patients with unexplained poor glycemic control or recurrent hospitalizations (in diabetic patients) should be screened for eating disorders, as recommended by Diabetes Care 5