Oral signs of frequent vomiting in anorexia

The key to early diagnosis of anorexia nervosa could be in the oral cavity, where signs of frequent voluntary and/or involuntary vomiting may be found. These effects of vomiting include chemical erosion of tooth structure due to high acidity of the vomitus; dentinal sensitivity due to the loss of tooth enamel, and sialadenitis due to electrolyte disturbances. Sialadenitis may result in xerostomia. Abnormalities of the tooth structure include erosion of the buccal and labial aspects of the incisors, cuspids and premolars, and erosion of the occlusal aspects of premolars and molars. Amalgam restorations may have a raised appearance. Suspicion of anorexia should be aroused when an emaciated patient, particulary a female adolescent or young adult, has these oral signs.