The first sign of an eating disorder is often seen in the mouth! Let’s chat about the oral connections of eating disorders in National Eating Disorder Awareness Week

The two most well-known eating disorders are anorexia and bulimia.  If an individual has anorexia,  he or she has a fear of gaining weight even though he or she is often underweight.  In order to deal with this fear, he or she will restrict their food intake or change his or her lifestyle to accommodate excessive exercising.  Some individuals will even turn to using laxatives or diuretics.  When an individual has bulimia, he or she goes through cycles of binge eating several times a week or even several times a day.  Since the individual consumes excessive amounts of food, he or she turns to self-induced vomiting, laxative use or diuretics to remove the food.  

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Eating disorders are often attributed to cultural and peer pressures for ideal body images portrayed in the media.  Other than the social-cultural factors, there are also other biological,  genetic, psychological causes.  Eating disorders can affect everyone; however, it is most common in teens and young adults.  Women are more likely to suffer from these disorders than men. The disorder does not only affect an individual’s quality of life and self-image, but also upsets personal relationships with family and friends.  The individual’s performance in sports and school may also suffer.  The sooner you are aware your child’s eating disorder,  the faster he or she can get the help and support needed and better the outcome.

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Some signs you can look to in the mouth suggesting an eating disorder are:

  • the teeth will change color, shape and length and may become brittle, translucent and weak due to nutritional deficiencies or

  • loss of tissue and erosions on the teeth due to stomach acid (this can happen as soon as 6 months after the beginning of the eating disorder)

  • tooth decay (aggravated by extensive brushing and rinsing after vomiting)

  • increased sensitivity to temperature of food and drink

  • dry mouth and lips with cracking seen

  • spontaneous tooth pain

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Some other signs related to the body are:

  • severe weight loss

  • abnormal eating patterns

  • hair loss

  • constipation

  • feeling cold

  • loss of menses

We, as dentists, may be the first to notice an eating disorder as changes in the child’s mouth are often the first signs of an eating disorder. A child with an eating disorder is at risk for numerous health complications beyond the mouth such as; kidney failure, heart conditions and even death if the eating disorder progresses without treatment.   Even if you do not notice any signs for an eating disorder, keeping up with your child’s regular examinations will allow us to detect any tell- tale alterations in the oral cavity over time.    Together, we can help your child by realizing the situation and  initiating interventions and  treatment.

Copyright 2014 The Children’s Oral Care Centre

Today is World Cancer Day. Unfortunately many children are undergoing cancer treatments not only today but every day. Oral hygiene for children who are undergoing cancer treatments and ways you can make them more comfortable during this time and keep their smiles shining bright!

Anyone undergoing cancer treatments has to deal with many challenges; you can only imagine what it is like for a child to go through.  The cancer itself can cause symptoms that are unfavorable but the treatments that are meant to help you also create barriers for an individual’s quality of life.  Nausea and vomiting along with hair loss are common side effects of cancer therapy but did you know that one third of individuals who are being treated for cancers develop complications in their mouth?  Even though the treatments of childhood cancers are becoming more and more effective with survival rates above 70% in parts of North America,  no one wants to see a child go through cancer treatments.  That’s why knowing proper mouth care is an integral part that can help make a child’s treatment experience more comfortable.

Oral complications can range from pain, difficulty swallowing, mucositis, infections and poor nutrition.

Cytotoxic therapies or chemotherapy work by targeting the rapidly dividing cells of your body which is how they suppress that out of control cancer.  However, they are often not specific to the tumor cells and will damage other rapidly dividing cells within your body.  The cells of your mucous membrane (like your gum) are therefore especially prone to inflammation and ulceration or the condition known as mucositis.  This can cause lesions in the mouth which then predispose the individual to fungal and viral infections and very serious systemic complications. These drugs can also dry up your mouth because it changes the flow and make up of saliva, leading to taste issues, difficulty chewing, swallowing, speech problems, dental caries and potential for premature tooth loss. Although it may seem like there is a lot going on and it is easy to let other things slide in the process, dental hygiene is one that should remain a priority for any child undergoing chemotherapy and radiation.

The American Academy of Pediatric Dentistry has put together some guidelines for the oral care of a child throughout their treatment regimen:

Before treatment begins it is important to stabilize any oral health issues and resolve any lingering sources of infection and local irritants in the mouth to prevent delaying the initiation of treatment and the potential for complications.  Your child’s cancer care team should include a dentist to help save his or her teeth and make he or she feel the best they can before starting treatments as any oral issues will be the last thing you want to worry about.  Prevention is important and therefore you must ensure he or she has good oral hygiene habits which include; brushing teeth and tongue 2-3 times a day and avoiding using any alcohol based products in the mouth as it can be dehydrating for the tissues and cause discomfort.  Ensure that if your child has orthodontic appliances or space maintainers that they fit impeccably or they can cause damage to the sensitive tissues.

During treatment it is important to maintain oral hygiene even if you have to be a little creative.  Sometimes the mouth can become so sensitive that brushing with a normal toothbrush is not a pleasant experience.  If this is the case, you may try using to an ultrasoft toothbrush softened by warm water or foam brush soaked in chlorhexidine.   Electric toothbrushes can be used as long as the child is able to use it without causing any trauma or irritation to his or her tissues.  Brushing after every meal is recommended and flossing once a day is important.  Choosing soft and easy to chew foods that are not too spicy, sour or crunchy will help alleviate pain to tender tissues.

If your child has signs of mucositis this can be managed by maintaining oral hygiene, analgesics, non-medicated oral rinses, mucosal coating agents or film-forming agents.  For a sore mouth and throat a simple solution is to rinse the mouth with ¼ teaspoon of baking soda, ¼ teaspoon of salt in a liter of warm water (making sure not to swallow).  In order to help with the dry mouth you can offer sugar-free gum or candy, saliva substitutes, sipping on water or oral moisturizers. If the child is having problems eating you can inquire about medications to numb the oral cavity so they are able to get the nutrients they need to help them get through this tough time.  You will want to check your child’s mouth every day and if you see any sores, swelling, bleeding, pain or a sticky white film you will want to call your cancer care team and notify them.

After treatment ceases it is important to maintain oral hygiene and keep your eyes out for long term consequences of the treatments in order to manage these effectively going forward.

Children who undergo cancer treatments are so resilient and inspirational to all of us.  We make it a priority to help their quality of life during this difficult time in any way we can.   Let’s keep our kids smiling bright while they fight against cancer through any tough times ahead!

cancer1Copyright 2014 The Children’s Oral Care Centre