DENTAL ASPECTS OF BULIMIA-NERVOSA - IMPLICATIONS FOR THE HEALTH-CARE TEAM

This paper reviews the published literature regarding the oral signs a nd symptoms of bulimia nervosa and discusses the benefits of involving the dental profession in the early identification of suspected cases. It is argued that the primary care dental team can act as a valuable resource to mental health professionals provided that liaison and mutu al education take place. The oral manifestations of bulimia nervosa in clude increased levels of dental caries, sensitivity to hot and cold s ubstances, dry mouth, enamel erosion and occasionally swelling of the parotid salivary gland. These signs can develop within six months of t he onset of bulimia nervosa. The general dental practitioner is ideall y placed to pick up these early warning signs. The oral condition may be controlled through local measures but the true value of the involve ment of the dental practitioner may only be realized if they are made aware of the importance of early referral for specialist advice and ma nagement of the underlying condition and the consequent improvement in prognosis. Recent work has suggested that many dental practitioners a re unaware of oral signs that may indicate the existence of bulimia ne rvosa and tend to restrict management to the local oral problem.