Bulimia Nervosa Causing Unknown Threat to Oral Health: A Comprehensive Review
Owen R. Thornton *
Department of Psychology and Neuroscience, UNC Chapel Hill, Chapel Hill, NC, USA.
Wenjun Li
Department of Craniofacial Biomedicine, UNC Chapel Hill, Chapel Hill, NC, USA.
*Author to whom correspondence should be addressed.
Abstract
Bulimia nervosa (BN) is a severe psychiatric disorder characterized by recurrent episodes of binge eating followed by compensatory behaviors, such as self-induced vomiting, misuse of laxatives, and excessive exercise. The oral and dental repercussions of BN can be profound, and dental professionals are often the first healthcare providers to detect clinical signs associated with this condition. Despite growing awareness, BN remains underdiagnosed in the dental setting due to insufficient knowledge of its systemic and oral manifestations, as well as the stigma attached to mental health disorders. This comprehensive review aims to provide an in-depth analysis of bulimia nervosa, highlighting the key oral manifestations, diagnostic tools, interdisciplinary treatment approaches, and the role of the dental practitioner in early identification and management. Recent literature (from 2010 onward) is synthesized to offer evidence-based insights, guiding clinical practice and promoting better patient outcomes. The ethical and legal considerations relevant to managing patients with BN are also discussed.
This review concludes by underscoring the importance of an integrated, multidisciplinary approach and the need for further research to refine preventive strategies and optimize patient care.
Keywords: Bulimia nervosa, dental erosion, binge–purge cycles, oral health, early detection, dental management, interdisciplinary care, eating disorders