"Smile while you still have teeth" - an adage we come across way too often.

Let us straighten this once and for all - a white pearly smile is always not just about those white teeth that you see. These pearls are supported unconditionally by small yet significant pink parts called as the gums.

As simple as it may seem, taking perfect care of these gums is not child's play. Those people who see these pink areas bleeding incessantly even on the gentlest brushing every morning will know what i am talking about. This bleeding condition of gums is called as Gingivitis.

If ignored, it can further lead to a condition called peridontitis where the very foundation of the tooth becomes diseased. The tooth becomes loose; there is an ugly exposure of the tooth and soon the ugly possibility of the tooth popping out in its entirety!

It is just not about the appearance-imagine your teeth planing their own gala movements in their sockets while you are just getting started on your peristaltic movements! This weakened support invites various harmful bacteria to enter through your blood because bacteria are just looking for an easy way to enter your body and make you sick!

This passage becomes way more welcoming to these unfriendly bacteria when the person's immunity is low. The immunity can be low due to various diseases that the person might be suffering from Diabetes, AIDS, persons on immunosuppression drugs of physiologic states like pregnancy. 

It might sound bizarre but the sixth most important complication of Diabetes is periodontitis! To paint a clearer picture-diet restrictions, regular exercise regime coupled with frequent rants about how difficult it is to chew all those foods that you do not even like! The bacteria once in the blood can enter many other important organs in your body like the heart and cause diseases like infective endocarditis which you definitely do not want.

Apart from all these, there are a significant group of people who are ignored in this category of  diseases associated with periodontitis. This is not about those people who live to eat even to live. Diagnosed with various eating disorders, it stems from their underlying negative body image and anxiety. They struggle day in and day out to just eat normally and lead a very normal life.

The most common eating disorders are:

  •  Anorexia nervosa
  •  Binge eating
  •  Bulimia nervosa

Anorexia nervosa

Anorexia nervosa is an eating disorder in which the person constantly sees themselves as overweight, when in reality they are extremely underweight. Due to this they constantly limit themselves from eating normally. This group has the hugest mortality rate under the psychiatric disorders.  This is because the overall nutrition uptake is stunted to dangerously low levels.

Binge eating

Binge eating is about those who lose control over eating. These people are obese as they eat morbidly large amounts of food at a time and continue to eat so even when they are no longer hungry. This state of hunger is frequently linked to various underlying psychological problems like stress. This uncontrollable eating episode is often followed by a pang of guilt - which leads to stress, and to cope with it, they eat yet again - and so on continues the cycle.

Bulimia nervosa

Bulimia nervosa is another form of binge eating where the people over-eat uncomfortably, followed by either forced vomiting or laxative intake to force the ingested food out of their bodies. This succeeding act gives them a sense of satisfaction making them feel that they will not put on weight. This frequent vomiting - clinically presenting with normal weight - is associated with sore throat,  gastroesophageal reflux disease (GERD), swollen salivary glands etc. due to frequent acid regurgitation.

People suffering from these eating disorders, primarily suffer from underlying psychological issues. They tend to isolate themselves from society as people have frequently ridiculed mental illness. This attached social stigma prevents them from seeking any professional help at the earliest and mainly, ignoring any dentally associated problems to the state they can no longer flaunt their natural yet perfect smile.

Periodontitis in these people is fairly common yet easily ignored. Anorexia nervosa renders the person malnourished, due to which there is mucosal palloer, dryness of mouth etc., which further makes the teeth carious - prone and causes accelerated again of the periodontium. Binge eating presents with severe attrition of teeth due to frequent mastication and stress associated bruxism.  Bulimia nervosa exposes the person to reddish inflammation of the mouth, swollen salivary tonsils, sore throat and burning sensation in mouth.

The importance of these dental findings - DO NOT IGNORE THEM. So muster the courage to take that little trip to your dentist's office with your headphones on, ignoring the society's unsolicited, unrequited advice. Your dentist will definitely help you out.

The treatment involves the coming of various fraternities together - psychiatrist, nutritionist, lifestyle coach, dentist and a very supportive group of family and friends. Self help and support enables speedy recovery and well-being of the person. Moreover, this would also bring us one step closer to understanding mental illness and developing a holistic approach to improving their health, wellness and function.

We all have our inner demons. Just remember that you do not have to fight them alone. Let us be a part of the battle. We, as dentists, will not disappoint you-we are more then willing to go that mile to brighten up that perfect smile of yours.