Pica combined with bulimia can have adverse effects on an individual’s oral health during pregnancy and also can be hard to diagnose and treat during those nine months, according to a study published in the May/June 2006 issue of General Dentistry, the Academy of General Dentistry’s (AGD) clinical, peer-reviewed journal.

Pica, usually a secretive behavior, is a compulsive eating disorder in which sufferers have a constant appetite for non-nutritious substances. Bulimia is a condition in which patients overeat and then purge due to a fear of gaining weight. While the conditions’ association and cause during pregnancy are not known, many suggest cultural and physiological factors are to blame. Others believe depression or iron and zinc deficiencies during pregnancy could be a factor.

“Eating disorders can cause serious erosion of the tooth’s enamel, as well as sensitivity, thinning, and chipping,” says Paula Jones, DDS, FAGD, AGD spokesperson. “Dentists can detect the signs and provide patients with treatment options.”

While women often believe they should avoid dental care during pregnancy, it is very important for those suffering from eating disorders to continue with their dental visits. “Dentists are often the first to witness the physical effects of an eating disorder on an individual’s oral health,” says Dr. Jones. “Many of those who suffer will not self-report the problem.”

If the problem is not reported, eventually the medical and dental complications will force the patient to seek help. In these cases, the dentist will work with other health care professionals to make the appropriate referrals and manage the patient’s care.