Teenagers often have the worst diets and are the most difficult age to counsel. Peer pressure, weight control, rapid growth, hormones, and stress challenge the body and mind both psychologically and physically. Pizza, burgers, and soda and energy drinks hardly begin to provide the basic nutritional needs. Females by this time have reached their maximum linear growth and begin to increase their percentage of body fat. Males on the other hand are still building muscle and bone mass, so their calorie needs will be much higher. When counseling this age, appeal to body image and encourage healthy snacks-nuts, popcorn, cereal, cheese, and fruit. Educate teenagers, with the use of visual aids, about the negative effects of soda and energy drink consumption on tooth and bone health. Better options include flavored sparkling and fitness waters, 100% fruit juice, and low-fat milk.7

Anorexia nervosa, bulimia nervosa, and binge eating, is a bio-physio-social illness that affects 8 million Americans – seven million woman and one million males annually. Patients suffering from eating disorders may use a combination of starvation, purging, and/or binging. Orally, erosion is normally limited to the lingual surfaces of the maxillary anterior teeth. Chronic regurgitation caused by purging may also cause sensitivity due to the exposure of dentin.1

Image 15: Image of erosion of teeth from chronic vomiting
Erosion caused by chronic vomiting in bulimia.
Image source: ©2003 Lippincott Williams & Wilkins.

Treatment options include medical intervention, psychological and nutritional counseling, behavior modification, fluoride treatments, and sodium bicarbonate rinses.7