Oral signs and symptoms in the diagnosis of bulimia.

Bulimia is an eating disorder disease that presents difficulties in its diagnosis, primarily because of the secretive nature of the person with the disease. The disease is most common in young females, and there is an average of a 4-year delay between the onset of the disease and the patient's self-referral for treatment. Objective oral signs and symptoms of bulimia do exist and their presence can facilitate a diagnosis of bulimia during routine examination. The realization that five oral signs and symptoms of bulimia--enamel erosion, salivary gland enlargement, xerostomia, oral mucosal erythema, and cheilosis--are associated with the disease can eliminate some laboratory tests as well as facilitate an earlier diagnosis of bulimia.