Which of the following is not an oral sign of bulimia nervosa?

Severe gingival swelling is not typically considered an oral sign of bulimia nervosa. Bulimia nervosa is characterized by recurrent episodes of binge eating followed by compensatory behaviors, such as self-induced vomiting, which can lead to specific oral health issues.

The enlarged parotid glands are often associated with the frequent vomiting, as the salivary glands can become swollen due to the body’s response to the repeated purging. Dental erosion occurs as a result of the acidic contents of vomit repeatedly coming into contact with the teeth, leading to the wearing away of enamel. Xerostomia, or dry mouth, can also occur due to dehydration from the vomiting and reduced saliva production.

In contrast, severe gingival swelling is more often related to gingivitis or periodontal diseases, which are not directly tied to the behaviors associated with bulimia nervosa. Thus, while the other signs indicate oral health issues directly linked to the consequences of bulimic behaviors, severe gingival swelling does not fit within that context.