Bulimia is an eating disorder in which a person binges (eats a large amount of food in a short period of time) and purges, or tries to compensate for the amount of food eaten, by vomiting, using laxatives or diuretics, and/or exercising excessively. What many people do not realize is that self-induced vomiting can lead to many serious health problems such as ulcers, gastrointestinal problems, anemia, irregular menstrual cycles, blood pressure irregularities, and many dental problems. This article will focus on the dental ramifications of this condition.
How Self-Induced Vomiting Affects Teeth
When you vomit, large amounts of stomach acids are brought up. These acids can wear away your dental enamel (the outermost covering of a tooth). The enamel protects the tooth from decay, sensitivity, and tooth fractures. As the enamel is worn away a patient may experience tooth sensitivity whenever they eat hot or cold foods. Even breathing in cold air may elicit the same sensitivity. Once the outer layer of enamel disappears, damage to your dentin (the second layer of tooth structure that protects the nerve), can occur. The dentine is more prone to break down and cannot be left untreated and unprotected in your mouth.
Vomiting may also causes changes to the tooth color and/or texture. Teeth may appear almost clear in color. As tooth erosion progresses your teeth may become weaker, more brittle, and prone to fracture. Your teeth may chip more easily and look ragged at the ends.
The high acid content can also wear away gingival tissue in your mouth and can leave painful sores. Sometimes gingival surgeries are required to repair the missing tissue. People who suffer from bulimia often have a higher risk of decay as well as a higher probability of infections of the mouth.
Oral Manifestations (Recognizing Bulimia Teeth Damage)
Dental professionals, including dentists, and dental hygienists, can frequently detect oral manifestations of bulimia. Smooth outer surface erosion can be seen on dental examinations. Teeth may have a smooth glassy appearance void of stains or lines. Frequently the maxillary (top) teeth will be worn on the palate (tongue) surface. These teeth become more susceptible to decay and infection, requiring some form of dental treatment and maintenance.
Dental Treatment Protocol
Professional cleanings with a dental hygienist and proper home care are very important. Routine cleanings can help maintain the remaining tooth structure and gingival tissue. In office fluoride treatments as well as daily home applications can promote the re-mineralization of enamel. Rinsing your mouth with water immediately after vomiting can reduce the amount of acids in your mouth.
One important fact many people do not realize is that it is a bad idea to brush your teeth immediately after vomiting. This can cause further abrasion to tooth enamel. Simply rinsing your mouth with water is recommended instead. Alternatively, you can rinse your mouth with a mixture of water and baking soda which will neutralize the acids in your mouth.
High fluoride toothpaste can be purchased at your drug store. Your dentist may also recommend a prescription strength toothpaste to aid with sensitivity and help repair your teeth.
Once self-induced vomiting is halted, the teeth can be restored in a number of ways depending on the severity of destruction. Treatment can vary from composite filling restorations (white filling), to porcelain laminates (veneer), to full coverage crowns. In the most extreme cases, extractions with dental implants may be indicated.
Dentists are in an excellent position to pick up on signs and symptoms of bulimia. There are effective treatments for bulimia and other eating disorders and a referral to a treatment professional could save a patient’s life. If someone is underage and exhibits signs of bulimia, it is the dentist’s responsibility to inform the patient’s parent or guardian.
As you can see, good dental care is very important for people with bulimia. If you have bulimia, you may feel embarrassed to see a dentist about any problems with your teeth, but you need to see a dentist regularly in order to prevent tooth loss as well as prevent or treat painful dental problems. Any experienced dentist has seen patients with bulimia before and you don’t need to feel ashamed about having bulimia. You may want to ask someone you trust to go with you.
Etiology of dental erosion – Intrinsic factors
Petra Scheutzel, Volume 104, Issue 2, 178-190, April 1996
About The Author:
Dr. Scott Russ has practiced General and Cosmetic Dentistry at his Long Island office since 1991. Dr. Russ is an expert in surgical implant placement and restorative dentistry.