When engaged in bulimia nervosa, caring for teeth becomes an uphill battle. Dental problems are early signs of engagement in purging (vomiting).
How Bulimia Harms Teeth
In purging, stomach acid rushes out of the body along with food. The acid comes in contact with the teeth on its way, wearing away at tooth enamel. As loss of enamel increases, teeth become sensitive (as the underlying dentin is exposed, and eventually the tooth's nerve itself), decayed (since enamel is a key defense against tooth decay), and unattractive.
Damage is not immediate; it can take two or three years to appear. But when it does, it's easy for dentists to spot.
Restoring Damage to Teeth From Bulimia
What a dentist does to fix the teeth (after he refers his patient to eating disorder treatment) depends on the severity of the damage. In more moderate cases, the dentist can cover the affected tooth surfaces with a protective layer of resin-based composite. For severe damage, some teeth can be crowned. But in more difficult cases, teeth must be replaced -- either individually, or by construction of complete dentures.
Many dentists will not perform cosmetic work on teeth if a patient is not in recovery from bulimia. Continuing to purge will eventually erode the teeth under crowns and other repairs, potentially forcing a whole new round of repairs (or tooth removal).
Care for Your Teeth in the Face of Bulimia
If you've been neglecting your teeth as you binge and purge, here are some notes on how you can begin to limit the damage.
- Get treatment for your eating disorder.
- Make an appointment with your dentist.
- Avoid brushing teeth after vomiting. This accelerates the wearing of enamel.
- Instead of brushing, rinse with water after purging.
- Some dentists recommend:
- Flouride rinse to add minerals to the enamel and neutralize acids
- 1,200-1,500 milligrams of calcium per day
- Desensitizing toothpaste for when you do brush
- Brushing with a flouridated toothpaste before vomiting for added protection
- Avoiding acidic foods and drinks like citrus fruits and coffee
The Bottom Line
Caring for your teeth is a way to care for you, and this can be hard for many when they don't believe they deserve it. But without care, damage to teeth from bulimia can leave a person with expensive, painful, and time-consuming problems.
More health problems with bulimia nervosa
Health problems with other eating disorders
Sources:
Bouquot JE, Seime RJ. Bulimia nervosa: Dental perspectives. Pract Perio Aesth Dent 9 (1997): 655-664.
Christensen GJ. Oral care for patients with bulimia. Journal of the American Dental Association 133 (2002): 1689-1691.
National Institute of Mental Health. [link url=http://www.nimh.nih.gov/health/publications/eating-disorders/bulimia-nervosa.shtml]"Bulimia Nervosa." Reviewed June 26, 2008. Accessed 3 November 2008.
