Bulimia and Oral Health

Bulimia nervosa is most commonly diagnosed in women between the ages of 18 and 30, who have had a history of obesity. This eating disorder as well as being a psychiatric disorder affects the whole body physically and specially the oral health. Due to the physical changes that result in the oral structures, many times dentists are the first to diagnose bulimia.

The disorder is characterized by an obsessive desire to loose weight. Binge eating, self-induced vomiting, vigorous exercise, and abuse of laxatives accomplish weight loss. The frequent exposure of the teeth to stomach acids (hydrochloric acid) in vomit, chemically dissolve the enamel. The teeth appear to be very thin, especially on the tongue side, and fillings appear raised due to enamel erosion. The eroded surfaces result in sensitivity of most of the teeth. As the disorder progresses, the weakened teeth are more susceptible to cavities and infections.

Bulimia results in discolored, shortened, weak teeth that can affect a person’s self-esteem as a result, the person becomes less reluctant to smile. Other typical dental findings in individuals suffering with bulimia include dry mouth and enlarged parotid gland. These glands are located at the back corners of the lower jaw on the lower sides of the face. With continued vomiting, the glands become hard and enlarged. Usually two fingers are used to induce vomiting, and sores on fingers are another sign of the bulimic. The sores form as the fingers are pushed against the upper front teeth.

There is usually a lot of shame involved in the process of throwing up to loose weight along with taking laxatives and enemas. Bulimics hide their actions so well, even close relatives oftentimes don’t know it exists. Depression is usually present as the disorder progress. If left untreated medically, complications such as kidney and urinary tract infections, cardiovascular problems and even death can result.

If needed dental care is not treated, eroded, weakened teeth result in cavities, infections, and loss of teeth. If the vomiting continues, crowns are the only treatment that will withstand the corrosive affects of the stomach acids. However, crowns may eventually form decay under them resulting in pulp degeneration.

Once the person has been treated medically for bulimia, porcelain crowns and fillings will help render a beautiful and healthy smile. It’s important to practice proper hygiene. Before, during and after medical treatment for bulimia oral health care products that will neutralize acids should be used. Toothpastes that contain baking soda such as Grace FibroSmile Oral Health Care Products are effective. Toothpastes with strong tartar control ingredients may erode the teeth even further and cause more sensitivity.

Family and friends should encourage the bulimic to seek not only medical and psychiatric treatment, but also dental care to prevent serious problems and loss of teeth in the future.

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Written by Flora Parsa Stay DDS

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