Bulimia

Bulimia as Destructive to Teeth as Body

Dentists diagnose life-threatening disorder through oral damage

NEW YORK, N.Y. – Although the trend in modeling is thankfully moving away from the malnourished look of the early 90s, one glance at the movie or television screen shows there is still an ultra-skinny trend in entertainment. This pattern isn’t lost on adolescents either – one study found that 30% of girls who sought to look like movie stars were likely to develop an eating disorder. But interestingly, dentistry is the medical field that often identifies one of the most common but under-detected disorders.

Nearly 1.5 million women in the United States suffer from bulimia, and twenty-eight percent of cases are first diagnosed during dental examinations. Bulimia is characterized by binge-eating and then purging – very often through vomiting. And when teeth are repeatedly bathed in acid from the stomach, the teeth’s enamel begins to erode causing sensitivity, extensive decay, thinning and chipping.

"It may seem like ordinary tooth decay to that individual or their friends and family, but dental erosion from vomiting follows a very different pattern that many dental professionals recognize," says New York dentist Dr. Clifford Williams. "Ordinary tooth decay occurs more often on the biting surface of the back teeth in the form of a crevice or hole. Dental erosion, however, occurs primarily on the inside of the front teeth, which eventually might cause them to appear rotted and crumbling, especially around the biting edges."

Bulimics who vomit may purge from several to more than a dozen times a day, dissolving the enamel and exposing the ugly yellow dentin layer underneath leading to pain and possible root canal problems. But if this discomfort is what prompts someone to visit the dentist, it may be too late. "Once the dentin is exposed, the tooth erodes very quickly," continues Dr. Williams, whose cosmetic practice sees a tremendous amount of female patients. "Since you can’t replace the enamel, the next step is often extensive reconstructive dentistry."

But if the bulimia continues, the acid will eventually disrupt and possibly even loosen the existing restorations. "Repairing teeth from the effects of bulimia is expensive, but it’s not a reason for which I ever want to see someone in my dental chair."

Dr. Williams strongly encourages any person with bulimia to see an appropriate health professional immediately. But even after treatment begins, he recommends seeing your dentist to discuss restoration options, reminding patients that the enamel on their teeth will not regenerate and once it’s gone, that’s it.

Until a person seeks help, however, Dr. Williams and the Academy of General Dentistry offer these recommendations for preserving one’s teeth:

• After vomiting, immediately rinse your mouth with soda water or other bicarbonate to help neutralize the stomach acids.
• If soda water is not available, at the very least rinse your mouth and teeth thoroughly with water.
• If you are using a mouthwash, make sure it is sugar-free. Stomach acid will instantly soften the enamel allowing sugar to speed up erosion.
• Because the acid softens the enamel, be very careful brushing your teeth immediately after purging. Use only use a soft-bristled brush with very gently strokes.
• Try to avoid soft drinks or juices that contain a lot of acids, as this will only promote further decay in a weakened tooth.

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