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May 18, 2017

Addressing Dental Concerns in Bulimia Recovery

Woman Receiving A Dental Cleaning

Contributor: Marge Crotty, Director of Nursing at Timberline Knolls.

Medical, psychiatric, and nutritional stabilization are high priorities while in recovery from bulimia, particularly during the more acute phases of the recovery process.

The dangerous and perpetual binge/purge cycle associated with bulimia results in medical complications that must be addressed in treatment, including electrolyte imbalances, irregular heartbeat, gastrointestinal distress and more. However, another direct consequence of bulimia involves damage to the teeth, which can create a host of difficulties in itself, including problems chewing, eating, low self-esteem, an increased incidence of periodontal disease, and more.

How Bulimia Impacts Dental Health

Adverse dental issues can arise in individuals who self-induce vomiting as a means of purging. The recurring exposure of stomach acid to the teeth can cause the tooth enamel to erode, which can increase the risk for decay and teeth sensitivity. However, the complications do not end there.

Research that studied women with bulimia has identified a variety of oral and pharyngeal signs and symptoms, including [1]:

  • Tooth erosion
  • Dental pain
  • Increased levels of cariogenic bacteria
  • Chronic dry-mouth
  • Mouth sores
  • Loss of gum tissue
  • Decreased saliva secretion
  • Orthodontic abnormalities
  • Swallowing impairments

While dental erosion is one of the major findings in individuals with bulimia due to recurring vomiting episodes, repeated bingeing also impacts dental health, increasing risk of dental cavities and infection.

With the cessation of bulimic behaviors, the majority of these dental concerns can be reversed, with the exception of cavities and tooth erosion, which require professional repairment of damaged surfaces. This aspect of bulimia recovery is often postponed until bingeing and purging behaviors have subsided and are controlled. For these reasons, it is crucial to prioritize professional and comprehensive treatment for bulimia prior to seeking out dental treatment and restoration.

Dental Interventions for Restoration

Young Man Receiving A Dental CleaningOnce comprehensive treatment for bulimia has been sought, dental treatments should be acquired in order to address any complications. This may include restorative work to repair erosion, tooth loss, and cavities. Some of the common dental treatments needed for bulimic women may include veneers, bonded crowns, composites, or complete-coverage restorations [2].

Ideally, dentists assisting with repair work should interface with eating disorder treatment specialists for comprehensive management and to prevent further enamel destruction; however, it is difficult to predict if relapse will occur after treatment and intervention. Other treatments to prevent further enamel deterioration may include fluoride treatments to prevent further demineralization.

The cost of dental treatments can be overwhelming for an individual recovering from bulimia, especially after paying for treatment. However, dental interventions are necessary as part of the treatment process and for overall health and wellness.

If you have struggled with dental concerns relating to your eating disorder, be sure to seek out the care and recommendations of a specialist. Many dentists can also work on a payment plan or provide financial assistance to ensure you are able to get the care you need to restore your dental health as part of your recovery from bulimia.


Marge CrottyAbout the author: As Director of Nursing at Timberline Knolls Residential Treatment Center, Marge provides leadership, vision, direction and supervision to those who interact with the residents 24 hours a day. She works closely with the entire treatment team to move each woman or girl toward recovery from her disorder or addiction.

Marge has 30 years of practical and managerial experience in teen and adult psychiatric nursing. Prior to Timberline Knolls, she served as manager of clinical operations for the Department of Psychiatric and Substance Abuse Services at Advocate Christ Medical Center in Illinois. She was responsible for the planning, management, implementation and evaluation of operations of a 46-bed psychiatric unit.


[1]: Bretz, W. A. (2002). Oral profiles of bulimic women: Diagnosis and management. What is the evidence? The Journal of Evidence-Based Dental Practice, 2(4), 267–272.
[2]: Woodmansey KF. Recognition of bulimia nervosa in dental patients: implications for dental care providers. Gen Dent. 2000;48:48–52.

The opinions and views of our guest contributors are shared to provide a broad perspective of eating disorders. These are not necessarily the views of Eating Disorder Hope, but an effort to offer discussion of various issues by different concerned individuals.

We at Eating Disorder Hope understand that eating disorders result from a combination of environmental and genetic factors. If you or a loved one are suffering from an eating disorder, please know that there is hope for you, and seek immediate professional help.

Published on May 18, 2017.
Reviewed By: Jacquelyn Ekern, MS, LPC on May 18, 2017.
Published on EatingDisorderHope.com

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