There are various side effects that occur when a person is struggling with bulimia nervosa.
One of these is dental damage and enamel erosion. When an individual is binging and purging, the acidity from the bile that comes up affects dental health.
How Does Vomiting Affect Teeth?
When a person self-induces vomiting after a binge, large amounts of stomach acids are also brought up.
Acid can break down and wear away the enamel of a person’s teeth. This is the first line of defense that covers and protects a person’s teeth.
Enamel works to protect teeth from decay, sensitivity, and tooth fractures. As the enamel is worn down, a person may start to have a sensitivity to hot and cold foods or even breathing in different air temperatures.
Once this outer layer is gone, damage to the dentin or the second layer of the tooth structure occurs. This is the layer that protects the nerve endings . If this layer is damaged, it cannot be left untreated and unprotected.
With continued purging, changes in color and texture of a person’s teeth may occur. The teeth can become almost clear in color in some cases. As the layers of the teeth break down, teeth can become weaker, more brittle, and can be prone to fracture .
Not only are the teeth affected, but so is the gingival tissue in the mouth which can lead to painful sores. Some individuals who struggle with bulimia may have a higher risk of infections in the mouth as well.
Treating Dental Decay
Being able to care for your teeth is extremely important if you struggle with bulimia. Getting professional cleanings and using proper home treatment is essential. Including this care and a Dentist on your treatment team for your eating disorder treatment is essential.
Being able to get routine cleanings can help maintain the remaining tooth structure and gingival tissue in the mouth that has not been compromised by the eating disorder.
Often the dentist will prescribe and use fluoride treatments in the office and daily home applications as well. This can aid in re-mineralization of the enamel.
Ceasing purging is recommended when recovering from bulimia, but if there is a setback or continued purging, rinsing your mouth with water immediately after can help rid our mouth of acids.
It is not recommended, although it is believed, that brushing your teeth directly after a purge will help.
It does not, but actually, can cause further damage to the tooth enamel .
Also, using high fluoride toothpaste, with doctor’s permission, can be purchased over-the-counter and used when regular brushings are done.
Once purging has stopped, teeth can be repaired using various methods, and depending on the severity of the damage.
One treatment option is composite filling restorations or white fillings, porcelain laminates, or full crowns. In some extreme cases, pulling teeth and using implants may be necessary to protect the health of the rest of the mouth.
Severe purging can not only damage a person’s teeth, but also the way they bite, or the way the upper and lower teeth come together .
Some teeth, especially in the back can change in size or lost forever. It can take approximately three years of erosion on the teeth to become apparent.
A person may experience dry mouth after purging as well, and some doctors recommend drinking water or using saliva replacements that can be prescribed by a dentist .
Also, if treatment is just beginning or purging continues, the dentist can talk with your treatment team and give an appliance that covers the teeth and protects it from stomach acids.
Swelling and inflammation of the salivary glands can cause less saliva, or dry mouth to occur. Saliva is a protectant for the teeth, and without it, more infections, erosion, and cavities can develop .
What Can Be Done at Home
When caring for your teeth at home, ideally a person needs to be brushing their teeth two times per day and with a recommended or prescribed toothpaste from their dentist.
Use floss, and clean between the teeth and gum line. After a purge, rinse the mouth out with water, or fluoride mouthwash (if prescribed).
If a person is consuming sugary drinks or foods, again wash the mouth out with water or fluoride mouthwash. The individual can also brush their teeth prior to eating, or wait at least 1 hour before brushing after consuming sugary foods or liquids .
Reversing the damage from binging and purging can be done, based on the duration and severity of the eating disorder. Sometimes teeth may have to be pulled and replaced with bridges to keep the mouth and teeth healthy.
Working with your treatment team and dental provider can help you make the best choices and educated decisions on your oral health. Being upfront with your dental provider can help protect your teeth and mouth from further damage.
About the Author: Libby Lyons is a Licensed Clinical Social Worker and Certified Eating Disorder Specialist (CEDS). Libby has been practicing in the field of eating disorders, addictions, depression, anxiety and other comorbid issues in various agencies. Libby has previously worked as a contractor for the United States Air Force Domestic Violence Program, Saint Louis University Student Health and Counseling, Saint Louis Behavioral Medicine Institute Eating Disorders Program, and has been in Private Practice.
Libby currently works as a counselor at Fontbonne University and is a Adjunct Professor at Saint Louis University, and is a contributing author for Addiction Hope and Eating Disorder Hope. Libby lives in the St. Louis area with her husband and two daughters. She enjoys spending time with her family, running, and watching movies.
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 Bulimia. (2003, February 24). Retrieved August 26, 2017, from http://www.colgate.com/en/us/oc/oral-health/conditions/anorexia-bulimia/article/bulimia
 Bulimia and Teeth. (2017, May 01). Retrieved August 26, 2017, from http://eatingdisorders.com/articles/bulimia/bulimia-and-teeth
 Bulimia: Caring For Your Teeth. (n.d.). Retrieved August 26, 2017, from http://eating-disorders.org.uk/information/caring-for-your-teeth/
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 November 14, 2017.
Reviewed By: Jacquelyn Ekern, MS, LPC on November 14, 2017.
Published on EatingDisorderHope.com