Oral Manifestations of Bulimia

Teeth eroded away by stomach acid

You would be surprised to know how many people suffer from Bulimia because they are often able to hide it from there friends.  It is more difficult to conceal the secret from your dentist because of the signs which show in the mouth.

Ten manifestations of Bulimia are:

1.    Smooth enamel without stain or loss of enamel and dentine from the biting surfaces and inner surfaces of the teeth.  This is the result of erosion the effect of the stomach acid dissolving the teeth away by repeated vomiting.

2.    The teeth are highly prone to decay, and become sensitive and may even have nerve damage requiring root canal therapy.

3.    The margins of fillings in the back teeth may appear higher than the surfaces of the tooth enamel in the surrounding tooth.

4.    The cheeks at the corner of the jaw may become enlarged because the Parotid gland swells.  This swelling is common in bulimics.  The enlargement of the gland is related to the duration and severity of vomiting.

5.    Dry mouth is also a common symptom of Bulimia.  The amount of saliva secreted is effected by abuse of laxatives, by diuretics, and by dehydration from fasting and vomiting.

6.    Gum tissue trauma and changes in the character of the gums.  This condition is due to ingesting large amounts of food and by the force of vomiting. also by the presence of the irritant of gastric juices in the mouth.  If objects are used to force vomiting they can injury the soft pallet.  Dehydration will effect gum tissue.

7.    It is not uncommon for irritated areas or a callus to develop on the top surface of right or left forefinger or the back of the hand.  This is caused by rubbing the finger or back of the hand on the incisal edges of the upper anterior teeth while inducing vomiting.

8.    There are conditions which tend to occur with bulimia. For example, three-fourths of bulimics have serious anxiety disorders, and many experience depression. People with bulimia may also develop alcohol or drug dependencies. These conditions can also affect your dental health and any medications to treat them may affect your dental treatment plan. Make your dentist aware of any medications you are taking, as well as their doses.

9.    Many people with bulimia may have chronic sore throat and small hemorrhages under the skin of the palate.  They also may have swallowing impairments.

10.    Many people with bulimia may be malnourished, which can cause anemia, poor healing and increase the risk of periodontal disease.

Ten aspects of Dental Treatment Protocol for Bulimia

1.    Start with rigorous hygiene and home care.

2.    Frequent regular professional dental cleanings , with In-office fluoride applications to prevent further erosion and decrease dentin sensitivity.

3.    Daily home application of fluoride in custom trays to neutralize acids and to promote remineralization of the enamel.

4.    Rinsing their mouth with water immediately after vomiting to decrease the acidity in the mouth, and with a bicarbonate of soda solution to neutralize the acid completely.

5.     Do NOT brush teeth after vomiting, it will lead to excessive enamel erosion.

6.     Commitment to professional treatment.

7.     Use desensitizing toothpaste to decrease dentinal sensitivity.

8.     Esthetic treatment should not be done during the active phase of this disorder.  Restoring esthetics can be done in the recovery stage.  When treating during RECOVERY their teeth may need to be restored to normal appearance.

9.     To help  dry mouth, drink water to keep your mouth moist.

10.    There are also saliva replacements your dentist can prescribe if necessary.

Crowns protecting upper teeth 


Crowns protecting lower teeth