Bulimia nervosa and oral health

Bulimia nervosa, an eating disorder characterized by episodes of binging on large amounts of food followed by purging through self-induced vomiting to control weight, not only damages the body but also causes problems inside the mouth.

Professors at the Texas A&M University Baylor College of Dentistry say the acid that comes up during vomiting episodes can have a devastating effect on one of the hardest tissues in the mouth — tooth enamel.

Oral complications associated with bulimia include erosion of the teeth, bleeding gums, cavities and loosened fillings. In addition, braces and temporary restorations may not stay on the teeth because stomach acid will dissolve the temporary cement used to keep these materials in place.

Naturally, the most important advice is to seek the help of a physician in overcoming the disorder. Meanwhile, to prevent further wearing of the teeth, sufferers should rinse the mouth frequently with water.

“Water is best, as is gentle brushing with a fluoride toothpaste,” says Dr. Charles W. Wakefield, professor and director of the Advanced Education in General Dentistry Residency Program at TAMBCD. “It is thought that more excessive wear of teeth occurs immediately after purging because stomach acid softens tooth enamel and makes it more susceptible to rapid wear.”

Sufferers also are advised to reduce sugar in the diet, brush and floss properly, chew sugarless gum to increase salivary flow or use artificial saliva, and apply fluoride either in toothpastes, rinses or gels to reduce sensitivity of teeth and build resistance to decay from acid.

“Patients should never sip drinks with high acidity, which include all carbonated drinks of both regular and diet varieties, sports drinks, new energy drinks, fruit juices, and water with lemon juice added,” Dr. Wakefield says. “Dentists have materials they can prescribe to make teeth more acid-resistant and also help remineralize them — or stop the erosion process — once the habit is discontinued.