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Bulimia

Oral Effects
The dental changes seen in many people with bulimia are often recognizable. Frequent vomiting may cause your salivary glands to swell and the tissues of your mouth and tongue to become dry, red and sore. People with bulimia may have chronic sore throat and small hemorrhages under the skin of the palate.

Frequent vomiting can erode your tooth enamel, especially on the tongue side of the upper front teeth. This sharply increases the risk for decay in these areas and can make these teeth sensitive to temperature. Severe erosion can lead to changes in your bite, or the way your upper and lower teeth come together. Your back teeth can be reduced in size and some teeth can even be lost eventually. Tooth erosion can take about three years to become obvious, but not all bulimics experience it.

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

During the treatment of your eating disorder, it may take a while to control the episodes of induced vomiting. To minimize damage done by stomach acid during episodes of vomiting, rinse your mouth with baking soda mixed in water. You also should rinse with a mouthwash containing .05 percent fluoride, which your dentist can prescribe. Don't brush your teeth immediately after vomiting because stomach acid weakens tooth enamel and brushing can cause erosion of the enamel. When you do brush, use a toothpaste that contains fluoride. Fluoride helps strengthen teeth.

To help  dry mouth, drink water to keep your mouth moist. There are also saliva replacements your dentist can prescribe. Your dentist can prescribe daily fluoride treatments with prescription-strength rinses or gels.

At the Dentist
If you are bulimic, your dentist may give you fluoride treatments during your dental visits and may prescribe a fluoride gel for home use. Visit your dentist regularly; he or she can detect decay or infections.

Dental treatment can be an important part of treatment for your bulimia. Your dentist will work with your health care team and together you can coordinate dental treatment with treatment for the eating disorder. If you have severe tooth damage and are still undergoing treatment for bulimia, your dentist may be able to give you an appliance that covers your teeth and protects them from stomach acids.

Once your bulimia is under control, you may need to have some of your teeth restored. If the enamel loss is stopped at an early stage, it can be replaced using materials called composite resin or amalgam. More severe erosion will require tooth extraction. Lost teeth can be replaced with bridges or implants.

Some conditions 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.

2/24/2003

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