Bulimia

Dentists often can see oral changes in people with bulimia. These changes include:

Swollen salivary glands
A dry, red, sore tongue
A sore throat that doesn't go away
Small bruises on the roof of the mouth

Frequent vomiting can erode the tooth enamel. This happens most often on the tongue side of the upper front teeth. When the enamel wears away, the tooth is at risk for decay. It also can be sensitive to cold or heat. If the enamel erosion is severe, it can change the way your upper and lower teeth come together. The back teeth may actually shrink. Some teeth can even be lost. Tooth erosion can take about three years to become obvious. Not all people with bulimia will have it.

Many people with bulimia may be malnourished. This can lead to poor healing. It also increases a person's risk of periodontal (gum) disease.

Even after you start treatment for your bulimia, it can take a while to control the vomiting episodes. To minimize the damage done by stomach acid when you vomit, rinse your mouth with water or with a mouthwash containing fluoride. Don't brush your teeth immediately after vomiting. Stomach acid weakens tooth enamel, and brushing can wear away the enamel. When you do brush, use toothpaste that contains highly concentrated fluoride. Fluoride helps to strengthen teeth. Your dentist can prescribe daily fluoride treatments with rinses or gels.

Drink water to help with dry mouth. Your dentist also can prescribe saliva replacements.

Your dentist may give you fluoride treatments (varnishes) during your dental visits. He or she may prescribe a fluoride gel for you to use at home. Visit your dentist regularly.

Dental treatment can be an important part of treating your bulimia. Your dentist will work with your health care team. If you have severe tooth damage and are being treated for bulimia, your dentist may 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 fixed. Some teeth may need fillings. Others may need crowns. Severely damaged teeth might need to be removed. Lost teeth can be replaced with bridges or implants.

Some conditions (such as depression, anxiety disorders and social disorders) tend to occur with bulimia. People with bulimia also may be addicted to drugs or other substances. These conditions, and the medicines used to treat them, also can affect your oral health. Let your dentist know which medicines you are taking, as well as their dosages.