People with bulimia often binge on food and feel a loss of control. They use means such as vomiting or abusing laxatives to keep from gaining weight. Many, but not all, people with bulimia also have anorexia nervosa. Bulimia affects women more than men and most often affects teenage girls.
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
- Wearing away of tooth enamel
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 also may increase their risk of developing 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. Brushing weakened enamel can wear it away. 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.
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 restored. Some teeth may need fillings and others may need crowns. Severely damaged teeth might need to be removed. Lost teeth can be replaced with bridges or implants.
Several other conditions tend to occur with bulimia. They include depression, anxiety disorders and social disorders. People who suffer from bulimia also may have other health issues such as being 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.