Bulimia and Oral Health

Bulimia is both an eating and psychiatric compulsive disorder. Periods of normal eating are followed by dieting or severe restrictions of food intake. Weight gain is controlled by self-induced vomiting, vigorous exercise, fasting, and abuse of diuretics or laxatives. While dentists do not treat eating disorders, they do treat the physical damage to oral structures that results. Technically, binge-eating episodes must occur at least twice a week for 3 months to be diagnosed as bulimia nervosa. Often, dentists are the first to diagnose bulimia because the self-induced nausea washes the teeth with acids and erodes the enamel on the  tongue-surfaces of the teeth.

Signs & Symptoms of Bulimia

• Braces and temporary restorations may not stay on the teeth because the acid will dissolve the cement used to keep these materials in place.
• Callouses near the first knuckle of the index finger due to pushing against the upper teeth to induce vomiting.
• Changing weight gain of 5-20 pounds per week.
• Chronic gum chewing (7-8 packs/day) and the compulsive use of mouthwash.
• Dizziness, thirst, and fainting due to dehydration.
• Dry lips and skin around the mouth.
• Dry mouth from decreased salivary flow and parotid gland dysfunction.
• Enamel erosion of all teeth due to the chronic exposure to acid in vomit.
• Excessive tooth brushing.
• Heartburn and abdominal pain.
• Ice chewing and nail biting.
• Increase in occurrence of cavities
• Increase in diet soda intake (10-12 cans/day).
• Muscle cramps and weakness.
• Silver fillings will appear raised due to erosion of the teeth.
• Small, purplish-red lesions on the palate from objects used to induce vomiting.
• Swollen lymphnodes and parotid gland enlargement.
• Teeth may be discolored or look dull from the acid.
• Tooth sensitivity and sore throat.
• Broken blood vessels in and around eyes due to the strain of repeated vomiting.