**Content warning: This post includes discussion of purging behaviors. Please use your discretion when reading and speak with your support system as needed. The following information is not intended as dental or medical advice or as a substitute for professional treatment.
With over 14 years’ experience, Dr. Kumar Kolar is a dentist in London, England. He is focused on empowering readers to learn about their dental health and have confidence in their teeth and smile. You can learn more about him on his website and read more of his articles on his blog.
Like all eating disorders, bulimia nervosa is a mental health disorder that also affects the well-being of our physical bodies. One of the first places that exhibits physical signs of damage is the mouth and teeth. People with bulimia may experience pain, discomfort, and sensitivity when chewing as a result of bulimic behaviors.
Bulimia is characterized by bingeing, or eating unusually large amounts of food in a single episode, and purging. Feelings of shame and disgust often accompany these binge eating episodes, leading to compensatory behaviors such as self-induced vomiting, laxative abuse, over-exercising, and/or restricting food.
Interestingly, the damage to dental health is not primarily caused by bingeing. Though acid from food can destroy teeth and create cavities, saliva provides a natural defense to this acid. Saliva washes away, dilutes and neutralizes the acid, and thus protects the teeth from harm. Therefore, most of the dental complications of bulimia are not caused by bingeing but rather purging behaviors.
The stomach is packed with some of the most potent acids in the body. When vomiting, these acids enter the mouth and erode the enamel as well as the layer directly beneath the enamel, called dentin. This progressive damage thins these outer layers of teeth, making them brittle, weak, and sensitive.
Laxatives and diuretics remove water from the body, which can lead to dehydration. With dehydration comes reduced saliva and swollen salivary glands. Less saliva weakens the defense to bacteria and acids in the mouth.
Excessive exercise and restriction—especially when fluids are restricted—also contribute to dehydration. Sugary sports drinks can cause further damage without the natural protection of saliva. Dehydration can also lead to cracking in the corners of the lips, as well as fungal and bacterial infections.
Some common signs of dental complications related to bulimia include:
It can be daunting to visit a dentist, but dentists are there to support you and keep your teeth healthy. Most dentists have been trained to recognize the signs of eating disorders in their patients, and they will understand the impact of these disorders on your teeth.
Your dentist will be able to record the condition of your teeth, which will serve as a baseline for reference at future appointments. The baseline records may include x-rays, photographs, and intraoral scans.
Next, dentists will be able to give you personalized preventative advice and work with you to make sure it works. If you are suffering with pain or the appearance of your teeth, they can help with this as well.
It’s important to find a dentist you have a connection with so that you have confidence in the service they are providing. If you don’t have a good experience the first time, don’t give up on dentists; look for another one.
Eating disorders can cause serious long-term damage not only to your teeth, but to your overall physical, mental, and emotional health. But these disorders don’t have to be permanent. Recovery is possible. If you or a loved one are struggling, reach out to The Emily Program at 1-888-364-5977.
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