Bulimia Nervosa

By: J. Shahangian, DDS, MS- San Diego Board Certified Pediatric Dentist

Bulimia Nervosa
Estimates show that out of 100,000 people, 14 suffer from bulimia nervosa.  This eating disorder mainly affects women and adolescents.  If left untreated, your child could develop serious problems with their teeth.  Statistics show that one third of people who suffer from bulimia have a history of obesity, and the other third of have a history of anorexia nervosa.

Bulimia nervosa has several symptoms that include periods of regular eating followed by extreme food intake restrictions, and binge eating.  In order for a diagnosis of Bulimia to be made, the person must have at least two episodes of binge eating twice a week for three months.  The person will use self-induced vomiting, arduous exercise, strict fasting, and abuse diuretics and laxatives to control his/ her weight.

Recurrent episodes of self-induced vomiting can cause teeth erosion due to acid found in vomit.  The reason why bulimia nervosa leads to an increase in cavities is due to dry mouth that is associated due to decrease salivary flow and parotid gland dysfunction.  Saliva helps prevent cavities because it cleans the mouth.  If there is a decrease in saliva production, then there is a higher propensity for developing cavities.  Lastly, binge eating causes an excessive intake of carbohydrates which makes the person more likely to develop cavities.
There are other signs and symptoms of bulimia nervosa such as purplish-red abrasions on their palate because of chronic use of objects for inducting vomiting.  Other complications including the raising of the silver fillings due to teeth erosion, and the inability of temporary restorations and braces to stay attached to the teeth because of acid dissolving the cement used to keep the teeth in place.  Lastly, the teeth may look dull or discolored due to the acid.

Instead of brushing your teeth after vomiting, it is better to rinse out your mouth with water.  I recommend using a basic rinse such as baking soda with water, which helps to neutralize the acid.  To remove plaque, I recommend that you properly floss and brush your teeth.  To increase saliva production, I recommend chewing sugarless gum.  To increase your resistance to tooth decay and to also reduce your teeth sensitivity, I recommend that your brush your child’s teeth with fluoride toothpaste or mouth rinse.[1]