Bulimia nervosa is an eating disorder that is characterized by binge eating followed by purging behavior. Purging behavior can include forced vomiting, taking diuretics or laxatives, or excessive exercise. Individuals with bulimia indulge in purging behavior in order to rid their bodies of all the extra calories they have consumed during the binge.
Over time, the constant cycles of bingeing and purging have a severe impact on your heart, kidneys, and other organs. However, perhaps the biggest damage of bulimia happens to the teeth. Read on to find out the impact of bulimia on teeth.
Overview of Bulimia Nervosa
Bulimia nervosa, commonly known as bulimia only, is one of the most well-known eating disorders. This is a severe mental health condition that can be life-threatening if left untreated. Bulimia is typically characterized by binging on a large amount of food, followed by purging behavior.(1, 2, 3) Purging can happen in several ways, including forced or self-induced vomiting, taking laxatives or diuretics, extreme fasting or dieting, or excessive exercise. People with bulimia display purge behaviors, and they tend to follow a binge-and-purge cycle.(4, 5, 6)
Individuals with bulimia are usually found to have an unrealistic body image, and they are obsessed with their weight. They are also intensely critical of themselves. Many people with bulimia are often of normal weight or sometimes even underweight. This makes it challenging for family and friends to notice the signs of the eating disorder.(7)
Research shows that around 0.5 percent of men and 1.5 percent of women experience bulimia at some point in their life. Bulimia is most commonly observed in women, especially in the teenage and early adult years. Approximately 20 percent of college-age women report symptoms of bulimia. Athletes whose weights and bodies are closely watched, models, dancers, actors, and performers have been found to be at a greater risk for developing eating disorders like bulimia.(8)
Impact Of Purging Due To Bulimia On Your Teeth And Mouth
Repeated vomiting can cause severe damage to your teeth. Vomit is known to be toxic because it contains stomach acids. Stomach acids help break down the food in your stomach to allow the body to digest it easily. However, when these stomach acids are present in the mouth, they become corrosive. In fact, they can be so corrosive that they can wear away at the enamel that protects and covers your teeth. Brushing your teeth too roughly or too hard after vomiting can also cause tooth decay.
Here are some of the impacts of bulimia on your teeth:
- Cavities: The stomach acids from regular vomiting can cause wear and tear of the tooth enamel to such an extent that it can leave a hole or cavity. Furthermore, binging on sugary foods and beverages can also lead to tooth decay. When you have tooth decay, you might find that your gums start bleeding when you brush. If you do not get the cavity filled, the hole will become bigger over time, and you can end up losing that tooth.(9)
- Yellow and Brittle Teeth: Regular vomiting can make tooth erosion worse. You will notice that the texture and color of your teeth change. Your teeth may also become more brittle and weaker than usual. They may look ragged at the bottom, and the teeth may chip easily. In some people, the teeth become yellowish and take on a glassy look. Bulimia can also cause changes to the length and shape of your teeth.(10)
- Mouth Sores: As mentioned above, stomach acid wears away at the enamel of the teeth. Similarly, it can also erode away the skin present on the sides and roof of your mouth. This can cause damage to your throat and leave painful sores inside the throat and mouth. These sores can get inflamed and even get infected. Some people might even feel like they have a persistent sore throat.(11)
- Inflamed Salivary Glands: The stomach acid present in vomit can cause irritation to the glands located on the sides of your cheeks. These glands are responsible for producing saliva, which is the essential fluid that helps you swallow. It also protects your teeth from decay. You will notice there is swelling around your jawline if your salivary glands are affected due to bulimia.(12) While most changes to your teeth caused by bulimia are not reversible, swelling of the salivary glands does go down once you stop bingeing and purging and seek treatment for the swelling.
- Dry Mouth: A lack of saliva due to bulimia can constantly make you feel like your mouth is dry or dehydrated. This condition is known as dry mouth, and though you might think this is a minor inconvenience, it is actually much more than that as it affects the way you eat by altering the taste of food. Dry mouth also damages the teeth because saliva present inside the mouth helps wash away the bacteria that cause tooth decay. Having a dry mouth means you don’t have saliva present in the mouth, and it can make any existing tooth decay from bulimia much worse.(13)
- Toothache: As you start to lose the tooth enamel, it exposes the sensitive inner part of the teeth. You will start to notice your teeth hurting as the enamel wears away. Many people will experience sensitivity and pain when eating or drinking hot or cold food and drinks. They may feel pain or discomfort whenever they eat something hot, or they have some ice cream.(14)
Can These Dental Problems Due to Bulimia Be Treated?
Many of your dental symptoms that stem from bulimia will go away on their own once you seek treatment for your eating disorder. The short-term treatment for any dental problem caused by bulimia is to treat the specific dental condition. Your dentist will fill up the cavities, repair any broken or chipped teeth, and educate you on how to take proper care of your gums.
The long-term solution to these dental problems, of course, is to seek treatment for your bulimia. Remember that dental repairs can only help you to a certain extent if you continue to indulge in purging.(15, 16)
Apart from causing internal damage to your organs and bodily systems, eating disorders like bulimia can cause long-term damage and visible side effects on the body. If left untreated, bulimia can even result in death. The mouth and teeth are at a high risk for decay and infection, which can cause you a significant amount of pain and also appear unsightly. If you or someone you know has bulimia, it is important to seek help from a medical professional. Seeking help is the first step you can take to prevent irreparable damage to your teeth and body.
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- Fairburn, C.G. and Beglin, S.J., 1990. Studies of the epidemiology of bulimia nervosa. The American journal of psychiatry.
- Keel, P.K., Mitchell, J.E., Miller, K.B., Davis, T.L. and Crow, S.J., 1999. Long-term outcome of bulimia nervosa. Archives of general psychiatry, 56(1), pp.63-69.
- Garner, D.M., Rockert, W. and Davis, R., 1993. Therapy for bulimia nervosa. The American Journal of Psychiatry, 150(1), pp.37-46.
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- Keel, P.K., Wolfe, B.E., Liddle, R.A., De Young, K.P. and Jimerson, D.C., 2007. Clinical features and physiological response to a test meal in purging disorder and bulimia nervosa. Archives of general psychiatry, 64(9), pp.1058-1066.
- National Institute of Mental Health (NIMH). 2021. Eating Disorders. [online] Available at: <https://www.nimh.nih.gov/health/statistics/eating-disorders> [Accessed 27 December 2021].
- DeBate, R.D., Tedesco, L.A. and Kerschbaum, W.E., 2005. Knowledge of oral and physical manifestations of anorexia and bulimia nervosa among dentists and dental hygienists. Journal of dental education, 69(3), pp.346-354.
- Milosevic, A. and Jones, C., 1996. Use of resin-bonded ceramic crowns in a bulimic patient with severe tooth erosion. Quintessence International, 27(2).
- Dippel, N.M. and Becknal, B.K., 1987. Bulimia. Journal of psychosocial nursing and mental health services, 25(9), pp.12-16.
- Vavrina, J., Müller, W. and Gebbers, J.O., 1994. Enlargement of salivary glands in bulimia. The Journal of Laryngology & Otology, 108(6), pp.516-518.
- Dynesen, A.W., Bardow, A., Petersson, B., Nielsen, L.R. and Nauntofte, B., 2008. Salivary changes and dental erosion in bulimia nervosa. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology, 106(5), pp.696-707.
- Otsu, M., Hamura, A., Ishikawa, Y., Karibe, H., Ichijyo, T. and Yoshinaga, Y., 2014. Factors affecting the dental erosion severity of patients with eating disorders.
- BioPsychoSocial medicine, 8(1), pp.1-7.
- Simmons, M.S., Grayden, S.K. and Mitchell, J.E., 1986. The need for psychiatric-dental liaison in the treatment of bulimia. The American journal of psychiatry.
- Kirkley, B.G., Schneider, J.A., Agras, W.S. and Bachman, J.A., 1985. Comparison of two group treatments for bulimia. Journal of Consulting and Clinical Psychology, 53(1), p.43.