Although eating disorders are often accompanied by a variety of physical and emotional complications, perhaps the most painful are those leading to severe dental problems. To be sure, there is some overlap with respect to the specific impact each type of eating disorder has on our teeth and mouth.

The list of dental complications for each eating disorder is listed below:

•Loss of tissue and erosive lesions on the surface of teeth due to the corrosive effects of acid [Bulimia]
•Changes in color, shape, and length of teeth. Teeth becoming brittle, translucent, and weak. [Anorexia, Bulimia]
•Increased sensitivity to temperature. In some instances exposing the pulp and leading to infection, discoloration, or death of the tooth [Anorexia, Bulimia, Binge Eating Disorder]
•Enlargement of the salivary glands, dry mouth, cracked lips and in some instances impaction and infection of the salivary glands.
*Tooth decay, which ironically may be aggravated by extensive tooth brushing or rinsing following vomiting [Bulimia]
•Extensive caries and tooth decay secondary to increased ingestion of sugar, soft drinks with carbonation [Bulimia, Binge Eating]

It’s obvious the best approach to these issues is to treat the eating disorder and repair as much of the damage as possible with good dental care. Unfortunately the longer the active eating disorder has been in place, the greater the probability the damage is irreversible. That said, a visit to the dentist is in order. Much of the damage can be treated, albeit expensive and initially uncomfortable with root canal work, crowns, caps, and prosthetic measures such as dental implants.

If you suffer with an eating disorder and opt to continue until you’re ready or willing to get help, here are a few recommendations from the American Dental Association, some of which are noted with our prior article regarding dental problems and eating disorders:

• Maintain vigilance with oral hygiene including brushing and flossing
• Immediately after throwing up, DO NOT brush but rather rinse with baking soda to help neutralize the stomach acid coating your mouth
• Consult with your dentist about caring for your mouth
• See your dentist every 4 to 6 months

Bulimia and Purging Eating Disorders: Special consequences and advice:

What happens:
Each time someone vomits, stomach acid attacks the enamel on the teeth. Frequent vomiting can cause the enamel to completely wear away leaving the pulp and nerve endings exposed. Teeth may appear 'moth eaten' or ragged and as well as fixing cavities, most people need whole teeth crowned, which not only is expensive, but will only stay fixed if the person stops vomiting.

Taking Care of Your Teeth:
It is very important to not brush your teeth after vomiting. While it takes the taste away it can cause extra damage to the teeth by damaging the surface crystals on the enamel layer of the teeth. The best option is to wash your mouth out with plenty of water and wait several hours before brushing your teeth or eating anything acidic such as fruit or fizzy drink. This allows the saliva to neutralize the stomach acid that seeps into the surface enamel after vomiting. Brushing your teeth destroys the protective layer of enamel, making it easier for the acid to attack it.
If you absolutely must brush your teeth, just use a brush dipped in water, avoid toothpaste, especially smokers’ toothpaste.
You can also minimize the effects of the acid by eating cheese or drinking milk - however if these foods are likely to cause you to go into a panic binge, just settle with rinsing your mouth out with water.

Tell your dentist:
Although it may be embarrassing going to the dentist regularly it is very important that you do so. Try to be honest with them so they can help you in saving your teeth. Plan to go for a check up at least every six months and more often if you are bingeing and vomiting very frequently or have bleeding gums.
If you are seeking help for your bulimia, your clinic may be able to recommend a sympathetic dentist in your area.

Marty Lerner, PhD.
CEO, Milestones In Recovery, Inc.

Author's Bio: 

Dr. Lerner is the founder and executive director of the Milestones in Recovery Eating Disorders Program located in Cooper City, Florida. A graduate of Nova Southeastern University, Dr. Lerner is a licensed and board certified clinical psychologist who has specialized in the treatment of eating disorders since 1980. He has appeared on numerous national television and radio programs that include The NPR Report, 20/20, Discovery Health, and ABC’s Nightline as well authored several publications related to eating disorders in the professional literature, national magazines, and newspapers including USA Today, The Wall Street Journal, New York Times, Miami Herald, Orlando and Hollywood Sun Sentinels. An active member of the professional community here in South Florida since finishing his training, Dr. Lerner makes his home in Davie with his wife Michele and daughters Janelle and Danielle and their dog, Reggie.