Bulimia Tooth Damage

Tooth damage caused by bulimia – what you need to know

In the treatment of dental damage caused by eating disorders, the dentist has an important role to play in terms of early detection and advice. We explain the long-term consequences and treatment options of bulimia damaged teeth as well as optimal dental care after vomiting.

The harmful effects of bulimia on the teeth are mainly caused by the stomach acid that enters the mouth during vomiting. Stomach acid is much more aggressive than fruit acid, which we normally ingest with our daily diet. The damaging acid can act on the teeth for a longer period of time because saliva is not able to neutralize stomach acid as quickly.

Tooth erosion, also known as dental erosion, is a gradual process of tooth substance loss due to the repeated contact of teeth with acids. To treat tooth erosions, the dentist uses various materials and methods to seal the defects or rebuild or reconstruct the tooth.

It is important to seek professional help for signs of bulimia to treat the physical and psychological effects of this eating disorder and prevent long-term damage, including dental damage.

What are the long-term effects of bulimia?

Dissolution of the tooth surface by acid is the most common type of tooth damage in bulimia patients. About 70% of patients suffer from erosions, which mainly affect the backs of the teeth. Other damage and symptoms may include:

• Increased sensitivity of the teeth to hot and cold foods and drinks, acids and sweets
• Rounded tooth contours and loss of occlusal relief
• Thinned and shortened incisors of the anterior teeth. The teeth appear translucent or transparent
• Secondary deep bite
• Gingivitis due to decreasing pH in the mouth. The consequence of this can be pain and receding gums.
• Exposed tooth necks due to the receding gums can lead to severe pain and tenderness
• Bad breath due to stomach acid and food particles that enter the mouth when vomiting (halitosis)

The first signs can be seen after as little as six months of the eating disorder. Signs of wear and tear on the backs of the front teeth or the loss of enamel often allow dentists to recognize the first signs of bulimia.

Empathetic and professional treatment by Dr. Nina van Sprundel

As an empathetic dentist, Dr. van Sprundel understands how difficult it is for people with eating disorders to talk about their illness. Every member of the practice is aware that

The treatment of dental damage caused by bulimia is a sensitive issue and is committed to ensuring that their patients feel safe and understood throughout the treatment process.

Dr. van Sprundel is the author of numerous publications on the subject of bite elevation after erosion damage and has extensive knowledge in diagnostics and treatment.

Patients can feel safe and secure. She attaches particular importance not only to professional competence, but also to empathetic and empathetic care.

In our practice in Baar, we always plan sufficient time for individual consultation and treatment. This is the key to achieving the best possible outcomes for our patients. With Dr. Nina van Sprundel as a dentist, patients are in the best hands when it comes to the dental health and aesthetics of their teeth.

What are the stages of tooth erosion?

Normally, there is a balance in the oral cavity between the demineralization and remineralization of the tooth enamel. If this balance is disturbed, erosive changes in the tooth substance occur.

In the first stage of tooth erosions, there is no discomfort. Once the enamel is damaged to the point where the dentine becomes visible, pain and temperature sensitivity occur.

To assess the degree of wear, Dr. Adrian Lussi has developed the following erosion index:

• Grade 0 – No erosion is currently visible, enamel is shiny
• Grade 1 – superficial melt loss. The enamel appears matt and smooth. Those affected often do not notice this condition because there are no noticeable changes in the color of the teeth.
• Grade 2 – Deep bite, dentin exposed on less than half of the tooth surface
• Grade 3 – Secondary deep bite, dentin exposed on more than half of the tooth surface

The erosions can affect all teeth. Most patients suffering from bulimia or reflux often have erosions on the backs of the maxillary incisors. When exposed to acid from the outside, the front of the teeth is more likely to be affected by erosion.

Additional factors that accelerate the breakdown of tooth enamel

• Acidic foods and beverages: Frequent consumption of acidic fruits (e.g. oranges and apples), soft drinks, fruit juices, sports drinks and wine can attack tooth enamel and lead to the development of tooth erosion.
• Medications and supplements: Taking acidic medications such as aspirin or vitamin C supplements can contribute to the erosion of tooth enamel.
• Dry mouth: Dry mouth lacks acid-neutralizing saliva, increasing the risk of tooth erosion.
• Improper dental care: An aggressive tooth brushing technique with hard bristles, strong pressure or abrasive toothpastes can further weaken the tooth surface and promote erosion.
• Nocturnal teeth grinding (bruxism): Teeth grinding further damages the tooth surface and promotes the development of tooth erosions.

In case of eating disorders or reflux disease, medical treatment should be sought to reduce the risk of tooth erosion.

After vomiting, keep your hands off your toothbrush!

Because the enamel softens very quickly due to the stomach acid, brushing your teeth after vomiting is taboo. After about 30 to 60 minutes, you can start brushing your teeth. Prior to this, a neutralizing mouthwash, such as a solution of sodium bicarbonate or fluoride mouthwash, can support neutralization.

How can tooth damage caused by bulimia be prevented or reduced?

To prevent tooth damage, it is important to reduce the effects of stomach acid on tooth enamel. After vomiting, you should not brush your teeth immediately, but give the saliva time to neutralize the acid.

After about 30 to 60 minutes, you can start brushing your teeth, before which a neutralizing mouthwash, such as a solution of sodium bicarbonate or fluoride mouthwash, can help neutralize. In case of frequent vomiting, a soft toothbrush and fluoride toothpaste may also be helpful.

Optimum protection of the teeth can be achieved with a so-called "medication carrier splint". This is made individually after the jaw has been taken and should be inserted before vomiting – preferably with a neutral fluoride gel. This splint can then also be worn overnight to build up the enamel.

Acidic foods should also be avoided as much as possible. Regular visits to the dentist are crucial to detect damage at an early stage and to have it professionally treated. In some cases, dental crowns, dental bridges, veneers or implants may be necessary to repair the consequences of tooth damage and restore dental health.

A healthy mouth and physical well-being go hand in hand, which is why it is of paramount importance to take care of both your own teeth and the underlying mental health issues.

How is dental damage from bulimia diagnosed?

The diagnosis of tooth erosions is made by the dentist by examining the changed tooth surfaces, changes in shape and possible discoloration. During the diagnosis, the dentist or oral surgeon also asks about the patient's eating habits, as certain foods and drinks can promote the development of tooth erosions. Information about existing conditions such as reflux disease or eating disorders can also be helpful for diagnosis.

In some cases, the dentist may take photographic documentation and impressions in order to record the extent of the tooth damage and to better control the course of the erosions.

If tooth erosion is suspected, it is essential to consult a dentist in order to obtain a diagnosis and initiate appropriate treatment measures.

Dental care after vomiting

Since stomach acid softens the tooth substance, it is essential to refrain from brushing the teeth immediately after vomiting. It is better to wait 30 to 60 minutes for saliva to develop its neutralizing effect.

If you vomit frequently, you should use a soft brush with rounded bristles. In general, only a small amount of pressure should be applied to the teeth with the toothbrush. Heavy cross-scrubbing should be avoided. It is also advisable to use a fluoride toothpaste and a fluoride gel once a week to strengthen and protect the teeth.

Visit your dentist regularly for a professional tooth cleaning and have your teeth treated with fluorides to harden tooth enamel.

How to treat bulimia-damaged teeth?

The treatment of tooth erosions depends on their stage and should first be aimed at eliminating the causes. Since lost tooth enamel cannot be rebuilt, the focus is on preventive measures and subsequent treatment options, depending on the degree of tooth destruction:

• Sealing: In the early stages, when erosion is only visible on the surface of the tooth, the tooth can be sealed with a special varnish to prevent further degradation of the substance. This protective layer lasts about six to nine months
• Restoration: In advanced tooth erosion, dentists can fill in bumps or indentations with materials such as composite to restore the shape and function of the tooth. Inlays & onlays or veneers can also be used to protect and reconstruct the affected teeth.
• Reconstruction: If erosion has progressed to such an extent that it impairs chewing function, reconstruction of the dentition may be necessary. Dental prostheses, for example made of ceramics, are used to restore the appearance and function of the teeth.

It is important to detect tooth erosions at an early stage and to take preventive measures together with the dentist to prevent or at least slow down the progressive loss of tooth substance. Regular check-ups at the dentist and proper dental care are essential to successfully counteract the loss.

Treatment of a bite elevation after bulimia

A bite lift may be necessary if the teeth are severely worn by an eating disorder such as bulimia and the bite is disturbed as a result. Such treatment can help restore the bite and improve the appearance of the teeth.

• Dental examination: At your first appointment, we will perform a thorough examination of your oral cavity to assess the condition of your teeth, jaw and temporomandibular joints. We will decide together which solution is best for you. We use state-of-the-art technology, such as a digital scanner, to get an accurate impression of your teeth.
• Treatment simulation: Due to the complexity of the therapeutic measures, a treatment simulation is carried out in the dental laboratory before the treatment begins, which provides information about the aesthetic and therapeutic goal of the treatment. Here, the target situation is illustrated as a wax-up on the patient's study models. A plastic mock-up can demonstrate directly in the mouth what the teeth and any resulting changes in the facial profile and physiognomy could look like after the therapy has been completed.
• Making a temporary prosthesis: First, we make a temporary plastic prosthesis that has the shape and color of your future teeth. You will wear this temporary for a few weeks to get used to your new bite.
• Preparation of permanent restoration: After a few weeks, you will come back to the practice to adjust the temporary restoration and take further steps. We use digital technology to produce a permanent ceramic restoration 1:1.

Often, during this treatment, all anterior and posterior teeth of the upper jaw are fitted with new crowns. If necessary, the lower jaw can also be treated. Aesthetics play an important role in bite lifting, as your smile is an important part of your appearance. All-ceramic dentures are indistinguishable from natural teeth and can help you feel comfortable in your skin again.

It is important not to wait too long to lift the bite, as teeth that are too short can make it difficult to attach the crowns. With the right treatment, we can help you to have a healthy and beautiful smile again.

Bite elevation

Aesthetic treatment of bulimia-damaged teeth with the help of veneers

To improve the appearance of teeth damaged by eating disorders, veneers can be an effective method. These are wafer-thin ceramic shells that are glued to the teeth. This anterior restoration is particularly popular with the incisors.

Veneers are durable, resistant and give teeth a natural look. Thus, patients who have suffered from bulimia can regain their self-confidence and smile radiantly again.

Veneers