Teeth Damaged from Bulimia

I suffered from bulimia for almost 20 years. With counseling, I’ve been able to overcome this illness but my teeth have suffered severely. They are now worn down to 1/2 their size. My teeth no longer touch in the front and where they do touch they don’t fit well. My front teeth are chipped due to the frailess from years of acid damage and are paper thin. I also suffer from temporal headaches due to the left side of my jaw protruding out almost an inch every time I open my mouth to bite or chew. I’d like to see a cosmetic dentist to improve my smile and the functionality of my bite. I can send a picture if it will help. Is there any hope for me given the severity of my issues?
- Hopeless in Atlanta

Dear Hopeless,
The good news is that yes, you can have a beautiful, functional smile with modern dentistry. Bonding technology can be used to restore your teeth to look as good as new, maybe better.

Here at our office, we specialize in seeing people with bulimia or other eating disorders, and it is so satisfying to help them get a beautiful smile that helps restore their self-esteem. We’d be happy to see you here, but if you don’t want to travel that far, I would recommend that you look for a good cosmetic dentist in Atlanta.

Your headaches are due to TMJ disorder, which is another area of special training of mine. Many people who have recovered from bulimia have similar issues. So look for a dentist who is current with all the new cosmetic dentistry bonding techniques and is also comfortable treating TMJ disorders. If your back teeth are severely damaged, too, you will probably need crowns there also. All porcelain crowns are not only beautiful, but they can be bonded to the teeth with a very strong bond. So you don’t have to have a lot of tooth structure left, necessarily, to be able to hold them on.

I wish you the best. By working to overcome your eating disorder, you are over your highest hurdle. When you get your smile restored, my wish is for you to feel whole again.

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How to tell if someone is suffering from bulimia

People wonder how to tell if a friend or family member is suffering from bulimia.

It can be hard to tell. They don’t necessarily have to be thin. People suffering with bulimia have been known to be thin, but they may even have normal weight or be overweight. Here are some helpful signs:

• See if they seem to be using extreme measures to control their weight. This can show an obsession with weight loss. Things to look for would be the use of diet pills, or taking pills to try to have a bowel movement.
• Notice if they go to the bathroom immediately after every time they eat. Or if they go in the middle of a meal and then come back and eat more.
• Do they have an obsession with exercise? Do they exercise even when they’re hurt of tired?
• Watch for rough skin on their knuckles. Bulimics may use their fingers to get themselves to throw up, chafing their knuckles in the process.
• Look for broken blood vessels in the eyes.
• Do they comment about being too fat, even when this isn’t true? A bulimic tends to hate his or her body or worry excessively about gaining weight.
• Bulimics will tend to not like herself or himself. Are they moody or sad? Do they isolate themselves?

Dentally, we look for signs of acid erosion on the teeth, particularly on the insides of the upper front teeth, as this is where the acid from vomit tends to act and dissolve away the enamel and dentin of the teeth.

Read more about bulimia and teeth or eating disorders and dentistry on Dr. McKay’s web site. Dr. McKay is a Seattle cosmetic dentist who treats people from all over the country who are recovering from bulimia and other eating disorders. You may be interested to read Aimee’s story of bulimia and dentistry - how Dr. McKay helped her.

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Suggestions if you suffer from bulimia

Here is a list of suggestions for you, if you suffer from bulimia and have not yet overcome it, but want to protect your teeth as much as possible:

1. Professional care - Stay up-to-date with dental checkups. Purging strips the enamel from the insides of the teeth, particularly the upper front teeth. Your dentist will need to keep a close eye on this. As an added protection, having regular professional fluoride treatments will help strengthen your teeth against the acid attacks of bulimia.
2. Home care - Besides regular brushing and flossing, you can also get a prescription for home fluoride treatments in custom trays.
3. After vomiting, rinse your mouth with water as soon as possible. The quicker you get the acid out of your mouth, the better.
4. Restorative treatment is best done after you have begun recovery from bulimia.

Other links:
Read more about Seattle cosmetic dentist Dr. Brian McKay and the services he offers.
Read what Dr. McKay has to say about bulimia and teeth. People suffering from bulimia come to him from great distances, because of his expertise in dealing with this disorder and his supportive attitude.

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Should I get my teeth restored before getting over my bulimia?

Dr. McKay,
I have been suffering from bulimia, and am trying to get over it. Meanwhile, my front teeth are badly chipped and look terrible.

If I get porcelain crowns on the front teeth, and I still have problems with bulimia, will the acid dissolve away the porcelain? Or can I get this dental work done while I am trying to get over my problems?

- Unnamed

Dear Unnamed,
If you get porcelain crowns, the porcelain won’t dissolve away in the acid when you purge. The problem is that there is always a small area of the tooth next to the attachment to your gum that the crown doesn’t cover. And if you are still having problems with bulimia, that tiny area of the tooth will be subject to dissolving away, which can create a gap in the margin of the crown that will allow food particles and bacteria to get up inside your crown.

I’d recommend seeking professional help for your bulimia, if you haven’t already. It’s possible that your therapist may think it wise to proceed with some dental restoration as part of an overall recovery program, but I’d defer to their professional judgment on that.

Links:
Bulimia and teeth
Seattle cosmetic dentist
Laser dentistry

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What’s best to do when recovering from bulimia?

I have been suffering from bulimia for about eight years. I’m starting to recover but my teeth look paper thin, they are very sensitive, and they are stained. What do you suggest I do? I haven’t been the the dentist yet but I am mostly concerned about how thin the front ones are, then about the sensitivity.

- Valerie in Pennsylvania

Dear Valerie,
With bulimia, your teeth dissolve away from the inside surfaces, because of the acid that comes up from your stomach. So when you reconstruct the teeth, you also need to build up that inside surface, meaning that you most likely will need full crowns, which cover the tooth all the way around. That will strengthen the teeth, restoring their natural thickness, and it will cover the sensitive areas as well, so it will solve both problems.

And I believe that it’s important, when you’re recovering from bulimia, to be restored with a beautiful, natural smile, to help you get over that feeling of being abnormal that troubles people with this problem. If you have crowns with a metal foundation, they’re going to look fake. They will probably look opaque, and they will develop a dark line at the gumline. So I would recommend bonded all-porcelain crowns.

And to do those well, you need an expert cosmetic dentist. So be careful who you go to. If you get a dentist who has been associated with the Las Vegas Institute, or with PAC-Live, as Dr. McKay has been, your chances are that you have an excellent cosmetic dentist who could do this well. They should be proudly displaying photographs of their work, and should be good listeners. These are some things you could look for. Of course, if you would like to come to Seattle, we’d be happy to see you here and would treat you well.

Related links:
Bulimia and teeth
Porcelain crowns

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Looks like Acid Reflux

I am having some issues with my teeth. About 10 years ago, during my college days, I had a bad habit of drinking soda. I consumed a lot of soda, on a regular basis.

After college, when I started my first prof job in Jan 2002, I again began to see the dentist regularly (every 6 months) for cleanings and check-ups. I diligently brush and floss on a regular basis.

However, the back of my teeth (inner side near the tongue) is wearing away. I believe I permanently damaged the enamel on the inner surface of my front upper and lower teeth, and over time my teeth have become thinner. I recently noticed that my front upper teeth have become so thin, that they’re wearing away (a small chip, and degrading to a different shape).

Is there any type of procedure/fix that I could get done to correct this? What do you recommend? Thanks.
- Paul from Florida

Paul,
You say you had the soda-drinking habit ten years ago. Can I assume that you don’t have this habit any more? If so, it doesn’t sound like your old soda habit is what is hurting your teeth.

When the insides of the teeth, particularly the upper front teeth, dissolve away, that is one of the signs of acid reflux or bulimia. Tooth decay is different - it usually starts with one spot where it penetrates the tooth and then it creates a soft spot there. If the teeth are being washed in some acid on a regular basis, that will cause a general thinning of the teeth at the surface where the acid touches. This will also happen if you suck on lemons, for example. Then the teeth, which continue to get thinner, will start to chip away.

Now, soda is acidic and can cause this same sort of problem if the soda is held in your mouth before swallowing. It is possible that the soda dissolved away all or almost all of the enamel and that now the softer dentin is exposed.

The treatment is to get the vulnerable surfaces of the teeth covered with porcelain. This restores the missing tooth structure and strengthens the teeth against further attacks. Full porcelain crowns work very well for this. It’s also important to resolve whatever the issue is that caused the teeth to weaken so that the treatment will not be undermined by continued acid attacks.

Links for further information:
Bulimia and teeth
Seattle cosmetic dentist

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My battle with bulimia

I am 39, and bulimia is something I’ve fought a battle with for many years. I’m currently winning more or less. One of the results has been to have to live with teeth that I find horrifying. I don’t remember what it’s like to really smile, not be on guard when talking. I refuse to let even my children take my picture. I’ve been out of my marriage for almost 4 years but can’t date, and don’t socialize. People used to listen to what I had to say. Now it’s as if once I begin to speak and my teeth are exposed, that becomes their focal point. Doesn’t matter how intelligent I may be, they are no longer listening. I just stay with my kids–they aren’t judgemental–they accept me as I am. Watching the program on NW Afternoon gave me hope, but hope can be a scary thing.
- Sherry

Sherry,
You have really laid out very articulately the pain people go through when they are recovering from bulimia, and have highlighted why we enjoy treating people like you. It gives us deep satisfaction to help people like you put their lives back together. We can really help you with all of these issues.

Links:
Bulimia and teeth

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Can you help me with anorexia nervosa?

Hello. Do you treat only people who have had bulimia or can you help people who have had anorexia nervosa as well? I had anorexia nervosa and NEVER vomited/purged, have always taken excellent care of my teeth but I have a lot of dental problems (even at the young age of 23) such as enamel erosion, tooth sensitivity, and am showing signs of gum disease. Can these be caused just by anorexia and malnutrition? I am now recovered and eat healthily but my teeth are showing the effects. Please let me know if you also treat people with anorexia nervosa, and if my dental issues could be related to this.
Thank you.
Sincerely, Leslie

Leslie,
Yes, we treat people with anorexia, too. Your dental problems aren’t as severe as those of people with bulimia, but they can be significant. We can help you with the tooth sensitivity and the gum disease, which could easily be related to your anorexia.

Depending on the severity of you gum disease, you may be a candidate for laser dentistry treatment.

Links:
Seattle Cosmetic Dentist
Bulimia and Teeth

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