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Caring for Your Teeth During Recovery from an Eating Disorder


As you recover from Bulimia and Anorexia Nervosa it is even more important to care for your teeth. I can’t begin to express how critical superb oral hygiene is for those who are actively participating in self-induced vomiting and/or are malnourished. During recovery and sometimes following recovery oral care recommendations need to be above the ‘standard’.


It is well known that bulimia, specifically self-induced vomiting causes oral manifestations but I also believe that individuals severely malnourished are at risk of the dental problems discussed below. There is little evidence to support that malnourished individuals without bulimia are at higher risk of dental problems but the risks of taking your hygiene up a notch is not harmful.


The most common dental problem seen in those who engage in self-induced vomiting is erosion on the enamel (smooth outer surface of teeth). Self-induced vomiting causing hydrochloric acid from the stomach to be released into the oral cavity. This acid wears down the enamel of teeth and leads to a decrease in salvia, erosions, bacterial infections, dental plaques, tooth decay, and eventually tooth loss.


Dental problems often occur after 1 to 2 years after the onset of self-induced vomiting. Regardless of how long you or your loved one has been engaging in self- induced vomiting appropriate dental hygiene should be started immediately. Common symptoms of dental problems caused by self-induced vomiting include the following:


Decrease in salvia: this leads to xerostomia aka dry mouth. Xerostomia can occur from self-induced vomiting as well as abuse of laxatives, diuretics or chronic dehydration.


Salvia is used as the mouths very own cleaning product. It helps to clear food debris so bacteria can’t feed off of your leftovers and grow. Without salvia harmful mouth bacteria can grow rapidly and lead to infection. Saliva also helps to reduce the acidity of the mouth. When there is too much acid in the mouth tooth decay, gum disease, and something called burning mouth syndrome can develop.


Irritation of the oral cavity: self-induced vomiting can cause irritation and trauma to the throat, palate (roof of mouth), lips and even enlargement of the parotid salivary glands (these are located in your mouth by your jaw line).


Tooth erosions: can lead to nerve damage and infections of teeth. As the nerve root becomes damaged hypersensitivity of the teeth can cause an intolerance to hot and cold temperatures. Teeth with erosions will often have a glassy, smooth appearance with a loss of the biting surfaces.


As you work with your eating disorder treatment team it is important to care for your teeth. I recommend the following to protect your teeth as you move towards recovery:


Fluoride Mouthwash:


Purchase: This can be purchased over the counter or through your health care provider.


General Directions: Use the recommended dose daily 1-2 times a day. Swish for 1 minute, do not swallow. Spit out the remaining mouthwash. Do not eat, drink, or brush your teeth for at least 30 minutes after using.


Fluoride Toothpaste:

Purchase: This can be purchased over the counter or through your health care provider.


General Directions: Use the recommended dose daily 1-2 times a day. Do not eat, drink, or brush your teeth for at least 30 minutes after using. Some forms come in paste that is rubbed on or normal toothpaste form


Re-mineralizing Toothpaste:

Consider using a re-mineralizing toothpaste that helps to strengthens tooth enamel.

I do not endorse any product but I have heard M.I. Paste Plus is helpful.


Other interventions:

Eroded teeth may require restorations with a protective enamel covering placed to the surfaces of your teeth. This can be performed by your dentist. Options include onlays, crowns or composite resins.

Immediately act after a purge:

  • Be kind to yourself, you are in recovery

  • Rinse with sodium bicarbonate (this can be made at home), do not swallow, rinse and spit after 1 minute

  • Do not brush your teeth as this will worsen damage



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