How long does it take for bulimia to destroy teeth?

I live uncomfortably post-eating disorder in fear that I might’ve done some irreparable harm to my body over the years of violently making myself sick multiple times a day, so I have as a result avoided going to seek medical advice on those potential lasting effects to my physical health – but in truth, I know in my heart that you can’t be a professional bulimic for half a decade and not have caused some damage.

Eve has been nudging me to go to my GP about some ear problems I’ve been experiencing for a while, where my ears will pop (the way they might on a plane) for days at a time, and I am convinced that this is probably due to the enormous pressure wretching puts on your ears. The thought of having vandalised my own body is a difficult thing for me to face up to, as it a) confirms that all those years of pain actually did happen and b) that I’m going to be stuck with a reminder of my eating disorder each time I smile through my off-white teeth.

I’m aware that rinsing my mouth out with my own stomach bile repeatedly has painted my teeth a beautiful canary-yellow colour because my four front teeth are crowns (I broke them as a young bean when my little brother tripped me up while lying down pretending to be dead on our garage floor and I piled over him forgetting to put my arms out and smashing my face on the concrete…but that’s a story for a different day.) and in comparison to my natural teeth, these have remained relatively white, the contrast detailing the destruction of my bulimia.

I’m also aware that compulsively making yourself sick has probably had other detrimental effects on my physical health that I need to deal with in time, but having only just finally been able to tackle the mental health beast living within my eating disorder, I think I’m almost ready to make some bodily progress – teeth first.

I spoke to one of my good friends from back home who was sensible enough to get a proper job as a dentist – not a fluffy writing one – and asked her what happens to your teeth when you make yourself sick, so she pointed me in the direction of the Colgate website, which reads: “Frequent vomiting may cause your salivary glands to swell and the tissues of your mouth and tongue to become dry, red and sore. People with bulimia may have chronic sore throat and small haemorrhages under the skin of the palate.

“Frequent vomiting can erode your tooth enamel, especially on the tongue side of the upper front teeth. This sharply increases the risk for decay in these areas and can make these teeth sensitive to temperature. Severe erosion can lead to changes in your bite, or the way your upper and lower teeth come together. Your back teeth can be reduced in size and some teeth can even be lost eventually. Tooth erosion can take about three years to become obvious, but not all bulimics experience it.”

Consulting a dentist during my time as a bulimic was never something I thought to be necessary, but it absolutely makes sense after reading the above. During bulimia recovery, it’s unusual for you to stop making yourself sick cold turkey – I know, it took me a while – so Colgate advises: “To minimise damage done by stomach acid during episodes of vomiting, rinse your mouth with baking soda mixed in water. You also should rinse with a mouthwash containing .05 percent fluoride, which your dentist can prescribe. Don’t brush your teeth immediately after vomiting because stomach acid weakens tooth enamel and brushing can cause erosion of the enamel. When you do brush, use a toothpaste that contains fluoride. Fluoride helps strengthen teeth.” But please, make sure you go to your own dentist first and foremost for advise – and if possible, an eating disorder professional too.

Once your bulimia is under control, you may need to have some of your teeth restored if damage has been done. Colgate says that if the enamel loss is stopped at an early stage, it can be replaced using materials called composite resin or amalgam. More severe erosion will require tooth extraction. Lost teeth can be replaced with bridges or implants.

As I write this piece, I can feel my stomach tighten and my teeth become more sensitive, almost curling in my mouth. It’s all well and good preaching to Not Plant Based readers that this is what happens to your teeth during bulimia blah blah and telling people to seek advice from their own doctors blah, but isn’t that hugely hypocritical of me? It’s probably about time I confessed to my own dentist about my past in order to face up to the harm I might’ve done to my teeth. I’ll keep you updated on that…maybe I’ll do a follow up on my own appointment…

As for my vanity, I could always get my teeth professionally whitened when/if I have the money to do so, and I’m absolutely not against that idea of that in the future. For now, my life is about trying to face my problems and my past head on without crumpling into a whimpering heap each time I remember that I’ve failed – bulimia, for me, is something I still consider to be a huge failure in my life, rightly or wrongly. But as J K Rowling once famously said: “It is impossible to live without failing at something, unless you live so cautiously that you might as well not have lived at all – in which case, you fail by default.”

I’m trying to accept that my discoloured teeth aren’t necessarily a display of my failings, but are trophies representing what I have been able to overcome, and that is seven years of mental illness. If that isn’t something to flash a non-Hollywood smile about, I don’t know what is.

Next stop after the dentist…the ear doctor.

It may not seem obvious at first that a psychiatric disorder would cause dental problems. However, some of the first telltale signs of bulimia nervosa are often spotted by dentists.

Bulimia nervosa can cause serious medical problems as well as dental problems. It’s important for patients with bulimia nervosa to not neglect their oral health, but what exactly are the concerns?

Studies show that between 47 and 93% of bulimia nervosa patients who vomit exhibit damage to tooth enamel. If you engage in self-induced vomiting, you should be aware that bringing acidic contents of your stomach into your mouth may cause erosion of the enamel surface of your teeth.

This damage usually appears primarily on the inside and biting surfaces of the teeth, and the extent of the damage to the enamel can vary between patients. Some factors believed to influence one’s susceptibility to tooth erosion include dietary and oral hygiene habits as well as how often self-induced vomiting occurs.

Not surprisingly, individuals who induce vomiting up to several times a day have a higher risk of developing dental erosion than those who vomit less frequently. However, there can be great individual variation and some people may have more damage with less frequent vomiting. Tooth erosion may become apparent after only six months of self-induced vomiting.

Over time as the enamel is eroded by repeated exposure to gastric acid, teeth may lose their shine, break, turn yellow, wear down, chip, and look ragged.

Damaged teeth can further exacerbate any concerns about one's appearance. But tooth decay is much more than a cosmetic concern.

Your teeth may feel more sensitive to heat and cold. This can make eating more difficult and complicate recovery. In extreme cases, the teeth may die and extensive and expensive dental work to repair the damage may be needed.

Regardless of whether or not they engage in self-induced vomiting, many individuals with bulimia nervosa who binge consume high sugar foods, which can increase the risk for cavities.

Those who vomit have an even higher risk for dental cavities due to the additional stomach acid. Dentists have recognized a higher incidence of cavities in individuals with bulimia nervosa.

Individuals who engage in chewing and spitting, which can be a symptom of other eating disorders as well as bulimia nervosa, can also experience dental problems such as tooth decay and cavities.

Frequent vomiting can cause gum irritation and bleeding and sores on the angles of the lips. It can also cause enlargement of the salivary glands along the lower jawbone and in front of the ear, which can cause a “chipmunk cheek” look.

Purging may cause a reduction in saliva that can, in turn, lead to dry and/or cracked lips, dry mouth, and a burning sensation in the mouth, particularly on the tongue.

Treatment involves stopping vomiting and paying careful attention to oral hygiene. Recovery is the best way to limit tooth damage and prevent medical consequences. If you have untreated bulimia nervosa, seek help from a treatment professional.

You can even start by seeing your primary care physician (who may then refer you to a doctor who specializes in eating disorders). Speaking openly about your condition is important for eventual treatment and recovery.

Get our printable guide for your next doctor's appointment to help you ask the right questions.

Cognitive behavioral therapy can be an effective treatment for bulimia nervosa. Self-help versions of cognitive behavioral therapy may also be helpful for some. Once the vomiting has stopped, patients with bulimia nervosa sometimes opt to have more extensive dental repairs.

Recovery from an eating disorder takes time. In the meantime, if you are still vomiting, there are some things you can do to minimize damage. Previously, patients were advised not to brush with fluoride toothpaste after vomiting episodes because there was a concern it would cause more damage. However, this has never been proven.

The current recommendation is to brush gently with fluoride toothpaste and then rinse with a neutral PH mouthwash or a baking soda solution (one teaspoon in one quart of water) to neutralize the acid residue.

Salivary gland swelling may be helped by hot compresses and tart candies.

Although you may feel embarrassed, you should also see a dentist regularly for check-ups. Try to be honest with them about your bulimia nervosa and your specific behaviors so they can help prevent more significant dental issues. Untreated dental problems could also lead to more serious medical complications.