Bulimia

As a pediatric dentist, I have treated many young patients who suffer from bulimia nervosa, an eating disorder commonly referred to simply as bulimia.

Bulimia is a serious condition that not only directly impacts oral health, it can be life-threatening. Bulimia is generally characterized by binge eating followed by purging. Purging can occur through forced vomiting, excessive exercise, or by taking laxatives or diuretics.

Research indicates that roughly 1.5 percent of women and .5 percent of men will experience bulimia at some point during their life. It is most common in women, and especially common during the teenage and early adult years.

As your pediatric dentist — and a member of your comprehensive health care team — I feel it is important to notice and appropriately call attention to bulimia symptoms I discover during an exam or treatment. While I realize that it can be a difficult discussion (parents frequently do not realize their child has bulimia), it is important that all parties understand the impact of bulimia on oral health.

If you have a child with bulimia, please know the disorder can cause:

• stained teeth (from stomach acid)
• gum disease
• tooth decay

Dental treatment can be an important part of treatment for bulimia. When treating a bulimic patient, I may give fluoride treatments during dental visits and may prescribe a fluoride gel for home use. I will encourage the scheduling of regular exams; I am looking to detect decay or infections.

I will work with the patient’s health care team and together we can coordinate dental treatment with treatment for the eating disorder. If my patient has severe tooth damage and is still undergoing treatment for bulimia, I may be able to provide an appliance that covers the teeth and protects them from stomach acids.

Once the bulimia is under control, my patient may need to have some teeth restored. If the enamel loss is stopped at an early stage, it can be replaced using materials called composite resin or amalgam. More severe erosion may require tooth extraction. Lost teeth can be replaced with bridges or implants.

Please know how important it is to consider me — your dentist ­— a vital part of your comprehensive health care team. Together, we can overcome the challenges of bulimia nervosa.

Note from Dr. Bui: In the Dear Parent Series, my goal is to provide parents with the information they need to make the best possible decisions related to their child’s pediatric dental care. Please ask me any follow-up questions you might have on these important topics. I will be happy to provide as much information as you need.