When should someone suffering from bulimia have their teeth fixed?

Question,
My friend has been struggling with bulimia for several years. She has talked to me about trying to quit, and has been in counseling for this. Meanwhile, her teeth are beginning to look pretty bad. They are getting smaller and are chipped.

I know that one of the issues she is wrestling with is self-esteem. I can’t think that it helps with her self-esteem that her teeth are looking so dingy. I know that bulimia damages your teeth, so wouldn’t it help if she got her teeth fixed, and that could maybe help her in her recovery?
– Alice from New Mexico

Alice,
If there is anyone who understands the patient suffering with bulimia, it would be Dr. Chal. To read more about his work, please see his bulimia and teeth page. Yes, you are correct that this is a self-esteem issue. However, it would not be wise to fix the teeth until your friend is solidly in recovery.

The treatment for teeth damaged by bulimia is full coverage porcelain crowns. And yes, if they look beautiful, they help tremendously in recovering the lost self-esteem. But, because of the constraints of the oral environment, no porcelain crown can cover the entire tooth down to the attachment of the tooth to the gum. If a dentist tries to do that, the gum will recede, exposing more of the tooth. If the patient then continues to practice the binge and purge habit, the acid will eat at the exposed part of the tooth, undermining the expensive dental work, and requiring it to be re-done. Dr. Chal couldn’t in good conscience do that to your friend.

The correct sequence of events is to first get control of the binge and purge behavior, then re-build the self-esteem with a beautiful smile makeover. Meanwhile, the best way for your friend to minimize the damage to her teeth would be to be sure to rinse her mouth thoroughly with water immediately after every purge event. This will neutralize the acid and prevent erosion of the enamel.

This blog is sponsored by Phoenix cosmetic dentist Dr. Arthur Chal

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