Cosmetic Dentistry and Eating Disorders

Question

Hi, I've had an eating disorder for over 20 years and I've spent time in a rehab to address the issues related to this behavior. It seems that when things are tough (economy) I return to the destructive behaviors of both bulimia and anorexia. Does the stomach acid break down the crowns, or veneers? What are my best options? I am deeply saddend the effects have had on my teeth -even though I knew it was inevitable. My teeth and smile were always pretty before.

George Koutsoukos, DDS · Answer

To answer your questions first:  Yes, stomach acid will eventually cause the crowns or veneers to fail, if you are still in the active stages of bulima. Stomach acid causes erosion around the margins of the veneer or crown, causing erosion around the tooth structure, subsequently causing the veneers or crowns to fail.  Your best option is to continue with therapy and, while in the active stage, use good hygiene, have regular  professional dental cleanings with applications of flouride to further prevent erosion.  Use flouride in trays to help with the remineralization of the the teeth.  Rinse your mouth out with bicarbonate of soda to neturalize the acid content,and  do not brush your teeth with toothpaste after purging.

	Esthetic treatment should be started when your eating disorder is in remission.  Your teeth and smile can be recreated with either crowns, veneers or implants. In the meantime, a good TEMPORARY fix is to use a product called Snap on Smile.  They are trays upper and lower that snap over your own teeth creating a beautiful smile when you need it. This is only temporary remember and good luck and stay in treatment!

Maryam Horri, DMD · Answer

Hi I am very sorry to hear of your ongoing issue. I do see a lot of young patients with eating disorder in my practice. Unfortunately bulimia can cause severe acid erosion of teeth. The other unfortunate issue is that it tends to affect most teeth indiscriminately. The good news is the look of your teeth is completely restorable and with the right design your teeth can look as good if not better than before. So stomach acid doe not affect ceramics but if you have veneers and onlays, acid can impact the back of restorations.

Kristen Berning, DDS · Answer

Stomach acid can cause a lot of damage to teeth, resulting in erosion and loss of tooth structure.  Even if crowns are placed, a small amount of tooth structure is still exposed and vulnerable to acid damage.  Fillings and crowns will fail or have problems if the acid is still attacking the tooth structure.  

	The best approach is to control the eating disorder with the appropriate therapy, as the psychological component is probably more powerful than what is happening physically.  It is also important to see your dentist for advice on how to protect the teeth as much as possible during this time.  Once the eating disorder is stabilized, there are various treatment options to help restore your smile to what it used to be.

Howard Perlmutter, DMD · Answer

The unfortunate reality is that eating disorders such as bulimia and anorexia are destructive to natural or cosmetically enhanced teeth. During your time in rehab i think its a great idea to have your dentist see what he can do to minimize or protect your teeth from further damage .Perhaps he can treat the damaged teeth with composite or bonded restorations. This can act as a good temporary remedy until your rehab is complete. Hopefully then you can be in a position to be re-evaluated to see what type of more definitive cosmetic treatment plan would work best for you. Good luck!

Paul D. Kantor, DDS · Answer

Unfortunately, until you are recovered, your teeth and any dentistry done will continue to break down. By continuing to see a dentist in the meantime, you can at least help to limit the damage.

Lawrence Gilbert, DDS (retired) · Answer

Sounds like it's been a huge struggle for you, it takes much strength to continue your journey to get better. Yes your health, teeth & cosmetics take a toll with this condition, your first step is to seek help so you can recover & when you're ready you can move forward to a healthy, beautiful smile. Start off with a good cleaning , x-rays & a full examination to determine which cosmetic option will work for you.

Mickey Bernstein, DDS (retired) · Answer

Thank you so much for your bravery to discuss your eating disorder. The psychological issues are far more complex and important than the dental issues. Please work very hard to seek the help you need to recover completely. Your life is at stake. Dentistry will not hold up until the bulimia is managed and only maintenance procedures should be performed. Once you have completed recovery, Cosmetic Dentistry can give you a beautiful and healthy smile once again. In the meantime, consider - Snap on Smile as a stop gap for appearance. I truly wish you the best as you move into the future.

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