How Bulimia Affects The Teeth + How to Find Hope

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Hi, I’m Dr. B, practicing functional dentist for 35 years. I graduated from the Dugoni School of Dentistry in San Francisco, CA in 1987 and am a member of the American Academy of Dental Sleep Medicine (AADSM), Academy of General Dentistry (Chicago, IL), American Academy for Oral Systemic Health (AAOSH), and Dental Board of California. I'm on a mission to empower people everywhere with the same evidence-based, easy-to-understand dental health advice that my patients get. Learn more about Dr. B

Struggling with bulimia can cause painful, and sometimes irreversible, damage to the teeth and mouth. But to fix the dental injury, it’s important to fix the underlying problem: the eating disorder.

Experts classify bulimia nervosa as an eating disorder. Bulimia occurs when people binge eat large amounts of food. Then, feeling guilty about their binge, they “purge” these calories through self-induced vomiting. Less common forms of purging can also include fasting, laxative abuse, or excessive exercise.

What might compel someone to put their body through this?

In this article, I explain why a dentist might be the first to recognize signs of bulimia. Plus, we’ll talk about how to conquer this disease and options for dental treatment with bulimia.

Why do people purge?

Bulimia has two overwhelming thoughts attached. First, there is an almost-irresistible urge to eat in excess and purge. Second, bulimics suffer from a morbid, irrational fear of gaining weight.

Like most eating disorders, the person’s relationship with food is highly skewed. This is a difficult condition that affects millions in the U.S., and plays a clear part in patients’ oral health.

Why might this mental health issue develop? Many factors can contribute to bulimia. These include a very slim ideal body image, family dynamics, age, poor self-esteem, stress, and a history of dieting or extreme exercise.

These risk indicators are difficult themselves, but can also compound into even larger problems. Bulimia increases the likelihood of other conditions. Those that purge are more likely to develop anxiety, depression, alcoholism, and more. (1)

Signs of bulimia could include the following:

  • Regularly eating large portions of food in one sitting
  • Feeling that you are unable to stop eating or control the amount of food that you eat
  • Deep regret after bingeing, followed by vomiting to avoid weight gain
  • Abusing laxatives to purge what you’ve eaten
  • Restricting food intake or fasting between binges
  • A constant preoccupation with weight or body appearance
  • A looming fear of weight gain

Not all bulimia is the same in severity. You can discern the degree of your bulimia by the number of times you purge each week. The standard of diagnosis is purging at least once weekly for 3 months.

Bulimia is a difficult condition to spot in those around us, despite its seriousness. Anyone from any weight class or body type could be suffering. Due to this, it can remain hidden longer than other eating disorders.

Bulimia’s effect on teeth is intense and can be brutal, but at times goes overlooked due to other health concerns.

At its worst, bulimia can result in:

  • Dire heart and digestive complications
  • Arthritis and bone issues
  • Malnutrition
  • Anemia

These critical health problems can dominate the conversation around bulimia, but teeth are no less affected. You may not imagine that your teeth could be important first signs of an eating disorder.

A dentist may be the first to spot telltale signs of bulimia.

As I’ve said before, your mouth-body connection is more important than you may realize. Indicators in your mouth can tell dental professionals what your eating habits–and even purging habits–look like. Your oral health is deeply connected to your overall health. Teeth affected by bulimia are no exception.

Many patients and loved ones who suffer from bulimia wrestle with fear before visiting a dentist. This shame is common and a real obstacle to seeking treatment. However, as you’ll see, the risks of avoiding your dental visit far outweigh the potential embarrassment.

And with regular dental care, you can feel confident as you chew without pain and get your sparkling smile back again!

10 Ways Bulimia Affects Teeth

Constant cycles of bingeing and purging take a massive toll on the heart, digestive tract, and kidneys, to name a few.

But why is it that dental professionals are the ones to spot early signs?

Well, bulimia acts fast and hard to wear down your pearly whites. Bulimia teeth typically look worn in ways that other, more “typical” teeth do not. The back sides of the front teeth show significant wear and tear. (2) This uncommon pattern is a major sign.

With treatment, you can shield yourself from the more unpleasant side effects of purging. Research has shown that without treatment, “a patient’s medical and dental health will deteriorate as the eating disorder progresses.” It only takes 6 months to begin to see the negative effects of vomiting. (3) Getting help now means better health down the road.

Here are some consequences that self-induced vomiting can bring:

1. Tooth Erosion

Consistently purging will regularly expose your teeth to stomach acids. These chemicals are vital in breaking down your food and assisting in the digestive process within the stomach. However, when they find themselves in your mouth due to purging, problems arise.

These acids begin to corrode the protective enamel layer around your teeth. The more you purge, the more they come into contact with this delicate covering. Over time, stomach acid can erode cavities into your teeth. (4)

The sugary foods that bingeing often involves can make tooth decay even worse. In studies, up to 69.7% of bulimia patients’ teeth had dental erosions. (5)

2. Bad Bacteria

Bulimic patients’ mouths have a higher balance of cavity-causing bacteria than others. (6) This is especially bad when the enamel is wearing down at a rapid rate due to purging. With these bacteria out in full force, your mouth is ready and waiting to create a new cavity.

3. Tooth Color, Shape, and Texture Changes

Teeth can’t hold up under the damage of stomach acid forever. Some may begin to yellow, become more brittle, or have a more porous texture.

In one study, 46% of patients with bulimia nervosa saw teeth that had changed in appearance. (7) This is often due to a structural weakening of the tooth itself. Chipping may also begin to occur at this stage.

4. Bite Problems

As your teeth continue to erode, the way they fit together will change. Back teeth are especially susceptible to long-term erosion, and patients could even lose them over time. Once this happens, your bite could become painful. This stage presents about 3 years into frequent vomiting. (8)

5. Bleeding Gums

Gingivitis and periodontal disease are almost inevitable. Stomach acid repeatedly washes against the gums, causing inflammation and damage. As the gums weaken, the teeth they hold can become loose or, in extreme cases, even fall out. (9)

6. Painful Lining of the Mouth

The eroding effect of stomach acid doesn’t stop with teeth and gums. The skin in your mouth and throat can experience this wear and tear as well.

This is particularly hard on the roof of your mouth and your esophagus as acid moves through. Painful sores can emerge, swell, or become infected, resulting in a chronic sore throat and aching mouth. (10)

7. Less Saliva

At first, this symptom may not seem serious, but less salivary gland production leads to many issues. This slower flow leads to higher instances of dry mouth. (11) Saliva and oral hydration is crucial to your mouth’s wellbeing. (12)

Stomach acid can irritate your salivary glands, leading to difficulty swallowing. Furthermore, the presence of saliva defends your teeth from decay. Its absence can worsen cavities already caused by erosion.

Up to 50% of patients with bulimia are estimated to have swelling in their salivary glands. (13) This dry mouth condition can even change how food tastes. (14) A dry mouth is also linked to an increase in bad breath.

8. Tooth Sensitivity

Bulimia and the accompanying purging can cause pain as your dental decay progresses. When tooth enamel continues to wear down, a more sensitive inner layer is exposed. This can lead to sensitivity to cold foods, warm foods, and sweets.

Teeth in bulimic patients typically show moderate to severe sensitivity. This discomfort continues to increase with the length of the disorder. (15)

You can read more on how to deal with sensitive teeth here.

9. Jaw Issues

Vomiting and binge eating put patients in a high risk category for chronic jaw pain, headaches, chewing issues, and snoring. (16)

10. Malnourishment

Patients with bulimia nervosa are often malnourished due to purging important nutrients. (17) This is problematic because your teeth remineralize and demineralize constantly, and you need good nutrition to support remineralization.

Without proper care, severe vitamin deficiencies can follow, causing a lack of nutrients needed to care for teeth. (18) Find out more about the ways nutrition impacts your teeth in this article.

In the end…

Dental erosion and other side effects of bulimia are serious issues. Thankfully, many of these items can be taken care of by dental treatment. Bulimia teeth restoration is possible.

However, in order to save yourself from continuous dental problems, you will need to seek treatment for bulimia and your dental issues.

Dental work can only repair eroding teeth and other issues. It cannot reverse or stop the effects of bulimia. Your mouth and body will continue to suffer as long as this habit continues, so opt for long-term solutions as well.

Your teeth are incredibly important, but so is your wellbeing. There are resources available to you that will improve your health and relationship with eating. As dentists, we play one part in the whole story of restoring you back to the healthiest version of yourself.

How to Repair Teeth Damaged by Bulimia

How do you begin to treat the damage to your teeth done by bulimia? Actually, you have many options for bulimia teeth repair.

Don’t Skip Dental Visits

Start by not skipping regular dental care. Maintaining scheduled cleanings can keep your teeth and gums free from plaque and tartar. This gives your gum tissue a chance to recover from all that acid.


While you may know I’m not typically a fluoride fan, in this case I’d recommend using it. Your dentist can prescribe and administer in-office fluoride treatments and prescription-strength fluoride toothpaste for your daily use.

These tools aid in remineralizing your teeth and preventing further decay. Personally, I would also prescribe a tray system for fluoride gel. This is a wonderful tool to compound the positive effects of fluoride aids for severe decay.

Stop Brushing (After Purging)

Many patients seeking treatment require time to control their purging habits. As you recover from bulimia, protect your teeth in other ways.

My main advice is to stop brushing your teeth directly after vomiting. This can etch the stomach acid onto your teeth and cause further enamel harm. (19)

Instead, neutralize the pH in your mouth and avoid more damage by rinsing with a mixture of baking soda and water. (20) You may also find that simply rinsing with water after a purge, then waiting 30-45 minutes to brush can help.

Post Treatment

After you’ve heroically conquered purging, there are several possible dental steps to consider. The determining factor for your dental care and cost will be how badly your teeth have been damaged. Fillings, crowns, veneers, or implants are all possible fixes for erosion issues.

As you plan your treatment, be sure to keep your mouth hydrated. Don’t forget, your salivary glands will likely still be recovering. On a positive note, science shows that taking careful care of your oral hygiene can minimize further erosion.

Don’t skip out on dental visits. Fluoride, in particular, can truly make a difference as you restore your smile. (21) There’s hope for your teeth after bulimia.

As you work toward reestablishing your oral health, try preventative measures. Antacids, cheese, xylitol chewing gum, and mouth guards can all help prevent more problems. (22)

Remineralizing your teeth can handle smaller cavities without fillings, as can taking the right supplements. You’ll be preventing future issues while you deal with current ones.

Trust Your Dentist

Don’t let embarrassment stand between you and good dental care. It’s unlikely you’ll have the first bulimic teeth your dentist has ever seen.

Our task as dental professionals is to protect your health and take care of your teeth. Shaming you isn’t in the job description. Since mouth pain so often accompanies bulimia, we want to help you feel better. Not only that, but we maintain strict confidentiality. Your struggle and recovery stays safe in our offices.

Since bulimia is often accompanied by other conditions, be sure that your dentist is aware of any other medications you are on. Additionally, you’ll want to tell your dentist about any accompanying mental health concerns. It’s not uncommon for bulimics to deal with anxiety or depression, which are also connected to dental health problems. (23)

Be aware that these can influence prescription choices, and let your dental professional know. Since alcohol abuse is more common in bulimic patients, ask about potential interactions with your medication. You’ll want to be safe about drinking and your prescriptions. (24)

Repairing your teeth is one step on the road to recovery. When accompanied by bulimia treatment, it can restore confidence. There’s no reason to let bulimia and tooth erosion keep you away from a visit. Use dental treatments to help you smile with pride as you create new, healthy habits.

Bulimia Treatment Options

If you are struggling with bulimia, there are many incredible options where you can find the support and strength you need to live a life without bingeing and purging.

Mayo Clinic has a fantastic and comprehensive guide on what to expect during treatment, self-care for bulimics, adopting a healthy lifestyle, and when to see a doctor.

Here’s a page from Eating Disorder Hope that assists in finding treatment by state, and a search you can personalize to your situation.

If you’re looking for a friendly voice and a conversation about treatment, you can call the National Eating Disorder Association helpline at 1-800-931-2237. They’ve talked to many people just like you, and they’re happy to help.

If you need inspiration, here’s a list of traits you can cultivate as you overcome bulimia.

Finally, if you’re looking for community, search here for ones near you. Don’t forget to include your friends and family in supporting you as well.

FAQs about Bulimia and Teeth

Q: Will my dentist be able to tell I have bulimia?

A: The short answer is yes. The obviousness of the symptoms can vary based on the length of your eating disorder, but erosion will occur with self-induced vomiting. The corrosive patterns purging creates are a clear giveaway of bulimic behavior, as are the lesions in the top of the mouth and swollen salivary glands.

Your dentist is likely to be the first to notice these symptoms and diagnose you. (25) However, don’t let that keep you away! Our job as medical professionals is to provide you with care, concern, and help.

Q: How can I prevent cavities when I throw up?

A: There is no long-term measure that can prevent the erosion that vomiting causes. As you seek treatment, you can minimize the damage by avoiding brushing directly after throwing up. Instead, try rinsing with a mix of baking soda and water. Keeping your mouth hydrated can also slow the spread of cavities.

Q: What do bulimia teeth look like?

A: While we won’t be displaying the graphic images here, bulimia teeth gradually decay as the side effects of purging kick in. To see images, scroll down on this report to see bulimia teeth pictures in multiple stages of decay. (WARNING: Images may be upsetting. Proceed with caution.)

Key Takeaways: Bulimia and Teeth

Bulimia takes a heavy toll on your oral health, from swollen salivary glands and a sore throat to bleeding gums and decaying teeth. No matter how far your disease has progressed, today is a great day to get help.

With the support of a treatment team, including great functional dentistry, you can move toward treatment and recovery.

Bulimia-damaged teeth can be repaired. You will smile again. I’ve seen it before in my patients who have gone through this and come out the other side—confident in the beauty that’s been there all along.

Learn More: CBD for Dental Anxiety: Use This Natural Method to Stop Anxiety FAST

25 References

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