Posts for: March, 2015
While most dental problems are caused by disease or trauma, sometimes the root problem is psychological. Such is the case with bulimia nervosa, an eating disorder that could contribute to dental erosion.
Dental erosion is the loss of mineral structure from tooth enamel caused by elevated levels of acid in the mouth, which can increase the risk for decay and eventual tooth loss. While elevated acid levels are usually related to inadequate oral hygiene or over-consumption of acidic foods and beverages, the practice of self-induced vomiting after food binging by bulimic patients may also cause it. Some of the strong stomach acid brought up by vomiting may remain in the mouth afterward, which can be particularly damaging to tooth enamel.
It’s often possible to detect bulimia-related erosion during dental exams. The bottom teeth are often shielded by the tongue during vomiting, so erosion may be more pronounced on the unshielded upper front teeth. The salivary glands may become enlarged, giving a puffy appearance to the sides of the face below the ears. The back of the mouth can also appear red and swollen from the use of fingers or objects to induce vomiting.
Self-induced vomiting may not be the only cause for dental erosion for bulimics. Because the disorder causes an unhealthy focus on body image, bulimics may become obsessed with oral hygiene and go overboard with brushing and flossing. Aggressive brushing (especially just after throwing up when the tooth enamel may be softened) can also damage enamel and gum tissue.
Treatment must involve both a short — and long-term approach. Besides immediate treatment for dental erosion, a bulimic patient can minimize the effect of acid after vomiting by not brushing immediately but rinsing instead with water, mixed possibly with a little baking soda to help neutralize the acid. In the long-term, though, the eating disorder itself must be addressed. Your family doctor is an excellent starting point; you can also gain a great deal of information, both about eating disorders and treatment referrals, from the National Eating Disorders Association at their website, www.nationaleatingdisorders.org.
The effects of bulimia are devastating to mental and physical well-being, and no less to dental health. The sooner the disorder can be treated the better the person’s chance of restoring health to their mind, body — and mouth.
If you would like more information on the effect of eating disorders on oral health, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Bulimia, Anorexia & Oral Health.”
Nolan Gould, who plays Luke on the popular TV comedy Modern Family, has beautiful, straight teeth. But in an exclusive interview with Dear Doctor magazine, the young actor said it wasn't always that way.
“My teeth used to be pretty messed up,” Nolan said. “I had two extra teeth when I was born. They hadn't come out (erupted) yet. And all the other teeth that were already there were starting to point backwards because it was getting so crowded in my mouth. At about the age of 7, I started going to the orthodontist to get my teeth checked.”
Age 7 may sound early for a visit to the orthodontist, but in fact that's exactly the age we recommend for a first orthodontic evaluation. Malocclusions (bad bites) often become noticeable around this time, as the child's permanent (adult) teeth erupt. We might already be able to see evidence of the following problems: crowding, too much space between teeth, protruding teeth, extra or missing teeth, and sometimes problems with jaw growth. So even if your child is too young for braces, it is not necessarily too early for an orthodontic evaluation.
This type of exam can spot subtle problems with jaw growth and emerging teeth while some baby teeth are still present. Early detection of orthodontic problems makes it easier to correct those problems in the long run. Waiting until all of the permanent teeth are in, or until facial growth is nearly complete, may make correction more difficult or even impossible. That's why the American Association of Orthodontists recommends that all children get a check-up with an orthodontist no later than age 7.
Orthodontic treatment itself usually begins between ages 7 and 14. Therapy that begins while a child is still growing, often referred to as “interceptive orthodontics,” helps produce optimal results. In Nolan's case, an early orthodontic evaluation allowed his orthodontist enough time to plan the most effective treatment. Nolan's two extra teeth were removed before they had a chance to push his other teeth even further out of alignment, and he was given orthodontic appliances which fit behind the teeth.
“You can remove them, which is really good for acting, especially because you can't see them. I can wear them 24/7 and nobody will ever notice.”
One thing that is noticeable, however, is Nolan's perfectly aligned smile!
If you would like to learn more about improving tooth alignment with orthodontics, please contact us to schedule an appointment for a consultation. To read Dear Doctor's entire interview with Nolan Gould, please see “Nolan Gould.” Dear Doctor also has more on an “Early Orthodontic Evaluation.”