As your Mississauga dentist our team at Credit River Dental Centre always want to provide you with as much knowledge as possible so you can make the best decision when it comes to your oral health. This includes eat disorders and its impact on your oral health. Unfortunately eating disorders affect almost 10% of the population and the prevalence is usually about 1.75-3 times more likely in women. Bulimia is one such example of an eating disorder. Bulimia may includerepeated episodes of vomiting or purging. The stomach acids are then able to erode the enamel of your teeth. As a result, dentists are often becoming the first line of defense when it comes to identifying possible eating disorders in their patients. Oral health includes all aspects of the health and functioning of your mouth, especially the gums and teeth. Your teeth say a lot about your overall health besides just allowing you to speak, eat, and laugh.
Patients with eating disorders are sometimes embarrassed to see their dentist because of oral issues they may be experiencing. Some of the signs that dentists use to determine if a patient suffers from an eating disorder include bad breath, sensitive teeth and tooth erosion.In fact, 89% of patients suffering from bulimiashow signs that can be seen dentally. For example, in patients with bulimia, the stomach acid from frequent vomiting wears away tooth enamel increasing the risk of tooth decay. This especially affects the tongue side of the upper front teeth as can be seen in the first photo.
Tooth enamel is softened by the stomach acids and if you vigorously brush, the tooth enamel may be further damaged by the scratching. After purging, patients should rinse their mouths out immediately with water to help remove acids or rinse with an alcohol-free fluoride mouthwash. This will give an added measure of protection against the acids from the stomach. Patients should then wait at least an hour to brush their teeth after purging.
When there is moderate to advanced erosion of the teeth which can include not only the enamel but also the layer under the enamel called the dentin, because there is very little tooth structure remaining as a result of the erosion, extreme caution must be used if we want to restore the teeth. The reason for this is that although we want to maximize the amount of tooth structure that the restoration can bond to for all patients, this is especially crucial when there is not much tooth structure to work with. In particular, enamel bonds better to restorations than dentin does and so we need to be very careful to preserve as much enamel as possible.
In the first photo, our patient is a woman in her 50’s and you can see how the tongue side of the upper teeth are affected by the stomach acids.
The first step was to perform a complete oral examination with all necessary photos and xrays as well as making sure that there was no joint pain or TMJ issues.
At the next appointment we took what is called a facebow measurement which orients the upper teeth to the jaw joints. Impressions were then sent to the lab to fabricate a wax up on which to duplicate for our mock up and temporary restorations.
14 minimally prepared restorations were placed on the upper teeth only as the lower teeth were unaffected Veneerlays (veneer/onlay) were placed on the 8 posterior teeth and “taco shell” veneers were placed on the 6 anterior teeth. The restorations were placed to not only improve her esthetics but also replace her lost tooth structure to give our patient her bite back. You can see in the final photo how much tooth structure had been lost due to the erosion and now replaced by the restorations.
Being able to detect the condition early usually helps ensure a more successful restorative outcome because there is likely less erosion. When treating teeth where there is a minimal amount of enamel presents a challenge when we are bonding porcelain restorations and we must be careful to preserve as much as possible.
If you have any questions regarding your smile or want to discuss ways your smile can be improved through a smile makeover don’t hesitate to contact one of our team members for a consultation at (905) 278-4297. We look forward to help you reach your smile goals!!!