Bulimia is the chief cause of tooth surface loss. Gastro oesophageal reflux, chronic alcoholism and excessive consumption of carbonated sports drinks also cause erosion of the teeth.

ACID EROSION OF TEETH

One of the most damaging side effects of Anorexia Nervosa is Bulimia. This self-induced vomiting to purge the stomach, causes acid erosion of the inside surfaces of the teeth. The teeth become thin and start to fracture. preparation of these teeth is very difficult requiring great skill. Provided that early diagnosis and intervention is initiated it is possible to arrest the damage to the dentition. 

Acid erosion of dental enamel associated with bulimia is an insidious disorder that is rarely noticed by the patient or attendant physician until it has reached fairly advanced stages. Hypersensitivity only occurs when the erosion has removed enamel exposing dentine. Erosion occurs primarily on the biting surfaces of the posterior teeth and the inside surfaces of the maxillary anterior teeth coincident with the flow pattern of the vomit.

As the teeth wear down the bite closes to a malocclusion resulting in attrition, parafunctional bruxing (grinding/clenching) and eventual temporomandibular joint dysfunction syndrome. the posterior teeth become flat with crater-like depressions. It is common for bulimic patients to brush their teeth immediately after vomiting to get rid of the unpleasant acid taste. This practice will result in further removal of enamel, dentine and sensitisation.