Bulimia Treatment for Teeth in Milwaukee
Overcoming Acid Damage
Porcelain Crown Reconstruction
Patients who have had to deal with Bulimia or Gastroesophageal Reflux Disease (GERD) can sustain damage that not only affects the cosmetic appearance and feel of natural teeth, but if left untreated for too long, these teeth can suffer irreversible structural changes that may be difficult to treat.
When Bulimia (binging and purging) is done repeatedly, the acid from the stomach erodes the enamel on the tongue side of the upper teeth as well as pitting and enamel loss on posterior teeth.
Acid in the regurgitated food is very strong and can quickly cause loss of tooth structure. When the tooth dissolves, the lower teeth super erupt (move upwards) into this space that is created.
Our patient, a single parent of 3 children, had a history of bulimia but neglected her own dental care for a few years to afford the dental care for her children as they were being raised. She had suffered with Bulimia for years and knew she had lost some enamel on her teeth. She didn’t like the gaps between her front teeth and the thin edges her teeth now had.
The first two photos in our picture series show the damaged enamel on the anterior surfaces of her teeth, as well as the lingual surfaces.
The patient was given her choice of different options for treatment plans and procedures.
The first option was to have Traditional Orthodontics to intrude the lower teeth to make room for the maxillary crowns. The patient however, refused to wear traditional orthodontic braces.
Ideally moving the lower teeth back down would eliminate the need for the dentist to perform further drilling on the tooth which has the potential of killing the nerve – since enamel erosion removed all the protective enamel. But …. the patient did not want to wear what she thought would be bulky orthodontic appliances that would not be very convenient.
The second option was to restore and/or reconstruct the affected tooth structures that would provide the best cosmetic outcome while re-establishing the best in oral health and dental function.
On examination of the photos, you can notice the shiny Sclerotic Dentin that is created from the “acid attack” that bulimic patients undergo when they purge. This dentin must be roughened so a crown can be cemented to it.
As in most treatment plans of this nature, some enameloplasty (tooth reshaping) was performed on the lower teeth to create space and allow for porcelain crowns to be custom fitted.
The patient worked closely with us during the wax up modeling process to achieve the desired contours of her crowns that were carefully duplicated by a master laboratory ceramist – Leszek Rapa Ceramics.
The patient was very pleased with the cosmetic and functional outcome. Weeks later, during a follow up visit the patient commented: “Dr. Rick you changed my life!
The pre-treatment conditions including the enamel damage and super eruption of certain tooth structures discussed in this bulimia treatment plan are very similar to events that can occur with patients who have a history of GERD. The acid attacks on tooth structures (more severe on posterior teeth) can slowly destroy tooth structure that will affect normal dental function and occlusal relationships.
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