Self-induced vomiting and dental erosion--a clinical study

BMC Oral Health. 2014 Jul 29;14:92. doi: 10.1186/1472-6831-14-92.


Background: In individuals suffering from eating disorders (ED) characterized by vomiting (e.g. bulimia nervosa), the gastric juice regularly reaches the oral cavity, causing a possible risk of dental erosion. This study aimed to assess the occurrence, distribution and severity of dental erosions in a group of Norwegian patients experiencing self-induced vomiting (SIV).

Methods: The individuals included in the study were all undergoing treatment at clinics for eating disorders and were referred to a university dental clinic for examinations. One calibrated clinician registered erosions using the Visual Erosion Dental Examination (VEDE) system.

Results: Of 72 referred patients, 66 (63 females and three males, mean age 27.7 years) were or had been experiencing SIV (mean duration 10.6 years; range: 3 - 32 years), and were therefore included in the study. Dental erosions were found in 46 individuals (69.7%), 19 had enamel lesions only, while 27 had both enamel and dentine lesions. Ten or more teeth were affected in 26.1% of those with erosions, and 9% had ≥10 teeth with dentine lesions. Of the erosions, 41.6% were found on palatal/lingual surfaces, 36.6% on occlusal surfaces and 21.8% on buccal surfaces. Dentine lesions were most often found on lower first molars, while upper central incisors showed enamel lesions most frequently. The majority of the erosive lesions (48.6%) were found in those with the longest illness period, and 71.7% of the lesions extending into dentine were also found in this group. However, despite suffering from SIV for up to 32 years, 30.3% of the individuals showed no lesions.

Conclusions: Dental erosion commonly affects individuals with ED experiencing SIV, and is more often found on the palatal/lingual surfaces than on the buccal in these individuals, confirming a common clinical assumption.

MeSH terms

  • Adult
  • Beverages / adverse effects
  • Bulimia Nervosa / complications*
  • Dental Enamel / pathology
  • Dentin / pathology
  • Feeding Behavior
  • Female
  • Humans
  • Hydrogen-Ion Concentration
  • Incisor / pathology
  • Male
  • Middle Aged
  • Molar / pathology
  • Time Factors
  • Tooth Crown / pathology
  • Tooth Erosion / classification
  • Tooth Erosion / etiology*
  • Vomiting / complications
  • Young Adult