When teeth are eroded due to bulemia or other acid sources, the treatment depends on the extent of the erosion. If caught very early (before much erosion of the enamel) bonding tooth colored composite resin to the teeth can provide some replacement of disolved tooth structure. This plastic material is softer than teeth and does not hold up well in areas that are subjected to any loading (back teeth). The material also has a tendency to stain over time and become unsightly.
Attempt to repair erosion with composite (arrows).
A more permanent treatment of erosion is to cover the teeth with crowns (caps)..
Smile with severely eroded teeth
View of the upper and lower teeth with the lips retracted. With so much tooth structure lost, the patient now closes farther than he used to before the teeth meet. This is called a loss of vertical dimension or a "closed bite". Crowns are needed to restore what has been lost.
A view of the chewing surfaces of the upper teeth of the above patient. Note the loss of enamel on the tongue side (lingual) of the upper front teeth. This is the classical appearance of erosion from bulimia.
A view of the chewing surfaces of the lower teeth of the above patient. Note the loss of enamel mostly on the chewing surfaces of the lower front teeth. This is also a classic appearance of erosion from bulimia. Patients with Gastric Reflux (GERD) usually exhibit loss of enamel on the cheek side (buccal) of the lower teeth which is not apparent in this case.
Here the upper teeth have been prepared for crowns. The lower teeth have already been prepared and now have plastic temporary crowns on them.
Upper teeth with plastic temporary crowns.
Smile of the finished crowns
Finished crowns with lips retracted
View of the chewing surface of the upper final crowns.
Before and after crowns.
Same patient 5 years after treatment. Although the patient has not ceased the bulimia, the teeth are protected since the porcelain is impervious to the acids.
Click here for additional images of bulimia treatment examples
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