I have a question about eating disorders and dental health.

October 18, 2015 12:39 PM

I have a question about eating disorders and dental health. It's probably not something you want to read if you are also struggling with ED or in recovery.

Bulimia relapse. Read somewhere that you shouldn't brush your teeth right after purging because that makes the damage to your teeth WORSE, but that seems like bullshit, right? Is there anything I can do to minimize the effects of having stomach acid in my mouth regularly?

There's a ton of HELPFUL TIPS! on pro-mia boards but I can't even google that shit, you have no idea how bad that would be for me.

This is not really a question you should trot out your "oh, honeys" and tough love on. Save it for relationship filter please.

posted by Juliet Banana to Health & Fitness (17 answers total)

Best answer: Short version:
-Rinse your mouth out with water (and optionally a fluoride mouthwash)
-Wait an hour before brushing.

That's from an info sheet here:

-Ideally teeth should be brushed twice a day using a small headed, medium bristled toothbrush and fluoride toothpaste (1500 parts per million fluoride).
-A fluoride mouthwash should be used either daily or weekly according to the manufacturer’s instructions.
-It is important to clean between the teeth and below the gum line, this can be done using dental floss or interdental brushes.
-Following an episode of vomiting, it is advisable to rinse the mouth out with water or ideally a fluoride mouthwash to avoid the effects of gastric acid on the teeth.
-After vomiting, teeth should not be brushed for at least an hour to allow the acid conditions created in the mouth to settle down. If the teeth are brushed immediately after vomiting, acid is brushed directly into the tooth surface causing further destruction.
-After bingeing on sugary foods/drinks, again the mouth should be rinsed with water or a fluoride mouthwash, taking care not to exceed the recommended dose. Ideally the teeth should be brushed before eating, but if this is not practical again wait at least an hour after sugar consumption.
-If pain and sensitivity are experienced, the use of a fluoride mouthwash or “sensitive” toothpaste may be beneficial. Ask your dentist, dental hygienist or dental therapist for advice.
-It is important to visit the dentist regularly for check-ups.

And it's obvious, but still, I hope you're in contact with someone who can support you in an ongoing way right now.
posted by LobsterMitten at 12:51 PM on October 18, 2015 [6 favorites]

This is a short fact sheet about eating disorders and tooth care which backs up the idea that you shouldn't brush your teeth immediately after purging as stomach acid weakens the tooth enamel.
posted by billiebee at 12:54 PM on October 18, 2015

I have gastric reflux, sometimes pretty bad, so my teeth have seen more than their fair share of stomach acid. It does weaken your teeth when the acid is on them and going at them with a toothbrush at that time is definitely a bad idea. The best thing to do is just wash them off with lots of water. It will get rid of the acid pretty quickly, then you can do whatever you like. Same goes for your throat actually, a big drink of water will go a long way towards removing the immediate acidity with the problems that brings.

I did some googling about reflux and tooth erosion and that backs up my experience.
posted by shelleycat at 12:55 PM on October 18, 2015

I really don't think it's going to make a big enough difference to matter.

Actually, tooth enamel dissolves at pH 5.5 and stomach acid is pH 2,0, brushing right then really can make a big and very real difference.
posted by shelleycat at 12:56 PM on October 18, 2015

(and I somehow edited out the 60 minute waiting period from my first comment but do that too)
posted by shelleycat at 12:58 PM on October 18, 2015

Best answer: In addition to rinsing with water, this article suggests rinsing with a neutralizing solution made of one part baking soda, eight parts water.

The article also agrees with the suggestion that other posters here have mentioned of waiting a minimum of 30 minutes before brushing after teeth have been exposed to acid.
posted by Hellgirl at 1:02 PM on October 18, 2015

Mod note: Couple of comments deleted; folks, this is not the best place for guessing, even if it's in a supportive spirit.
posted by LobsterMitten (staff) at 1:03 PM on October 18, 2015

I have also seen the baking soda recommendation + 1 hour wait, and that was in the context of chemo sickness so the baking soda was an "if you can stand it" suggestion, otherwise just water.
posted by Lyn Never at 1:12 PM on October 18, 2015

My dad had bad acid reflux, and his dentist had him using a strengthening toothpaste and mouthwash with extra fluoride.
posted by Rosie M. Banks at 1:22 PM on October 18, 2015

Best answer: If you can rinse and then chew a Tums- even if you spit it out after chewing, it will help neutralize the acid. Wait an hour before brushing. This is based on my experience as a mom of reflux kids who reflux up into their mouths. Ugh.
posted by PorcineWithMe at 2:13 PM on October 18, 2015

I'll nth that you should not brush your teeth immediately after. I've heard the same is true even if you've just had something acidic like Diet Coke. Stomach acid is extremely acidic. I would definitely rinse your mouth out thoroughly with water. I could see how adding baking soda which is alkaline (basic) would help neutralize, but I think that would make me gag more, personally, although of course YMMV. Thorough rinsing with water should help neutralize the acid pretty effectively followed by 30 to 60 minutes of waiting before you brush.

When you do brush your teeth, if you're interested in toothpaste recommendations, I have found Sensodyne pronamel toothpaste to work very well. It's definitely helped with my tooth sensitivity to hot and cold. (I am in recovery from an ED* and also have severe acid reflux, most likely because of the ED, so I've experimented with several different toothpastes.)

If you do start having any acid reflux symptoms, I would highly recommend taking prilosec or prevacid. (My PCP said that there's really no difference between prilosec and prevacid, so I usually just buy whichever is cheapest. Nexium always seems to be most expensive, so I don't buy that. Of course, IANAD/IANYD/etc.) The stomach acid from the reflux can definitely do additional damage to your teeth (as noted by previous commenters), and it can also damage your esophagus. The prilosec/prevacid doesn't always start working right away, so you can try something like zantac on more of an as needed basis, but from the research I've done, it seems like proton pump inhibitors (prilosec, prevacid, nexium) are more likely to promote long term healing/relief.

*FWIW, I appreciate the warning above the fold even though I read this question anyway. I also think you phrased this in a very neutral, non-triggering (for me) way.
posted by litera scripta manet at 2:21 PM on October 18, 2015

I don’t have bulimia but I do drink/eat a lot of acidic things and I think my teeth are also just kind of cavity/decay prone. Anyway I have had a couple dentists/hygienists talk to me about it since I’ve had a lot of cavities along the gumline, and they’ve told me not to brush immediately after eating/drinking, but to rinse with water immediately and wait at least 30-45 minutes before brushing.

I have also read that chewing sugarless gum after your teeth have been exposed to acid helps restore the ph balance faster/can help prevent damage.
posted by car s at 2:37 PM on October 18, 2015

I did a lot of damage to my teeth while I was pregnant by brushing my teeth after vomiting (I often threw up mid-brush, and I was on my way to work, so I'd just finish the brush). My dentist said warm water was the best, followed by mouthwash if I needed the stink gone, but to wait at least an hour afterwards to brush.
posted by geek anachronism at 2:44 PM on October 18, 2015

Best answer: (and optionally a fluoride mouthwash)

If you want to use a fluouride rinse, which I think is a really good idea here, I recommend the ACT brand blue spongebob flavor. Children's rinse will be 1) cheap and 2) devoid of harsh mints, alcohols, and whitner agents that will aggravate an acidic mouth. And the blue spongebob ACT is the best flavor (imo) on the market right now.
posted by phunniemee at 4:35 PM on October 18, 2015 [5 favorites]

My dentist recommends washing my mouth out well with water after vomiting, then later on that day using Sensodyne Pronamel toothpaste. It's supposed to help with acid erosion.
posted by congen at 8:59 PM on October 18, 2015 [1 favorite]

Tums/Baking Soda before vomiting helps a ton. I used to binge/purge as a teen. I'd finish a binge with ice cream and Tums, then vomit until I dry heaved, drink some baking soda and water, then vomit again. My teeth are fine. I actually have better teeth than my brother, who had a soda habit during this same time period.
posted by domo at 9:13 AM on December 22, 2015

Response by poster: Just in case anybody's wondering (I always wonder) I started seeing a therapist & attending support meetings and have been doing a lot better for a few months now :) Thanks for your support during a really dark time.
posted by Juliet Banana at 12:53 AM on August 8, 2016 [5 favorites]