GERD and Bulimia

Gerd or Bulimia

GERD is the acronym for GastroEsophageal Reflux Disease, also known as ARD--Acid Reflux Disease, has essentially the same effect on the anterior teeth as Bulimia, which is the name given to the eating disorder in which a person binges on food and then vomits it up in order to loose weight. Both are caused by a reflux of stomach acid, either intentionally as in bulimia, or unintentionally as in acid reflux disease.

Bulimia has the worst effects on the lingual aspects of the anterior teeth, while GERD effects the posterior teeth more than the anterior. However GERD and Bulimia both effect the lingual aspects of the anterior maxillary (upper) teeth in about the same way. As the palatal surfaces of the maxillary incisors erode, the incisal edges become more and more thin and translucent, eventually producing a knife-edge which is easily crazed and chipped. In the image above, nearly all of the palatal enamel has been dissolved by the acidic stomach contents which have been projected against the incisors. Note especially that the erosion stops abruptly at the gingival margin.

Bulimia

Compare the image below with the ones above. This is also an image of the palatal aspects of the maxillary incisors. The severe wear might be mistaken for bulimia or GERD, but the position of the wear is above the free gingival margin, unlike bulimia in which the erosion goes exactly to the free gingival margin. Also note the irregularity of the margins themselves. Plaster models of the upper and lower teeth would show that the lower incisors fit exactly into the defects at the gingival margins.

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