Erosion Caused by Bulimia

A 40 year old female presented with normal findings in her medical history.  Radiographs revealed generalized 1-2 mm bone loss with mild inflammation on gingival margins.  The IO exam showed signs of erosion of the entire dentition with no sensitivity.  The patient reported that she consumed a lot of acidic foods and beverages over a long period of time.  The patient was a heavy case and was treated in three visits.  The  patient did not disclose a past history of self-induced vomiting until the third visit in response to questions from the clinical instructor.  The patient admitted  that she was bulimic and routinely induced herself to vomit when she was approximately 17 years old and that this pattern continued for a period of almost two years.  She reported that she did not know that her bulimic behavior would cause erosion to her teeth.  She also reported that  she has no longer engaged in such behavior.

The treatment for the patient included: Use of 20% Benzocaine topical anesthesia, hand scaling, and application of 2% fluoride varnish.