Let's talk about teeth!

Today's topic is teeth. Yeah, I know, I've talked about it before on here. But I think it is one of the neglected parts of our bodies we talk about with eating disorders. And let's face it realistically, many of the symptoms, ie starving, purging, chewing/spitting, etc. can all cause some major teeth damage. It's only been fairly recently that we've realized how early dentists can pick up on the preliminary effects of an eating disorder, though I'm still not sure how much it is discussed in general (for one, none of my dentists ever said anything, I had to tell them)

For those off you who don't know my story, I was bulimic for many years. For over a decade now, I've had some numerous teeth problems, costing thousands of dollars, no joke! It is sadly probably one of the permanent damages from my eating disorder. Currently, I need like 3 or 4 implants and a bridge replaced. No fun, everyone. It sucks to lose your teeth to harsh, violating acts you have done on your body.

So here's the thing. Though logically I knew my teeth damage was likely permanent, I did have some hope I could reverse part of the damage or at least keep it at bay by not purging which I kicked when I began my "true" recovery about 2 1/2 years ago (gosh, it has been hard to believe it has been that long) For me, training for the marathon that year (2008) was part of the impetus to end that bittersweet love affair. There have been some other complications with that, but that is another story for another day.

A few weeks ago, I had a dental appointment. This was for a general cleaning (last time, they just did a light cleaning due to some "pockets") and to have 3 cavities filled. Yes 3! Prior to this, I didn't have any indications other than some slight tenderness to coldness. There hasn't been any purging in a long time, there was no major killer infection or toothache this time, yet still, I was surprised to have 3 cavities! I also have an irritation where one of my teeth was extracted, but my dentist said she could not find anything. It's annoying knowing that something is causing that irritation but not to have a reason.

In some wrong assumption (you know where logic fails you), I had thought that once I stopped purging, all my teeth problems would be resolved. I had felt that just like I was taking care of my body, I was also taking care of my teeth in the same way. I brushed, flossed (okay, this could be better), rarely drank soda or carbonated beverages, etc., but problems still arose. Don't get me wrong, I have far less trouble with my teeth than before, but it is still a reminder that I must be vigilant about them. And that, yes, I will likely always have some susceptibility to teeth problems.

So people, the take home message is don't forget about your teeth! You may not think you are doing damage now, but this like other symptoms of an ED can be lasting and permanent. This certainly doesn't mean that if you have teeth damage, then the hell with it, there is no hope. But rather, be vigilant, remind yourself that you only have your teeth once, so just like the rest of your body, they are important to take care of. (there's only been a very few people that I've known who could actually grow teeth!) Go see your dentist! Just like you would see a medical doctor, therapist, psychiatrist, or dietitian/nutritionist, your dentist is important too!

Okay, I'm done for my spiel of the day. :-)

A lapse on a slippery slope

Sarah from Bearing, Eating, Being blog told Cammy in a recent comment: "Slips and lapses can be turned around if you recognize what you've done and take immediate steps (as in THAT DAY) to change them."

In eating disorder recovery, there are bound to be slips, lapses, and even relapses (though I disagree that that is a requirement). It truly does matter how we respond to each event in determining whether we slide down the slippery slope or continue to climb our way back to the top. Sometimes, it's an easy choice to climb back up the slope, while at other times, you feel doomed and propelled downwards whether it is a conscious choice or gravity simply pulling you down.

I say all this, because I experienced a horrible lapse Sunday after already being tipped on the edge of the slippery slope. I purged for the first time in over 8 1/2 months which sums only a handful of time in the last year in a half. Somehow, I feel the need to justify myself--was in crippling stomach pain, doubled over, could barely walk, but really what average person thinks about purging when they are in severe pain? Despite feeling much better afterwards, not like some euphoric high but just better physically, there were after effects. This after effect, I had forgotten about, one that has not happened to me in all my ED years.

Subconjuctival hemorrhage, the medical term for a rupture of a blood vessel in your eye.

Yes, that is my eye in all its bloody glory. Seriously though, I was shocked when I saw this the next day as I was leaving for my therapy appointment. At first, I was very concerned, but after talking to my optometrist, I realized there wasn't much that could be done except a cold compress, prescription drops if there was pain, and waiting 10-14 days for the blood to reabsorb. I spoke to a friend about how this could have occurred since it has not in my many years of ED. Her answer, "well, you're older, your body is older and reacts differently, and EDs are cumulative."

In essence, this proved to be yet another reminder at the ill effects of purging. I know subconjuctival hemorrhage occurs with other things like a violent sneeze or cough, but there is such an element of shame in the fact that it was purging that caused this. At least, this is the way I feel about it. A few people have asked me about it, and I admit, I make up an excuse that something hit me in the eye. I know I could very well say I was violently ill with stomach bug and vomited, but somehow, that feels too close for comfort.

I truly know it is useless to self abuse myself further by dwelling on this incident. I am positive that purging is NOT going to become a habit again. But the question remains now about what next? Do I dust myself off, climb back the mountain or let gravity pull me down? I know which answer is right and logical, and that is the answer I want to give of course. But do I really believe it?

Ultimately, I know I'm going through a rough patch with an overgrown number of weeds, and it is not wise for the weeds to continue to accumulate nor the patch to grow any further. Therefore, I need to use some weed killer and monitor the patch. Because, in the end, who really wants weeds anyway?

Note--*I have no clue whether that last metaphor actually made sense.
*That photo was really hard to take. Had it been my left eye rather than my right, it would have been much easier and the picture clearer. I guess you get the idea though.

Restorative teeth

Ever wonder what your teeth could look like from bulimia? Here's an example:

Here's a result after major teeth restoration:

This specific case of a young woman who had recovered from bulimia was featured in the Journal of Cosmetic Dentistry Spring 2008 and is retold here by a Virginia dentist. The press release goes into much detail on the treatment plan and how her teeth were restored.

Besides these interesting details, the conclusion was the best part. This dentist said, "This patient's case involved many of the challenges we face daily in our practice. Just a few years ago, however, I would not have known in which direction to take her treatment. Perhaps I simple would have provided her with a bruxism appliance, while "patching up" some of her fractured restorations and attempting to improve her smile be restoring some of her anterior teeth with direct resins. these would have failed repeatedly, causing us both much frustration."

Though I certainly see this as a wonderful step in cosmetic dentistry, I hope that other dentists will follow in suit. I often wonder how many of us stop smiling or become more self-conscious due to our poor teeth conditions. It's kind of a sad predicament. I hope one day we will all be able to have our smiles back whether it is through cosmetic dentistry or not.

Note--*all images from Full Mouth Rehabilitation and Bite Management of Severely Worn Dentition

*Though the article doesn't talk about it, since this is cosmetic dentistry, the monetary costs for these procedures is quite substantial.

Tooth extracation day over

Just to report back that my tooth extraction went much better than either the periodontist and I had anticipated. I was in and out of there in an hour. It's definitely good that I was really numb, because periodontics is like the orthopedics of dentistry. I found it funny, because even though I had a sheet over my eyes, I still found myself closing them. Dr. V. said it was so water wouldn't splash into my eyes, but I think it's more for any tooth fragments that might fling into the air and hit your eyes.

Dr. V. was also very good about prescribing the meds I wanted, i.e. an antibiotic and pain med that doesn't give me side effects. Luckily, I have not had much pain at all. I think it's because he did not have to cut into my gum. I'm super glad about all this, however, chewing and eating are a bit challenging.

If you look at that dental x-ray picture in my previous post, basically imagine the entire upper left side gone but one tooth (originally, a bridge was there which they had to section), then a hole beside that tooth from the previous extraction. On the lower right side, a hole halfway between the back and front of my mouth. That's essentially what my mouth looks like now until I get the holes replaced with implants at some point in my life. I'm hoping nothing happens to that sole remaining tooth, then I'm up a creek without a paddle. Same goes for my right upper side which has a bridge as well.

As I left the office and was waiting to schedule my follow-up appt., I glanced over at another x-ray which was very similar to mine except that the person in the chair was much older than me. It was one of those moments of realizing how young I am with this much damage. People my age are not supposed to have ruined teeth. Even my mom who doesn't have the greatest teeth still have ones better than mine. And to think I used to compete with her as to not having cavities when I was younger.

Anyway, I'm now going to stop whining about my teeth. I can't change them for now but just accept it and move on just like the rest of life.

Tooth extracation day

image: about.com

I've been dreading this day since I made the appt. two weeks ago. I'm not even sure why I am so worried about it. I've had countless dental appointments unfortunately and a year in a half or so ago, another tooth extracted. I think it's the pain I'm concerned about. I'm never like this either. Pain to me is like a bone sticking out of your arm or blood gushing out of you. I'm not a wimp about pain, but teeth pain seems to be the hardest for me to deal with. I'm also worried that the dentist is going to end up prescribing some pain killer which gives me awful side effects despite me voicing my concerns about it. This has happened before, so it's not my imagination.

Please don't think I'm nonchalant about losing my teeth, because it really does sadden me quite a bit. It's a grim reminder that even if I never purged multiple times a day, my teeth are still ruined from it.

So at 2:30 PM today, be thinking of me. Hopefully, it'll go better than expected. I guess I should think "happy," positive" thoughts. Maybe it'd be better for me to go off to some la la state where I'm sitting on a beach sipping some non-alcoholic beverage watching the sunset. Okay, I know, a little cliche, but I can dream for the moment, right?