Bassiouny Mohamed A
Department of Restorative Dentistry, Temple University, School of Dentistry, Philadelphia, Pennsylvania, USA.
Gen Dent. 2008 Nov-Dec;56(7):719-26.
This article examines the case of a woman with hard dental tissue loss that was similar to perimolysis caused by bulimia nervosa; however, the patient's health history, signs and symptoms, and dietary habits refuted any eating disorder. All extrinsic causes and the majority of intrinsic causes were examined carefully and eliminated. The patient had undergone endometrial surgery 32 years earlier to remove a tumor, a procedure that was believed to be unrelated to the dental professionals' realm; however, a detailed patient history revealed severe pain associated with abdominal cramps that were in concert with the menstrual cycle. Over a period of nearly three decades, these cramps frequently caused forceful purging of stomach contents during episodes of dysmennorhea. The mechanism, force, direction, and frequency of purging closely resembled that of bulimia, producing similar (if not identical) consequential damage to the dental hard tissues. The process of identifying, differentially diagnosing, and finally determining the etiology of the erosion lesions was based on an in-depth knowledge of systemic disorders, recognition of various characteristics and causes of erosion lesions, and an accurately detailed systemic and dental health history.