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Pathology · single question

A patient with Bulimia — where are the teeth MOST affected?

  1. Lingual surfaces of upper maxillary teeth
  2. Lingual surfaces of lower mandibular teeth
  3. Buccal surfaces of posterior teeth
  4. Occlusal surfaces of molars
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Correct answer: A. Lingual surfaces of upper maxillary teeth

  • A. In BULIMIA NERVOSA (purging type), DENTAL EROSION occurs on the LINGUAL/PALATAL SURFACES OF THE MAXILLARY (upper) anterior teeth. This is because vomiting introduces gastric acid that flows upward and contacts the palatal surfaces of the upper teeth preferentially. The pattern: lingual maxillary erosion (acid from stomach) vs. buccal/facial erosion (acid from acidic beverages). Mandibular teeth may also be affected but MAXILLARY LINGUAL is the classic pattern.
  • B. The lingual mandibular surfaces are bathed in saliva (lingual to lower incisors is a salivary gland duct opening) and are protected from acid. Maxillary PALATAL/LINGUAL is the classic bulimic erosion location.
  • C. Buccal erosion is typical of ACIDIC BEVERAGES (sports drinks, citrus) — not bulimia.
  • D. Occlusal erosion occurs from acidic beverages or GERD, but is NOT the hallmark location of bulimic erosion.

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