What is the primary cause of enamel erosion in bulimia?

• A. Excess fluoride
• B. Stomach acid from vomiting
• C. Bacteria in plaque
• D. High sugar intake

Answer: (B)

Repeated exposure to stomach acid from vomiting is what drives enamel erosion in bulimia. Gastric juice is highly acidic, and when it contacts the teeth, it dissolves the mineral content of enamel. Saliva helps buffer this, but frequent vomiting overwhelms the mouth’s defenses, leading to progressive erosion, often most noticeable on the inner (palatal) surfaces of the upper front teeth where the acid pools. The other factors don’t cause this pattern: excess fluoride can harm enamel in other ways but isn’t the cause here; bacteria in plaque and high sugar intake mainly promote caries, not the chemical erosion produced by gastric acid exposure.