How Does Bulimia Affect Your Jaw?

Bulimia jaw is a term for a number of symptoms that can result from the purging aspect of bulimia nervosa (BN). It can refer to swelling, intense pain, and a misalignment of the jaw, and sometimes require surgery to correct.

The best way to prevent bulimia jaw is to seek help for bulimia nervosa as soon as possible. Working on ending purging behavior while also working to improve your diet can do a lot to reduce or eliminate the impact of bulimia jaw.

What is ‘Bulimia Jaw’?

When someone has been struggling with long-term bulimia nervosa, they can sometimes experience bulimia jaw. The ailment is derived from a number of issues connected to the purging behavior associated with BN.

Causes of Bulimia Jaw

Frequent vomiting can work to inflame the salivary glands, particularly the parotids, which are located just under the ears. This swelling can not only be painful but result in an altered face shape, sometimes referred to as bulimia jaw or bulimia cheeks.

The issue can also sometimes be connected to enamel erosion, also caused by frequent vomiting. In particularly bad cases, teeth can become so severely eroded it can lead to a change in your bite or the alignment of your teeth and jaw. [1]

And the malnourishment associated with long-term BN can also contribute to bulimia jaw. Osteoporosis, or a weakening of the bones, is a common symptom of malnourishment, and the effect can lead to a misaligned jaw. [1]

Bulimia's affect on teeth

What Are the Signs of Bulimia Jaw?

Generally, bulimia jaw looks like a change in the shape of someone’s face. Swelling in the cheeks and jaw will give a puffier appearance, and the experience can also be painful.

A misaligned bite may be harder to detect, but it’s characterized by teeth not meeting as they normally would. This particular symptom can also cause facial pain or result in neck pain, migraines, or even shoulder pain. 

At times, repeated purging behavior can lead to significant misalignment of a person’s jaw, which has the potential to be extremely painful in addition to causing notable bite changes. [2] 

When the swelling of the jowls and lower jaw becomes severe enough, it can push on the jaw joints, causing a domino effect that can send pain all the way from the shoulders to the neck. In some cases, surgery may be required to fix the issue.

How Long Does Bulimia Jaw Take to Develop?

More research is needed to determine how long it typically takes for someone to develop bulimia jaw. What’s clear, however, is that the ailment and its related issues are more common among people who purge frequently. And the longer a person has been purging, the more likely they are to experience these effects. 

One study noted that swelling along the jawline can take place as long as three to six days after a purging episode. [3] Still, every patient may experience the issue differently, depending on their unique habits, physiology, and the severity of their condition. 

Other Oral Health Problems Related to Bulimia Nervosa

Bulimia jaw isn’t the only oral complication that can be caused by frequent purging.

Self-induced vomiting can introduce an outsized amount of acid to the delicate digestive system, causing damage to the surfaces it runs over, including the lining of the esophagus and the enamel that covers your teeth.

And the combination of frequent purging and the nutritional deficiencies commonly associated with BN can result in a number of other issues, including: [4]

  • Enamel erosion
  • Dental caries (tooth decay)
  • Dental pain
  • Dry-mouth
  • Decreased saliva excretion
  • Decreased salivary pH
  • Swallowing impairment

Still, most of these maladies can be reversed or corrected completely with the return of a nutritious diet and the ending of purging behavior. The only two exceptions are tooth decay and enamel erosion, which, unfortunately, represent permanent damage and must be dealt with as quickly as possible to prevent worsening. [4]

How to Treat Bulimia Jaw

The oral effects of bulimia nervosa can be distressing and painful—and they are only some of the health impacts the condition can cause. 

In severe cases, some of these issues may require surgery in order to improve. Still, many of these problems will begin to self-correct once a person seeks treatment for BN. 

Adopting healthier eating habits and reducing or eliminating purging behaviors can go far to reduce swelling and any damaging effects of stomach acid. 

And happily, there are a number of treatments that can be used to help with bulimia nervosa, including: [5]

  • Interpersonal psychotherapy
  • Dialectical behavior therapy (DBT)
  • Group therapy
  • Family therapy
  • Art therapy
  • Self-help

Treating Bulimia Nervosa

Treatment for bulimia nervosa requires a multi-faceted approach, combining different types of therapies and sometimes medication and even hospitalization. 

Cognitive Behavioral Therapy

The preferred treatment for bulimia nervosa is a type of psychotherapy called cognitive behavioral therapy (CBT), as this treatment is one of the most evidence-based and effective treatments for eating disorders. 

In CBT sessions, patients are taught to reframe their thoughts, in order to change their behaviors. They’re encouraged to rethink how they view themselves, their relationship with eating and food, and other related factors that may contribute to their disordered eating.


Medication is also sometimes used to treat bulimia nervosa or mental health issues that co-occur with it. 

A class of drugs known as SSRIs, or selective serotonin reuptake inhibitorIs, have been found to be particularly helpful as a supplemental treatment. [6] Though, it’s generally recommended to take medication in conjunction with other types of treatment, such as therapy.

Regardless of which method you choose, treating bulimia nervosa itself is the best and only way to permanently treat bulimia jaw. The process may be long and difficult, but with help, support, and guidance, it will always lead forward on a path toward healing.


  1. Bulimia: Oral Effects. (2022). Colgate. Accessed December 12, 2022.
  2. Dangers of Eating Disorders. (2022). Mello & Tabib. Accessed September 14, 2022.
  3. Brady, J. P. (1985). Parotid Enlargement in Bulimia. The Journal of Family Practice; 20(5):496-500.
  4. Bretz W. A. (2002). Oral Profiles of Bulimic Women: Diagnosis and Management. What is the Evidence? The Journal of Evidence-Based Dental Practice; 2(4):267–272.
  5. Costa, M. B., & Melnik, T. (2016). Effectiveness of psychosocial interventions in eating disorders: an overview of Cochrane systematic reviews. Einstein (Sao Paulo, Brazil); 14(2):235–277.
  6. Fluoxetine. (2022, January 15). National Library of Medicine. Accessed September 14, 2022.

Last Update | 12 - 13 - 2022

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