Perimolysis Pattern — ORE Part 1 MCQ
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Correct answer: E — Erosion of the palatal surfaces of the upper anterior teeth
The correct answer is E. Perimolysis is the characteristic erosion pattern in eating disorders with self-induced vomiting, affecting the palatal surfaces of upper anterior teeth in 81% of affected individuals. This occurs because gastric hydrochloric acid (pH <2) directly contacts and demineralises these surfaces during regurgitation. Option B is incorrect: erosion predominantly affects palatal/lingual surfaces (41.6%), not buccal surfaces (21.8%). Option A incorrectly describes attrition (mechanical wear) rather than erosion (acid-driven loss). Option D misidentifies the mechanism and location; cervical areas are protected by gingival crevicular fluid and salivary buffering. Option C incorrectly suggests labial rather than palatal involvement; labial surfaces are relatively protected by the oral anatomy and salivary defence systems.
Reference: Uhlen M-M, Tveit AB, Stenhagen KR, Mulic A. Self-induced vomiting and dental erosion – a clinical study. BMC Oral Health. 2014;14:92. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4125596/; Prasad KVV, Kumar P. Factors affecting the dental erosion severity of patients with eating disorders. J Clin Diag Res. 2014;8(12):ZC07–ZC12. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4406023/