This study investigated oral pathologies associated with bulimia nervosa and examined the relationship between these pathologies and the bulimic's binge eating, vomiting, and postvomiting oral hygiene. Results revealed a greater prevalence of enamel erosion, dental caries, dentin hypersensitivity, parotid dysfunction, and xerostomia in the bulimic group when compared with a nonbulimic control group. Enamel erosion was related to the duration of vomiting behavior. After 6 months the majority of bulimics exhibited erosion, which increased in severity with time. Tap water rinsing appeared to enhance erosion and cannot be recommended as a postvomiting hygiene practice. Since oral pathology may be the only detectable sign of bulimia nervosa, the information provided by this study facilitates the identification of bulimic patients and provides guidelines for evaluation of oral pathology in bulimia nervosa.