Eating disorders: experiences of and attitudes toward oral health and oral health behavior

Abstract

It is well known that early signs of eating disorders (EDs), such as dental erosion and enlarged salivary glands, may be recognized in the dental clinic. Dentists acknowledge that approaching a patient to discuss the suspicion of an ED is difficult. However, little is known about how persons with EDs experience and manage dental visits. Therefore, this study aimed to uncover knowledge, experience, and attitude of oral health and oral health behavior among persons with EDs. The study design was cross‐sectional and 260 persons with EDs completed an electronic questionnaire. The participants were generally concerned about their teeth. Some participants had anxiety around having severely and irreversibly damaged teeth, and many were overly occupied with oral hygiene procedures. One‐third of participants had good experiences regarding communication with a dentist, and about half of the participants wanted the dentist to address their EDs in the clinic. However, participants with less‐positive experiences stated that there is a need for dentists with specialized knowledge about EDs and communication skills that emphasize an open, empathic, recognition approach from the dentist toward patients with EDs. In addition, it may be advantageous to integrate dental advice and treatment as part of the treatment of EDs in line with psychological and medical therapy.

Eating disorders and oral health: a scoping review on the role of dietitians

“…Specifically for individuals with a mental health condition, barriers to maintaining oral health included a reduced awareness of the presence/risk of oral health problems, the affect of medications such as antidepressants resulting in manifestations such as dry mouth, lower self-esteem and body image, poor diet and fear and distrust of dental providers [ 24 – 26 ]. Although individuals with ED were generally found to be concerned about their teeth especially the long term impact of dental issues such as enamel erosion [ 27 , 28 ], their perceived barriers for not seeking dental intervention included reduced energy levels, anxiety, uncertainty about oral hygiene and distrust of dental providers [ 27 , 28 ]. If left untreated, oral health complications can impede dietary intervention and ongoing ED treatment due to dental pain or discomfort [ 29 – 31 ].…”

Eating disorders through the periodontal lens

“…It is surprising that only one-third of individuals with eating disorders considered their dentist to be the most helpful source of oral health information. 105,106 It is important to avoid inducing feelings of guilt on the patient and to initiate a positive face-toface discussion with the patient. Although people with eating disorders may only visit their dental health professional for urgent dental care, a regular recall prophylaxis should be encouraged and maintained.…”

“…Barriers to communication between people with eating disorders and their dentists have been surveyed. It is surprising that only one‐third of individuals with eating disorders considered their dentist to be the most helpful source of oral health information 105,106 . It is important to avoid inducing feelings of guilt on the patient and to initiate a positive face‐to‐face discussion with the patient.…”

Erosive tooth wear - why clinicians should be aware of this condition

“…30 Due to dental implications, dentists may be capable of suspecting eating disorders and contributing to early referral for specific treatment. 30,31 However, it has been detected a need for dentists with communication skills to provide an open and empathic recognition approach toward patients with eating disorders. 31…”

“…30,31 However, it has been detected a need for dentists with communication skills to provide an open and empathic recognition approach toward patients with eating disorders. 31…”