Impact of an oral health education intervention among a group of patients with eating disorders (anorexia nervosa and bulimia nervosa)

Abstract

Background It is recognized that eating disorders are serious psychosocial illnesses that affect many adolescents and adults. A pre and post survey study was developed to assess demographics, oral health knowledge and self-image of patients with eating disorders participating in a hospital-based eating disorder clinic using an original oral health education program. The program’s aim is to change the self-image and oral health practices of patients with anorexia-binge eating/purging (AN-BP) and bulimia nervosa (BN) disorders. Methods A pre-survey was completed by each study participant prior to attending the three educational sessions over a six-week period. A post survey questionnaire was completed after participation in all the educational presentations. Forty-six patients attended all three educational sessions and completed the pre and post-questionnaires. Results Most patients knew in advance that AN-BP and BN behavior can cause erosion of the teeth but only 30% knew the most likely location for the erosion to occur. But, following completion of the educational interventions, 73% answered the location correctly. Patients who reported going to the dentist regularly were significantly more likely to respond that their teeth/mouth had a positive effect on how they looked to themselves and to others, their general health, and their general happiness. Positive responses to the effect of the teeth/mouth on kissing and romantic relationships were also significantly higher for those who go to the dentist regularly compared to those who do not. Conclusions There is a need to further understand AN-BP and BP patients’ oral health knowledge and self-image perceptions as it relates to their smile (teeth, mouth) to assist in developing a standardized oral health program for eating disorder centers to implement into their daily curricula. A dental team member in an interdisciplinary eating disorder treatment team is important. Including an oral health education program improves patients’ oral hygiene and oral health knowledge, as well as provides a supportive environment to empower the patients to take control of their overall oral health. Trial registration This study was retrospectively registered on April 18, 2019 in ClinicalTrials.gov, Identifier: NCT03921632 .

Oral Health Interventions in Patients with a Mental Health Disorder: A Scoping Review with Critical Appraisal of the Literature

“…With regard to the study design, four RCTs [45][46][47][48], six quasi-experimental studies [28,[49][50][51][52][53] and one cohort study [54] were included. Four studies were conducted in Europe, three studies in North America and four studies in Asia.…”

“…Quasi-experimental studies Barbadoro et al [51] x Khokhar et al [52] x De Meij et al [28] x x x x x x Mori et al [50] x Silverstein et al [53] x Singal et al [49] x…”

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

“…[86][87][88][89] Therefore, inclusion of a dentist trained in the examination and treatment of patients with eating disorders should be considered in multidisciplinary teams. 90 Given that the majority of non-dental professionals specialized in treating eating disorders (psychiatrist, physician, dietician, etc) are not satisfied with the level of oral health education during their formal education, collaborations between oral and non-oral health professionals are strongly encouraged. 91…”