No guidelines yet exist for dietitians working with persons with eating disorders.
Eating-disorder-related behaviors, including binge eating and purging, can lead to significant oral and dental complications. To make matters even worse, many people with eating disorders ignore their oral health due to general anxiety about dental care, or fear, or even embarrassment. This is certainly the case in Australia, according to the results of a recent study. Although Australian dietitians are well positioned to provide basic dental screening in general practice, their role has not yet been established, say researchers at Western Sydney University, Sydney, Australia (J Eat Disord. 2020; 8:49).
Tiffany Patterson-Norrie of the School of Nursing and Midwifery, Sydney, Australia, and a team of researchers recently reviewed major databases, and then performed a literature review to find guidelines and recommendations to better define the role of dietitians in treating oral health problems, including those in patients with eating disorders. The authors also sought to review the knowledge, attitudes, and practices of dietitians and current models of oral health care and resources.
The authors found that current national and international position statements encourage dietitians to conduct basic oral health screening and to promote oral health in high-risk populations, such as in persons with eating disorders. However, there was no evidence to indicate that most Australian dietitians performed oral health screenings or offered education for patients with eating disorders. Some oral health promotion resources existed for dietitians working in pediatric, HIV, and geriatric clinical areas; however, no resources were identified for dietitians working with eating disorders patients.
Research uncovers two statements on oral health, none related to EDs
The authors found two position statements on oral health and the role of dietitians, a joint position statement and guideline from the Dietitians Australia (Dietitians Association of Australia) and the Academy of Nutrition and Dietetics (https://daa.asn.au/what-dietitans-do/dietitian-or-nutritionist; Canberra: Dietetics Association of Australia, Dental Health Services Victoria; 2015. p. 32). Both official statements supported the belief that nutrition is an integral part of oral health across all stages of life, and emphasized a shift toward multidisciplinary collaboration for patient-centered care.
The statements support and stress the need for collaboration between dietitians and dental practitioners for promoting oral health, and show that dietitians can play an important role in oral health care. However, no models of care yet exist where dietitians promote oral health among individuals with eating disorders. There are also no training resources and screening tools for dietitians in this area. Further research is required to develop this model of care and assess its feasibility and acceptability.