Q. Several of my patients have oral health issues related to their eating disorders.Are there any dental health programs we might use to better educate these patients? (L.H., Louisville, KY)
A. It can be really helpful for people with EDs to better understand oral health. A recent study byDr. Laura S. Silverstein and a team at the University of North Carolina, Chapel Hill, NC, describes the impact of a 3-session oral health intervention among a group of patients with AN and BN (J Eat Disord. 2019; 7:29). The team evaluated the effectiveness of an original oral health education program, “Smiles Matter,” which aims to improve oral hygiene knowledge and dental practices to help individuals take control of their oral health
The study group attended 3 educational sessions, which covered general oral health, the effects of eating disorders on teeth, and nutritional ways to improve oral health. The patients learned which foods stimulate saliva and which stick to the teeth and raise the pH of the mouth. Sixty-seven entered the study and 46 attended all sessions and provided pre- and post-intervention data.
The authors found that 59% of the patients reported seeing a dentist regularly, but 20% reported seeing a dentist only when they had a dental problem. Only 11% said they did not plan to visit a dentist, and 93% of patients correctly answered that dental erosion was the most common dental finding among people with eating disorders. Fifteen percent had been referred to a dentist since their eating disorder was discovered. While most patients knew in advance that eating disorders can lead to erosion of the teeth, only about a third knew the most likely place in the mouth where erosions would occur.
Patients who made regular visits to the dentist 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 general happiness than did those who reported only going to a dentist occasionally. The authors stressed how helpful it is for those with eating disorders to have access to a welcoming dental practice, or dental “home,” to help provide a supportive environment for their oral health and self-image.