Experience of Dental Health Care in Patients With Eating Disorders

Objectives: There is no evident dental treatment protocol for patients with eating disorders. Dental treatment is therefore usually postponed until patients are medically rehabilitated. This may lead to extensive dental damage, with great suffering and costs for both the patient and the society. The objective of this study is to assess how patients with eating disorder experience their oral health and dental treatment.
Methods:
DATA COLLECTION
10 informants, all females, aged 23-51 years (M=37.5) referred to Eastman Institute, a dental specialist clinic in Stockholm, were included in the study between 20220131-20230118. They were selected with the method of purposeful sampling. All were diagnosed with an eating disorder and in need of oral rehabilitation.

METHODS
A psychologist conducted individual interviews, recorded on tape, using a topic guide consisting of open ended questions related to the perception of oral health related to their eating disorder and experiences and expectations of dental treatment. The interviews were transcribed and analysed using thematic analysis according to Braun and Clarke.
Results: In dental health care the respondents were met with lack of knowledge and limited experience of treating patients with eating disorders and the oral consequences of the condition. The dental damage led to inhibition in social contexts, that negatively affected the quality of life. Patients expressed anxiety for future deterioration of the oral health. A prominent theme was feelings of guilt and shame for having caused the dental damage themselves. Their expectation of the oral rehabilitation was to regain a normal healthy smile, not being reminded of the eating disorder every time they inevitably looked at their teeth.
Conclusions: Interdisciplinary approaches to integrate oral health into the medical treatment of patients with eating disorders could have a positive outcome on the clinical efficacy of the treatment.