Oral & Mental Health

Developing a Dietitian Initiated program for oral health and eating disorders

The prevalence of eating disorders has increased globally in the last 30 years. In Australia, more than 1,000,000 people have an eating disorder (9% of the general population) with prevalence rates increasing in children and adolescents. The adolescent phase (ages 13-18 years) has been identified as the peak period of onset for eating disorders. Compromised nutritional intake as a result of restrictive and obsessive dieting and purgative behaviours can have a damaging and irreversible impact on oral health. Individuals with eating disorders are at an increased risk of tooth sensitivity, demineralisation and caries which may impede dietary intervention and treatment. These individuals are also five times more at risk of developing dental erosion than those without an eating disorder. These dental problems can lead to a decline in self-esteem, quality of life and social psychology, all of which can be detrimental during the adolescence period where there is a focus on aesthetic appearance and development of self-concept and identity.

It is now recognised internationally and by the Dietitians Association of Australia (DAA) that eating disorders is an oral health risk in the adolescent population, and dietitians should encourage good dental hygiene and provide oral health care advice to this population. Dietitians form part of the multidisciplinary primary care team and are therefore in an ideal position to provide education, conduct oral health assessments, identify complications and recommend nutritional interventions during inpatient consultations. Despite these recommendations, currently there is no evidence of interventions that assist in early identification, screening or oral health education of adolescents and young adults with eating disorders. While previous research has identified dentists to be in an ideal position for identifying and addressing the oral health issues of individuals with eating disorders, other studies have shown that some adolescents are more likely to be less trusting and hostile towards dentists due to dental anxiety.

The overall aim of this study is to develop a program inclusive of a screening tool and education guide focused on capacity building dietitians to provide oral health risk assessments, education and dental referrals to Australian adolescents and young adults (AYA) with eating disorders. This will be implemented in the following phases:

    Phase 1: Systematic review
    Phase 2: Current perceptions of dietitians towards oral health and eating disorders
    Phase 3: Perceptions of adolescents and young adults with eating disorders towards oral health
    Phase 4: Development of an oral health screening tool and education guide

Project team:

    • Tiffany Patterson Norrie – Western Sydney University, SWSLHD, Ingham Institute
    • Assoc Prof. Ajesh George – Western Sydney University, SWSLHD, University of Sydney, Ingham Institute
    • Dr Lucie Ramjan – Western Sydney University, Ingham Institute
    • Dr Mariana S. Sousa – Western Sydney University, SWSLHD, Ingham Institute