Oral health and individuals with a lived experience of an eating disorder: a qualitative study

Plain English summaryThe link between eating disorders of any sub-type and poor oral health such as dental caries and enamel wear has been well established in the literature, but barriers such as embarrassment and dental fear can often deter individuals from seeking dental care. Non-dental health professionals such as general practitioners, nurses and allied health professionals including dietitians who work closely with individuals with an eating disorder may be able to play an active role in promoting oral health. The findings of this study provided insight into the experiences of individuals with an eating disorder and the impact this had on their oral health. Barriers to accessing oral health care included shame and embarrassment as well as the cost of dental services. However, many participants felt that having a trusted non-dental health professional such as their dietitian to provide education and referral to dental services would have been beneficial. Further research is needed to understand the requirements for dietitians and other non-dental health professionals to provide oral health promotion in eating disorder clinical areas. BackgroundLimited evidence exists describing the impact to oral health when living with an eating disorder and the availability of information or access to oral health services. This study investigated the perceptions of individuals with a lived experience of an eating disorder specifically to understand their needs and recommendations for improving access to early intervention and oral health promotion.MethodsUsing purposive sampling a total of 12 semi-structured interviews were conducted with participants across Australia who had a lived experience of an eating disorder. A hybrid inductive and deductive approach to thematic analysis was used to construct salient themes and subthemes.ResultsMost participants had experienced some oral health manifestation as part of their eating disorder hence, many felt quite knowledgeable on the topic. Following their eating disorder many participants felt confident in engaging with dental services, although, barriers including embarrassment, shame, and cost compromised access at times. Participants felt strongly that greater emphasis on oral health promotion during an eating disorder was important and this may be achieved by increasing the availability of resources and using trusted non-dental health professionals like dietitians.ConclusionsThe need for oral health promotion while experiencing an eating disorder was evident, however, dentists can often be a costly option. Non-dental health professionals like dietitians working with clients with an eating disorder may be an acceptable alternative for closing this gap.