Abstract
Background: The prevalence and incidence of eating disorders has been increasing globally. The 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 with more than 5x the risk of developing an eating disorder regardless of the eating disorder subtype. However, individuals with an eating disorder can experience barriers such as embarrassment and dental fear which can deter them from seeking dental care. To date there is limited literature that provides insight from individuals with an eating disorder into their experiences of oral health. Further, there is meagre insight into the oral health needs for those with an eating disorder including their access to dental professionals and resources.
Aim: This study investigated the perceptions of Australian 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.
Methods: Using purposive sampling twelve 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.
Results: Most participants felt knowledgeable about the impact of eating disorders and oral health because of their own experience with oral health issues. From their experience, participants recalled not receiving pre-emptive oral health promotion from their primary care providers despite experiencing oral health issues including enamel wear. Following their eating disorder many participants reported being confident in engaging with dental services, although, barriers to accessing oral health care included shame and embarrassment as well as the cost of dental services. Many participants commented that there needs to be more information on oral health during an eating disorder and his may be achieved by using information resources and engaging trusted non-dental professionals like dietitians to provide basic oral health promotion.
Conclusions: Eating disorders can significantly impact oral health however, accessing dental services can be fraught with barriers. Non dental health professionals who are already part of the primary care team in eating disorder clinical settings may have a role to play in providing oral health promotion.
Future directions: This study is part of a larger multi-phase study which includes qualitative and quantitative investigation into the knowledge, attitudes and practices of dietitians regarding oral health promotion. The findings from all the phases will be used to inform the development of a model of care to increase dietetic capability and capacity in oral health promotion.