Eating disorder professionals' perceptions of oral health knowledge.

OBJECTIVE: The aim of this study was to assess the oral health knowledge among professionals who specialize in treating eating disorders, and identify to what extent their education, and training addresses oral health care delivery, and recommendations for individuals with eating disorders. METHOD: Participants for this study were licensed behavioural and medical providers specializing in eating disorder treatment (n = 107), and recruited through professional eating disorder organizations. Participants completed an anonymous, online questionnaire (33 items) assessing level of oral health-related education, knowledge and treatment recommendations within the participant's respective eating disorder discipline. RESULTS: The majority of respondents (85%) were formally trained in eating disorders, and of those trained, 64.4% were not satisfied with the level of oral health education during formal education, and 19.5% report no oral health education. Respondents consider their knowledge of risk of oral disease for their clients/patients as average or above (84%), and ranked tooth erosion as the greatest reason for oral care (63%) while dry mouth led in the rankings for least significant reason for oral care (33%). Referral for oral care was found to be more common after reports of complication (55%). DISCUSSION: According to these findings, eating disorder professionals regard oral health care for their clients as significant, and may be unaware of associated oral risk factors, current oral care standards and long-term oral effects of disordered eating apart from enamel erosion.

Development of reflective judgement in the pre-doctoral dental clinical curriculum.

When dental students begin patient care in the clinical curriculum, they are required to move from the well-defined problems of the classroom to the more ambiguous and real life problems encountered in the context of patient care in the clinical setting. This change in learning environment requires development of reflective thinking. Reflective thinking refers to the process of thinking about uncertainty or ill-defined problems. King and Kitchener refer to the outcome of the reflective thinking process as reflective judgement. The purpose of this study was to explore the development of reflective judgement in the initial phase of the clinical curriculum. This exploratory study used a case study approach with qualitative methods. A convenience sample of third year predoctoral dental students (n = 16) volunteered to participate in writing a clinic journal and semi-structured interviews at three time points over a time period of one year. Student compliance in writing clinical journals was poor; therefore the qualitative data was primarily gathered from interview transcripts. The qualitative interview data were analysed using a coding scheme based on King and Kitchener's Reflective Judgement Model of Intellectual Development. The Cronbach alpha was 0.76 for reliability of the coding scheme. Based on the analysis of interview data, the there was an average growth in reflective judgement over the year from Stage 4.89 to 5.59 for an overall change of +0.70. Additional research is needed to explore the growth in reflective judgement over the final year of the clinical curriculum as well as to identify the most effective educational strategies to facilitate growth in reflective judgment.

Nutritional implications of xerostomia and rampant caries caused by serotonin reuptake inhibitors: a case study.

Serotonin reuptake inhibitors, such as fluoxetine, fenfluramine, and dexfenfluramine, are frequently used to treat obesity, depression, and bulimia. A common side effect of these medications is xerostomia, or dry mouth. A case study demonstrating the impact of drug-induced xerostomia on oral health and subsequent nutrition implications is presented. Rampant caries can result from a combination of xerostomia and inappropriate dietary and oral hygiene habits. Preventive dietary and dental guidelines are presented to assist nutrition and dental professionals in treating and counseling patients with xerostomia.

Nutrition and oral health guidelines for pregnant women, infants, and children.

Good oral health care and nutrition during pregnancy, infancy, and childhood are essential but often overlooked factors in the growth and development of the teeth and oral cavity. Pregnant women and parents and caregivers of infants and children often receive little guidance about proper preventive dental and oral health care, including fluoride and dietary measures. Pregnant women can maintain their health through proper diet, good oral hygiene, and appropriate use of fluoride. An adequate diet during gestation is important for optimal oral development of the fetus. To promote good oral health in infancy, caregivers need to provide the infant with appropriate amounts of fluoride in addition to a healthful diet. As the teeth erupt into the mouth, the caregiver needs to clean the teeth thoroughly on a daily basis. When solid foods are introduced in later infancy, it is also important to limit the frequency of caries-promoting fermentable carbohydrates between meals. Good oral hygiene habits and dietary practices that emphasize minimum exposure to retentive, fermentable carbohydrates; use of fluoridated water; and a varied, balanced diet should continue throughout childhood to set the stage for optimal oral health for a lifetime.

Importance of nutrition for optimum health of the periodontium.

As dental professionals become increasingly aware of the association between systemic and oral health, the importance of addressing systemic nutrition issues takes on a new urgency. Nutrition is one of the modifiable factors that impact the host's immune response and the integrity of the hard and soft tissues of the oral cavity. While nutrient deficiencies are rare in the general population of the United States, there are patient populations at high risk for nutritional inadequacies. Many of these medically compromised people are seen in dental practices on a daily basis. This article will also offer some basic recommendations for nutrition counseling.

Managing oral health related nutrition issues of high risk infants and children.

Dental professionals are in an ideal position to recognize children at high nutritional and oral health risk and provide early intervention. Some of the children at highest risk for nutritional and oral health problems include those born prematurely, children with failure to thrive, those on multiple medications, special needs children with developmental delays, children with gastroesophageal reflux, and those with lactose intolerance. Nutrition and oral health guidelines are provided to aid the dental practitioner in providing preventive nutrition intervention to these high risk children.

Guidelines for nutrition screening, assessment, and intervention in the dental office.

Patients with complicated disease and medication histories are being seen with increasing frequency in the dental office. Many are at high nutritional risk, which can impact their oral health status. Nutrition is an integral part of health promotion and prevention, but it often is a poorly utilized component of preventive dentistry. This article provides the dental hygienist with a systematic approach to determining which patients are in need of nutrition intervention, and discusses screening, assessment, counseling, and referral. Dental hygienists, as part of a multidisciplinary healthcare team, are in an ideal position to identify patients at nutritional and oral health risk, help them attain optimal oral and general health, and improve overall quality of life.