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Eating disorders

Any tips on how to discuss eating disorders with patients who aren’t open about it?
Ex: severe erosion & patient is obviously very very thin but has nothing noted on their health history about eating disorders.

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1 Answer

Discussing eating disorders with patients is always a sensitive subject, especially when they don’t disclose. Personally, I don’t ask straight out if they are bulimic or anorexic. Doing so can seem threatening and make the patient uncomfortable. I do discuss what I see clinically. For instance, erosion, pale gingiva, etc. Then discuss the causes, such as acid reflux, frequent purging, nutritional deficits, acidic food or drinks, things like this. Then you want to give the patient recommendations based on what you see clinically, whether that be Rx strength fluoride toothpaste or other remineralizing products, waiting to brush for at least 30 minutes after eating acidic foods/drinks or throwing up and/or swishing with a baking soda/water mix to help make the mouth less acidic. You really have to play it by ear and base what you say on what you see clinically and how receptive the patient is. If they look uncomfortable, tone in down. Always remember to speak with concern and not judgement. Again, its a tough one, but focusing on what you see clinically and prevention steps toward that, will hopefully help.

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