DentaltownUK April 2017 - 54

Research has shown that of the patients
who are suspected of having an eating disorder, about half (or their guardians) have given
confirmation when asked by their dentist.2 Hopefully
those who concealed their eating disorder accepted the
concerns expressed by their dental care professional as
a warning sign and sought help later.

Understanding eating disorders
Eating disorders are psychiatric illnesses characterized
by disturbed attitudes to eating and body image. They
are often accompanied by inappropriate, dangerous
methods of weight control. The three most common
eating disorders are bulimia nervosa (binge-purge),
anorexia nervosa (starvation), and binge-eating disorder
(bingeing without purging).3 There are also variations
of disordered eating, as well as eating disorders not
otherwise specified.4
Eating disorders often occur in individuals who
have suffered physical or psychological trauma5 and
are frequently accompanied by other psychiatric
illnesses6 such as depression,7 anxiety,8 self-harm
and chemical dependency.
Psychiatrist Dr. Wendy Spettigue
of the Canadian Academy of Child
and Adolescent Psychiatry described
the experience of some of her young
patients who have anorexia nervosa:
"Imagine a patient with severe
obsessive-compulsive disorder who
constantly thinks, 'There are germs
on my hands,' and the only thing that
makes it better is if they wash their
hands, which decreases the anxiety
temporarily; but the thoughts recur,
and the only thing that relieves the
agitation is washing their hands
again.
"Anorexia nervosa is the exact
same kind of illness where they can't
tolerate the severe anxiety and agitation
that go with the thoughts that have taken
over their minds that constantly say, 'You're
eating too much. You're gaining too much
weight.' They feel compelled to restrict or purge,
to get rid of that agitation." 9

Myths about eating disorders
*
*
*

54

Eating disorders are about food.
Eating disorders are a matter of choice or lifestyle.
Eating disorders are a matter of vanity or a way
to get attention.

APRIL 2017 // dentaltownuk.com

*

People at a normal body weight cannot have an
eating disorder.

Screening in the dental-office setting
Dental health professionals are in an ideal position
to participate in detection and secondary prevention of
eating disorders,10 which could improve prognoses11-and
even be a lifesaver, because eating disorders have the
highest mortality rate of all psychiatric illnesses.12
However, a 2015 Norwegian study13 found that 76
percent of dentists surveyed reported a need for more
education related to eating-disorder management.
Research findings from Finland14 suggested that many
dentists underestimated the number of patients they had
encountered with eating disorders.
In a recent informal survey, educators in several
North American dental hygiene schools have commented
about time constraints in the curriculum that preclude
covering eating disorders in much depth.
Clinical assessment includes the general appraisal,
which begins as soon as we greet a patient. A comprehensive medical history is also needed, along with
monitoring of vital signs.
Observe the following during the general appraisal:
* Gait and demeanor. Does the patient look alert,
or dazed? This could be a sign of electrolyte
imbalance, hypoglycemia, dehydration or
malnutrition.
* Facial symmetry. Individuals who purge by
vomiting often have swollen parotid glands,
giving a "chubby" look to the face, although they
might be underweight.
* Skin blemishes or a gray cast might occur due
to malnutrition, or carotenoderma-orange
skin from excessive intake of foods containing
carotene.15
* Sparse scalp hair.
* Bloodshot eyes and petechiae of the skin around
the eyes are related to forced vomiting.
* Lanugo hair, which is fine downy hair on the
face, arms and torso-related to excessive loss of
body fat.
* Clubbed fingers are a sign of malnutritionrelated myocardial atrophy or abuse of laxatives.
* Russell's sign: a callus or abrasion on the
knuckles from inserting fingers in the throat to
induce vomiting.
The following two questions are worth adding
to the medical history form, to assist in detecting the
possible presence of eating disorders:
* Do you eat in secret?
* Are you satisfied with your eating pattern?


http://www.dentaltownuk.com

Table of Contents for the Digital Edition of DentaltownUK April 2017

Cover
Meet the Team
Mike Gow
Industry News
Howard Speaks
International Dental Show
Through the Keyhole: Surgery—Home and Away
What's on Dentaltown
Golden Nuggets
Continuing Education
BACD: Rise of Cosmetic Dentistry
3-D Printing
Google: Leading Cause of Truth Decay
General Practice: Message Board
Time Out
Probing Report
Eating Disorders
Physiotherapy in the Treatment of Craniomandibular, Craniofacial and Craniocervical Disorders
Prosthodontics: Message Board
Plan Z
Online Marketing
Product Profile
Finance: Message Board
Lifestyle Section
Student Section
Poll
The European Society of Hypnosis
Wish List
DentaltownUK April 2017 - Cover
DentaltownUK April 2017 - Cover2
DentaltownUK April 2017 - 3
DentaltownUK April 2017 - 4
DentaltownUK April 2017 - Meet the Team
DentaltownUK April 2017 - 6
DentaltownUK April 2017 - 7
DentaltownUK April 2017 - 8
DentaltownUK April 2017 - 9
DentaltownUK April 2017 - Mike Gow
DentaltownUK April 2017 - 11
DentaltownUK April 2017 - Industry News
DentaltownUK April 2017 - 13
DentaltownUK April 2017 - 14
DentaltownUK April 2017 - 15
DentaltownUK April 2017 - Howard Speaks
DentaltownUK April 2017 - 17
DentaltownUK April 2017 - International Dental Show
DentaltownUK April 2017 - 19
DentaltownUK April 2017 - 20
DentaltownUK April 2017 - 21
DentaltownUK April 2017 - 22
DentaltownUK April 2017 - 23
DentaltownUK April 2017 - Through the Keyhole: Surgery—Home and Away
DentaltownUK April 2017 - 25
DentaltownUK April 2017 - 26
DentaltownUK April 2017 - 27
DentaltownUK April 2017 - What's on Dentaltown
DentaltownUK April 2017 - Golden Nuggets
DentaltownUK April 2017 - 30
DentaltownUK April 2017 - 31
DentaltownUK April 2017 - Continuing Education
DentaltownUK April 2017 - 33
DentaltownUK April 2017 - BACD: Rise of Cosmetic Dentistry
DentaltownUK April 2017 - 35
DentaltownUK April 2017 - 3-D Printing
DentaltownUK April 2017 - 37
DentaltownUK April 2017 - 38
DentaltownUK April 2017 - Google: Leading Cause of Truth Decay
DentaltownUK April 2017 - 40
DentaltownUK April 2017 - 41
DentaltownUK April 2017 - General Practice: Message Board
DentaltownUK April 2017 - 43
DentaltownUK April 2017 - 44
DentaltownUK April 2017 - 45
DentaltownUK April 2017 - 46
DentaltownUK April 2017 - 47
DentaltownUK April 2017 - Time Out
DentaltownUK April 2017 - 49
DentaltownUK April 2017 - Probing Report
DentaltownUK April 2017 - 51
DentaltownUK April 2017 - Eating Disorders
DentaltownUK April 2017 - 53
DentaltownUK April 2017 - 54
DentaltownUK April 2017 - 55
DentaltownUK April 2017 - Physiotherapy in the Treatment of Craniomandibular, Craniofacial and Craniocervical Disorders
DentaltownUK April 2017 - 57
DentaltownUK April 2017 - 58
DentaltownUK April 2017 - 59
DentaltownUK April 2017 - 60
DentaltownUK April 2017 - 61
DentaltownUK April 2017 - Prosthodontics: Message Board
DentaltownUK April 2017 - 63
DentaltownUK April 2017 - 64
DentaltownUK April 2017 - 65
DentaltownUK April 2017 - 66
DentaltownUK April 2017 - 67
DentaltownUK April 2017 - 68
DentaltownUK April 2017 - Plan Z
DentaltownUK April 2017 - 70
DentaltownUK April 2017 - 71
DentaltownUK April 2017 - Online Marketing
DentaltownUK April 2017 - 73
DentaltownUK April 2017 - 74
DentaltownUK April 2017 - 75
DentaltownUK April 2017 - Product Profile
DentaltownUK April 2017 - 77
DentaltownUK April 2017 - Finance: Message Board
DentaltownUK April 2017 - 79
DentaltownUK April 2017 - 80
DentaltownUK April 2017 - 81
DentaltownUK April 2017 - 82
DentaltownUK April 2017 - 83
DentaltownUK April 2017 - 84
DentaltownUK April 2017 - 85
DentaltownUK April 2017 - Lifestyle Section
DentaltownUK April 2017 - 87
DentaltownUK April 2017 - 88
DentaltownUK April 2017 - 89
DentaltownUK April 2017 - 90
DentaltownUK April 2017 - 91
DentaltownUK April 2017 - 92
DentaltownUK April 2017 - 93
DentaltownUK April 2017 - 94
DentaltownUK April 2017 - 95
DentaltownUK April 2017 - Student Section
DentaltownUK April 2017 - 97
DentaltownUK April 2017 - 98
DentaltownUK April 2017 - 99
DentaltownUK April 2017 - 100
DentaltownUK April 2017 - 101
DentaltownUK April 2017 - 102
DentaltownUK April 2017 - 103
DentaltownUK April 2017 - Poll
DentaltownUK April 2017 - The European Society of Hypnosis
DentaltownUK April 2017 - Wish List
DentaltownUK April 2017 - Cover3
DentaltownUK April 2017 - Cover4
https://www.nxtbook.com/farran/dentaltown/dentaltown-june-2021
https://www.nxtbook.com/farran/dentaltown/dentaltown-may-2021
https://www.nxtbook.com/farran/dentaltown/dentaltown-april-2021
https://www.nxtbook.com/farran/dentaltown/dentaltown-march-2021
https://www.nxtbook.com/farran/dentaltown/dentaltown-february-2021
https://www.nxtbook.com/farran/dentaltown/2021January
https://www.nxtbook.com/farran/dentaltown/2020December
https://www.nxtbook.com/farran/dentaltown/2020November
https://www.nxtbook.com/farran/dentaltown/2020NewGrad
https://www.nxtbook.com/farran/dentaltown/2020October
https://www.nxtbook.com/farran/dentaltown/2020September
https://www.nxtbook.com/farran/dentaltown/2020August
https://www.nxtbook.com/farran/dentaltown/2020July
https://www.nxtbook.com/farran/dentaltown/2020June
https://www.nxtbook.com/farran/dentaltown/2020May
https://www.nxtbook.com/farran/dentaltown/2020April
https://www.nxtbook.com/farran/dentaltown/2020March
https://www.nxtbook.com/farran/dentaltown/2020February
https://www.nxtbook.com/farran/dentaltown/2020January
https://www.nxtbook.com/farran/dentaltown/2019December
https://www.nxtbook.com/farran/dentaltown/2019November
https://www.nxtbook.com/farran/dentaltownuk/2019OctoberNovember
https://www.nxtbook.com/farran/dentaltown/2019October
https://www.nxtbook.com/farran/dentaltown/2019NewGrad
https://www.nxtbook.com/farran/dentaltown/2019September
https://www.nxtbook.com/farran/dentaltown/2019August
https://www.nxtbook.com/farran/dentaltown/2019July
https://www.nxtbook.com/farran/dentaltownuk/2019JuneJuly
https://www.nxtbook.com/farran/dentaltown/2019June
https://www.nxtbook.com/farran/dentaltown/2019May
https://www.nxtbook.com/farran/dentaltownuk/2019AprilMay
https://www.nxtbook.com/farran/dentaltown/2019April
https://www.nxtbook.com/farran/dentaltown/2019March
https://www.nxtbook.com/farran/dentaltown/2019February
https://www.nxtbook.com/farran/dentaltownuk/2019FebruaryMarch
https://www.nxtbook.com/farran/dentaltown/2019January
https://www.nxtbook.com/farran/dentaltownuk/2018Winter
https://www.nxtbook.com/farran/dentaltown/2018December
https://www.nxtbook.com/farran/dentaltown/2018November
https://www.nxtbook.com/farran/dentaltownuk/2018November
https://www.nxtbook.com/farran/dentaltown/2018October
https://www.nxtbook.com/farran/dentaltownuk/2018October
https://www.nxtbook.com/farran/dentaltown/2018NewGrad
https://www.nxtbook.com/farran/dentaltown/2018September
https://www.nxtbook.com/farran/dentaltownuk/2018September
https://www.nxtbook.com/farran/dentaltown/2018August
https://www.nxtbook.com/farran/dentaltownuk/2018July
https://www.nxtbook.com/farran/dentaltown/2018July
https://www.nxtbook.com/farran/dentaltownuk/2018June
https://www.nxtbook.com/farran/dentaltown/2018June
https://www.nxtbook.com/farran/dentaltownuk/2018May
https://www.nxtbook.com/farran/dentaltown/2018May
https://www.nxtbook.com/farran/dentaltownuk/2018April
https://www.nxtbook.com/farran/dentaltown/2018April
https://www.nxtbook.com/farran/dentaltown/2018March
https://www.nxtbook.com/farran/dentaltownuk/2018March
https://www.nxtbook.com/farran/dentaltown/2018February
https://www.nxtbook.com/farran/dentaltownuk/2018February
https://www.nxtbook.com/farran/dentaltown/2018January
https://www.nxtbook.com/farran/dentaltown/2017December
https://www.nxtbook.com/farran/dentaltownuk/2017Winter
https://www.nxtbook.com/farran/dentaltown/2017November
https://www.nxtbook.com/farran/dentaltown/2017October
https://www.nxtbook.com/farran/dentaltownuk/2017october
https://www.nxtbook.com/farran/dentaltown/NewGrad2017
https://www.nxtbook.com/farran/dentaltown/2017September
https://www.nxtbook.com/farran/dentaltownuk/2017September
https://www.nxtbook.com/farran/dentaltownuk/2017August
https://www.nxtbook.com/farran/dentaltown/2017August
https://www.nxtbook.com/farran/dentaltown/2017July
https://www.nxtbook.com/farran/dentaltownuk/2017July
https://www.nxtbook.com/farran/dentaltown/2017June
https://www.nxtbook.com/farran/dentaltownuk/2017may
https://www.nxtbook.com/farran/dentaltown/2017May
https://www.nxtbook.com/farran/dentaltownuk/2017April
https://www.nxtbook.com/farran/dentaltown/2017April
https://www.nxtbook.com/farran/dentaltown/2017March
https://www.nxtbook.com/farran/dentaltownuk/dentaltownuk/2017march
https://www.nxtbook.com/farran/dentaltown/February2017
https://www.nxtbook.com/farran/dentaltown/2017January
https://www.nxtbook.com/farran/dentaltown/2016December
https://www.nxtbook.com/farran/dentaltown/2016November
https://www.nxtbook.com/farran/dentaltown/2016October
https://www.nxtbook.com/farran/dentaltown/2016nge
https://www.nxtbook.com/farran/dentaltown/2016september
https://www.nxtbook.com/farran/dentaltown/2016august
https://www.nxtbook.com/farran/dentaltown/2016july
https://www.nxtbook.com/farran/dentaltown/2016june
https://www.nxtbook.com/farran/dentaltown/2016may
https://www.nxtbook.com/farran/dentaltown/2016april
https://www.nxtbook.com/farran/dentaltown/2016march
https://www.nxtbook.com/farran/dentaltown/2016february
https://www.nxtbook.com/farran/dentaltown/2016january
https://www.nxtbook.com/farran/dentaltown/2015december
https://www.nxtbook.com/farran/dentaltown/2015november
https://www.nxtbook.com/farran/dentaltown/2015october
https://www.nxtbook.com/farran/dentaltown/2015nge
https://www.nxtbook.com/farran/dentaltown/2015september
https://www.nxtbook.com/farran/dentaltown/2015august
https://www.nxtbook.com/farran/dentaltown/2015july
https://www.nxtbook.com/farran/dentaltown/2015june
https://www.nxtbook.com/farran/dentaltown/2015may
https://www.nxtbook.com/farran/dentaltown/2015april
https://www.nxtbook.com/farran/dentaltown/2015march
https://www.nxtbook.com/farran/dentaltown/2015february
https://www.nxtbook.com/farran/dentaltown/2015january
https://www.nxtbook.com/farran/dentaltown/2014december
https://www.nxtbook.com/farran/dentaltown/2014decemberb
https://www.nxtbook.com/farran/dentaltown/2014november
https://www.nxtbook.com/farran/dentaltown/2014october
https://www.nxtbook.com/farran/dentaltown/2014newgrad
https://www.nxtbook.com/farran/dentaltown/2014september
https://www.nxtbook.com/farran/dentaltown/2014august
https://www.nxtbook.com/farran/dentaltown/2014july
https://www.nxtbook.com/farran/dentaltown/2014june
https://www.nxtbook.com/farran/dentaltown/2014may
https://www.nxtbook.com/farran/dentaltown/2014april
https://www.nxtbook.com/farran/dentaltown/2014march
https://www.nxtbook.com/farran/dentaltown/2014february
https://www.nxtbook.com/farran/dentaltown/2014january
https://www.nxtbook.com/farran/dentaltown/2013december
https://www.nxtbook.com/farran/dentaltown/2013november
https://www.nxtbook.com/farran/dentaltown/2013october
https://www.nxtbook.com/farran/dentaltown/2013newgrad
https://www.nxtbook.com/farran/dentaltown/2013september
https://www.nxtbook.com/farran/dentaltown/2013august
https://www.nxtbook.com/farran/dentaltown/2013july
https://www.nxtbook.com/farran/dentaltown/2013june
https://www.nxtbook.com/farran/dentaltown/2013may
https://www.nxtbook.com/farran/dentaltown/2013april
https://www.nxtbook.com/farran/dentaltown/2013march
https://www.nxtbook.com/farran/dentaltown/2013february
https://www.nxtbook.com/farran/dentaltown/2013january
https://www.nxtbook.com/farran/dentaltown/2012december
https://www.nxtbook.com/farran/dentaltown/2012November
https://www.nxtbookmedia.com