Did you know Oral Health Month and Dental Hygienists Week are both celebrated in April?
There is a significant connection between oral health and Eating Disorders.
According to the Oral Health Foundation, Eating Disorders can cause the following: enamel erosion, dry mouth, mouth sores, dry/cracked lips, sensitive teeth, tooth decay, etc. – all warning signs of “vomiting, excessive sugar intake or nutritional deficiencies”. Dentists and Dental Hygienists can, therefore, be the first to recognize signs of an Eating Disorder.
Today, I had the pleasure to speak with Aviva Spiro, a Dental Hygienist, who has been in practice for over 40 years.
There are many studies which state that Dental Hygienists and Dentists may be the first to detect signs of an Eating Disorder? Was there any training related to this when you were studying?
There are studies available about Eating Disorder and oral health. I have over the years attended seminars on Eating Disorders. These seminars are not mandatory.
Do the Canadian Dental Hygienists Association or the Ontario Dental Hygienists Association offer webinars or training on Eating Disorders?
What do you see in patients that would indicate signs of an Eating Disorder?
As you mentioned before, one of the most apparent signs is the wearing away of the enamel on the upper front teeth, especially on the inside. There may also be signs of nutritional deficiencies such as bleeding gums, more cavities in the mouth due to the acid buildup after vomiting (which would indicate the patient has been struggling with bulimia).
What is the range of age that you have seen possible cases of Eating Disorders?
The age range is predominantly between 16-30. However, I know there are women in their 70’s and 80’s who have been suffering for decades with bulimia.
When you see this – how is it handled within the practice? There are many things to consider: If I felt that a patient had an Eating Disorder, I would gently try to speak to them about it as so many patients struggle with shame and stigma. If they refuse to speak about it, I will then speak to the Dentist about my concerns before the Dentist enters the room. If the patient still does not want to speak about it, the Dentist and I would then discuss what the best route would be for them after the appointment. It depends on the patient’s age, i.e., a child, adolescent, youth, or adult. Each presents different issues that would need to be addressed including confidentiality.
Do you feel that you and others in your practice are well prepared to have a conversation with a patient who may be showing signs of an ED?
As we see patients for years and have established relationships with them, I do feel that I have enough knowledge to have a preliminary discussion. It would, however, be beneficial for the staff to attend an information session. about Eating Disorders and then discuss steps.
What interventions do you think would be most helpful for a patient with an Eating Disorder? Are there resources or anything you can offer that would not be triggering to them?
If the patient is amenable to have a preliminary discussion, I would do that with them. I would determine the next steps by discussing their situation with both the patient and the Dentist. If the patient discusses it, I will do all I can to find the proper path for them providing resources like: https://sheenasplace.org/outreach-education/
Thank you so much for your time, Aviva! So glad we could honour Oral Health Month and Dental Hygienists Week with you!
Dental Hygienist, Aviva Spiro, shares her insights on the significant connection between oral health and Eating Disorders.Agnes Kopij2023-04-24T12:05:58-04:00
Let me introduce myself. My name is Agnes Kopij. I am a 4th year student at Wilfrid Laurier University and I have been a volunteer with NIED for just over a year. I am a part of the blog and social media team. I hope you all enjoy our upcoming interviews and blogs. We’re so excited and happy to bring these important discussions to you.
Now I’d like to introduce you to Debbie Berlin (BSW, MSW, RSW). I interviewed her in recognition of National Social Worker Month. Debbie also has training and specialization in health navigation for Eating Disorders, psychotherapy, crisis intervention, couples and family mediation, and more. She practiced clinical social work in the division of Haematology/Oncology at The Hospital for Sick Children (Sick Kids) for 17 years. She was previously the Executive Director of Sheena’s Place until 2020.
Questions and Answers:
What made you want to be a Social Worker?
I was a camp counselor and unit head for many years and I knew then that I wanted to work with kids and be a Social Worker.
What methods of assessment do Social Workers use? Are these guidelines or mandated?
From my training at SickKids, Social Workers tend to use a biopsychosocial assessment model.
No – these are not mandated.
As Eating Disorders are so complex and can have comorbidities, how would you say that your care differs for those who do and do not have an Eating Disorder?
My care with any person, focuses on the person’s history, challenges and strengths. My approach in care does not differ (for those who have Eating Disorders or not) – help your client identify what they want to work on, meet them ‘where they are at’ and help them get to where they want to be. All of that said, if they are not motivated towards change, then I will do my best to find creative and ‘outside the box’ ways to provide care.
How do you feel about the benefit of a multi-disciplinary approach and what are the barriers to having this team approach?
There are no barriers to a multi-disciplinary approach – we often need the support and guidance of other health care practitioners and I rely on them in my practice.
What are the ages of people who come to you for support?
17 and older.
What does your care look like for caregivers of people with eating disorders, are they included in your sessions?
Yes – I often work with caregivers/parents and help them with health/hospital navigation, self-care, and boundary setting.
Why is this type of support so crucial for a patient’s recovery?
Caregivers need to be well in order to take care of people – I also see this with clients who are caring for parents with dementia, Alzheimer’s and Parkinson’s. It is not uncommon for caregivers to become unwell and experience ‘burnout’. Caregivers need support, even if they resist it!
How does the care you offer differ from other professions? (ex. psychologists)?
I employ different modalities based on my ongoing training as a social work clinician – trauma informed care, emotion focused therapy, family-based therapy, and crisis intervention strategies.
Do you feel that Social Workers have the training they need to treat those with Eating Disorders? If not, what would you suggest could be done about that?
Social Workers need specific training and I wish this was offered more in BSW/MSW university programs. I think that it would be great if organizations specializing in Eating Disorders could offer more opportunities for learning, i.e. conferences, workshops and seminars.
Thank you so much to Debbie Berlin for this enlightening interview and for helping us honour Social Workers this month!