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ePaper created 2015-04-13, 15:09:21 | version 1.33.01
a prevention protocol based on our clinical findings. Definitive dental restorations cannot be completed while a patient is purging regu- larly, as acid erosion will compromise the restorations. Only essential restorative work should be done, to limit tooth damage and keep the patient free of pain. Pending the pa- tient’s recovery from his or her eating disor- der, the dental hygienist can provide inter- ventionstolimitdamagetotheoralhardand softtissue,andrelievexerostomiaanddental hypersensitivity. During dental hygiene ap- pointments, such patients should be pol- ished with a non-abrasive fluoride paste. A protocol to reduce caries risk should in- clude in-office fluoride varnish applications, plus self-applied neutral fluoride, and cal- cium and phosphate products, such as No- vaMin, Recaldent and nano-hydroxyapatite, to remineralise and desensitise. Xylitol-containingproducts,suchastooth- pastes, gum and candies, are also beneficial. When used for 5 minutes, five times per day, they stimulate salivary flow, reduce the oral populationofcariogenicbacteria,andreduce oral acidity. Patients should brush three times per day with a soft brush and a tooth- paste containing 5,000 ppm fluoride. They should clean the interproximal embrasures daily and clean their tongue too, to remove biofilm and acid residue. A mouth guard can be used to protect the dentitionduringvomiting.Brushingdirectly after vomiting causes more loss of tooth structure,andrinsingwithwaterreducesthe protective properties of the saliva. Instead, the oral pH should be neutralised by rinsing with one teaspoon of sodium bicarbonate in 250 ml water, or with a product containing calcium and phosphate ions. For additional support, we can share information on re- sources for those who struggle with eating disorders.23 With increased knowledge and vigilance, dental care professionals can en- hance detection of warning signs of eating disorders, for improved patient care and favourable outcomes. Editorial note: A complete list of references is available from the publisher. 27Dental Tribune United Kingdom Edition | 1/2015 The SCOFF questions* • Do you make yourself Sick because you feel uncomfortably full? • Do you worry you have lost Control over how much you eat? • Have you recently lost more than One stone (6.35 kg) in a three-month period? • Do you believe yourself to be Fat when others say you are too thin? • Would you say that Food dominates your life? * One point for every“yes”; a score of ≥ 2 indicates a likely case of anorexia nervosa or bulimia. Table3:TheSCOFFquestionnaireutilisesanacronyminasimplefive-questiontestdevisedforuseby non-professionalstoassessthepossiblepresenceofaneatingdisorder.24 Linda Douglas is a British den- tal hygienist currently residing in Ontario in Canada.She can be contacted at lindadouglas@sympatico.ca. © BrianAJackson TRENDS & APPLICATIONS AD © maga / shutterstock.com DTUK0115_24-27_Douglas 09.04.15 15:38 Seite 27 DTUK0115_24-27_Douglas 09.04.1515:38 Seite 27