DentaltownUK April 2017 - 55

The SCOFF questionnaire is a simple five-question
test created for use by nonprofessionals to assess the
possible presence of an eating disorder. Devised in
1999, it uses an acronym for easy mnemonics and
can be made available for the patient to complete
in private.
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
(14 pounds) 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?
Count one point for every "yes." A score of
greater than two indicates a likely case of anorexia
nervosa or bulimia.
Another screening questionnaire consisting of 25
questions is available at the National Eating Disorders
website. Go to nationaleatingdisorders.org and look
under the "Find Help & Support" drop-down menu.
Extraoral examination might reveal temporomandibular disorder or parotid-gland swelling, while
intraoral examination of the oral hard and soft tissues
could reveal signs of malnutrition (such as glossitis
and oral ulceration), traumatic lesions on the palate
caused by inserting objects to induce vomiting,

or dental erosion. Comprehensive documentation
should include detailed clinical notes, hard-tissue
and periodontal charting, radiographs, intraoral
photographs and study models to monitor damage.
These individuals need regular dental visits for
continuing care and support, with essential restorative
care to keep them free of pain, plus protocols for
caries prevention and remineralization, and also to
relieve xerostomia and dental hypersensitivity.
We should provide an environment in which
patients feel comfortable. Patients with eating
disorders must be regarded as medically compromised
because of the risk of grave medical complications,
particularly cardiac arrhythmias or cardiac arrest
due to electrolyte imbalance. 16, 17

Conclusion
Eating disorders are potentially fatal. To facilitate
early detection, effective care and improved prognosis,
dental care professionals need to be familiar with the
warning signs of disordered eating and encourage
patients to seek help. The dental team can participate
in secondary prevention of eating disorders, and
dental hygiene can help to minimize any related
oral complications.
Thus, it is very valuable to foster a nonjudgmental
environment that may facilitate disclosure and aid
timely referral for treatment. n

References
1
2

3
4
5

Bulimia: What Dental Health Professionals Need to Know, Amy Pezzente;
Oral Hygiene, November 2015
Berkman ND, Lohr KN, Bulik CM. Outcomes of eating disorders: a
systematic review of the literature. Int J Eating Dis. 2007;40:293-309.
Doi: 10.1002/eat.20369. [pubmed] [Cross Ref]
psychiatry.org/mental-health/eating-disorders
DSM-IV (Diagnostic and Statistical Manual, Volume 4)
Eat Weight Disord. 2012 Dec;17(4):e267-73. Repeated traumatic
experiences in eating disorders and their association with eating symptoms.
Carretero-García A1, Sánchez Planell L, Doval E, Rusiñol Estragués J,
Raich Escursell RM, Vanderlinden J.
Women Health. 2008;48(4):467-84. Doi:
10.1080/03630240802575104. Psychiatric comorbidity in women with
disordered eating behavior: a national study. Gadalla T1, Piran N.
Symptoms of depression and anxiety in anorexia nervosa: links with plasma
tryptophan and serotonin metabolism. Gauthier C, Hassler C, Mattar L,
Launay JM, Callebert J, Steiger H, Melchior JC, Falissard B, Berthoz S,
Mourier-Soleillant V, Lang F, Delorme M, Pommereau X, Gerardin P,
Bioulac S, Bouvard M; EVHAN Group, Godart N. Psychoneuroendocrinology. 2014 Jan;39:170-8. Doi: 10.1016/j.psyneuen.2013.09.009. Epub
2013 Sep 17. PMID: 24135616 [pubmed - indexed for MEDLINE]
Aust N Z J Psychiatry. 2012 Feb;46(2):118-31. Doi:
10.1177/0004867411432071. The comorbidity between eating disorders
and anxiety disorders: prevalence in an eating disorder sample and anxiety
disorder sample. Swinbourne J1, Hunt C, Abbott M, Russell J, St Clare T,
Touyz S.
Eating Disorders Among Girls And Women In Canada. Report of the
Standing Committee on the Status of Women. Hélène leblanc Chair
November 2014
Cynthia A. Stegman, RDH, Med, RD, CDE; Lynne H. Slim, RDH, MS.
Dentalcare.com Recognizing and Managing Eating Disorders in Dental
Patients

Natalie Kaweckyj, RDARF, CDA, CDPMA, COMSA, MADAA, BA.
Eating Disorders...Understanding the Dental Ramifications; dentalcare.com

Crow, S.J., Peterson, C.B., Swanson, S.A., Raymond, N.C., Specker, S.,
Eckert, E.D., Mitchell, J.E. (2009) Increased mortality in bulimia nervosa
and other eating disorders. American Journal of Psychiatry 166, 13421346.
Eating disorders-knowledge, attitudes, management and clinical experience of Norwegian dentists 2015 Johansson et al BMC Oral Health 2015,
15: 124 doi: 10.1186/s12903-015-0114-7
Lähteenmäki S, Saarni S, Suokas J, Saarni S, Perälä J, Lönnqvist
J, et al. Prevalence and correlates of eating disorders among young
adults in Finland. Nord J Psychiatry. 2014;68:196-203. Doi:
10.3109/08039488.2013.797021. [pubmed] [Cross Ref]
Eating disorders can be diagnosed early by recognizing skin signals.
Dermatology Times May 01, 2010 By John Jesitus, Remia Struma MD
Eat Disord. 2013;21(4):287-94. Doi: 10.1080/10640266.2013.797317.
Medical complications of self-induced vomiting. Brown CA1,Mehler PS.
Management and treatment of eating disorders with severe medical
complications on a psychiatric ward: a study of 9 inpatients in Japan. Saito
S, Kobayashi T, Kato S. Gen Hosp Psychiatry. 2014 May-Jun;36(3):291-5.
Doi: 10.1016/j.genhosppsych.2014.02.001. Epub 2014 Feb 10. PMID:
24630897 [pubmed - in process]

15
16
17

dentaltownuk.com \\ APRIL 2017

http://www.nationaleatingdisorders.org http://www.dentaltownuk.com

Table of Contents for the Digital Edition of DentaltownUK April 2017