by Advantages of the dental position
Dental offices have fewer barriers to initiating a nutrition conversation with patients. For example, they do not weigh elderly patients, and patients can usually visit their dental offices with ease. Some signs and symptoms of poor nutrition can only be noticed by a dental professional, as most medical office visits do.‘t including a thorough examination of the mouth.
The ADA recognizes this benefit and already has a dental code (D1310) to provide nutritional counseling to control and prevent oral disease. The frequency of dental visits is also an advantage. According to the Centers for Disease Control and Prevention, 65.5% of American adults and 86.9% of children visit their dental office one to four times a year.6
Hygienists usually spend 45 to 90 minutes with each patient. Building personal relationships and trust over repeated visits is a great way to help guide patients toward healthy choices. We already do this with patients by making recommendations to improve their oral health; it’s time we started nurturing our education services.
Note that dental professionals have equal or greater nutritional requirements in their programs compared to medical doctors. Most medical schools do not have a formal nutrition course; instead, they embed nutrition-based content in classes such as biochemistry, pathology and physiology.7 In contrast, the Commission on Dental Accreditation (CODA) requires all dental hygiene programs to have at least a three-hour nutrition course in addition to the biomedical science, anatomy, physiology, and pathology classes.8
Opinions in the dental setting
Dental providers note many things that can lead to discussions about nutrition. The first thing we do at every appointment is review medical history, medications and supplements. In most states, dental hygienists are required to take blood pressure. Many health conditions can benefit from proper nutrition or the addition of supplements.
When taking radiographs and diagnosing patients with multiple caries, it is easy to discuss reducing sugars and acids in the diet. Sometimes, calcified atherosclerotic plaques are seen in panoramic radiographs. An office policy should be in place to refer patients to their PCP, and to initiate a conversation about diet by explaining the disease process and providing basic nutritional advice, such as limiting high-cholesterol or triglyceride foods. This helps prepare the patient to hear lifestyle recommendations from another health care provider.
Bleeding, ggingivitis, and sometimes worsening periodontal disease can be attributed to a lack of proper vitamins and minerals. Periodontal patients should know the role of nutrition in periodontitis, and how to obtain essential nutrients through their diet.
Develop a strategy
Starting a conversation about nutrition can be difficult. You need to know your patients and their motivations. Change can be overwhelming, and making too many suggestions will result in no change. In recommending the first step, a patient may be more likely to add a serving of vegetables or a multivitamin rather than eliminate something.
Sit the patient upright so they can see your results and be an equal part of the discussion. Discuss their disease process and how to manage or reverse it with nutrition and supplementation. Resources such as brochures or websites are available through the American Heart Association, the American Diabetes Association, and the USDA. Document your discussion and note in their chart to follow up at the next visit.
Putting it together
Dental professionals have a distinct advantage when it comes to discussing nutritional needs with patients. Our patients see us more often, for longer periods of time, and usually enjoy seeing the same providers at each appointment.
Patients trust us with their mouths, but it’s time to connect the mouth with the rest of the body. Our knowledge of the human body allows patients to benefit by explaining how nutrition plays a vital role in disease prevention and treatment. We have the valuable expertise and insight to make recommendations to improve patients’ current nutritional intake.
Note to the editor: This article was published in the October 2024 print edition of RDH magazine. Dental hygienists in North America are eligible for a free print subscription. Register here.
References
1. Once again, the US and Europe are ahead in terms of daily calorie intake. United Nations News. December 12, 2022. Accessed May 20, 2024. https://news.un.org/en/story/2022/12/1131637
2. Dietary Guidelines for Americans, 2020-2025. US Department of Agriculture and US Department of Health and Human Services. December 2020. https://www.dietarguidelines.gov/
3. standard american diet. Nutrition facts. Accessed May 20, 2024. https://nutritionfacts.org/topics/standard-american-diet/
4. Amy NK, Aalborg A, Lyons P, Keranen L. Barriers to routine gynecologic cancer screening for obese White and African American women. Int J Obes (London). 2006; 30(1):147-155. doi:10.1038/sj.ijo.0803105
5. Denniss E, Lindberg R, McNaughton SA. Quality and accuracy of online nutrition-related information: a systematic review of content analysis studies. Public Health Promotion. 2023; 26(7): 1345-1357. doi: 10.1017/S1368980023000873
6. Oral and dental health. Centers for Disease Control and Prevention. May 22, 2024. Accessed June 3, 2024. https://www.cdc.gov/nchs/fastats/dental.htm
7. Millard E. How nutrition education for doctors is evolving. Time. May 24, 2023. Accessed June 3, 2024. https://time.com/6282404/nutrition-education-doctors/
8. Accreditation standards for dental hygiene education programs. Commission on Dental Accreditation. 2023. Accessed August 5, 2024. https://coda.ada.org/standards
