Non-Judgemental Dental Healthcare: Barriers & Bulimia

(Feel invited to contact me with questions!)

What have you ever been embarrassed to tell a doctor about?

Why were you embarrassed?

No One is Born Embarrassed.

Whatever image or ideal we have in our minds for how a perfect, well adjusted person is supposed to live their life—that doesn’t actually exist in reality. People can pretend as much as they want to, but in truth it’s more likely that even the most well adjusted person feels awkward sometimes.

The fact of the matter is, there are a lot of things in this world that conflict with other parts of our lives or that influence us to feel ashamed or at odds with ourselves. This isn’t a good thing, but it’s the current situation and there is no one correct way to react to it all. Now you might think I’m getting a little cryptic, so let’s take a step back and explain a little.

For example, in the media there is a particular narrative of what success looks like—it looks like an exquisite, expensive house, a six figure 9-5 (at least) job, the ability to afford good health insurance & save for old age, living with a life partner, being conventionally beautiful, and raising 1-3 kids who are polite and are following in the path to reach the same type of success as you, their parents. And oftentimes, people who don’t meet different elements of this mold are made to feel (via lovely social messages) that they are less-than successful, and in that are made to feel less happy and less satisfied with life then they’d otherwise feel.

In another example, there are a lot of people who are healthy and more-or-less comfortable with the way their bodies feel and look. But after seeing commerical after commerical after magazine article after movie that are chock-full of messages telling a person that the more skinny he/she/they are, the more beautiful he/she/they are, that messages tends to sink in to some extent or another over time. A person who previously had no issues with how they looked now doubts their own beauty and magnificense. All of these social messages add up over time and repetition, and the calculated result of that can all too quickly become a mixture of intermittent self-doubt, as well as conforming to what these messages suggest a person to do—to always strive to be skinnier, to seek a job that yields more money or fame, to stay inside of the box and draw neatly within the lines. Whether someone has to truly struggle to make a living, or if a wealthy person is taught that their body is too fat and too unattractive to be appreciated or loved, it’s all a part of the same puzzle. None of us are weak or stupid to get caught up in this system—it truly catches almost everyone at some time or another.

Taking On Supportive Roles: What might it look like?

But what does this have to do with giving health care, you may ask? A lot. Not to comment on the whole kit and kaboodle, but one of the ways that a lot of health care professionals (knowingly or unknowingly) participate in this system of making healthcare inaccessible is simply by not making it explicitly clear that personal judgement and adherence to social conventions is not a part of a health care providers scope of practice. (Hopefully.)

My job and passion is to help people achieve beautiful and healthy smiles, whatever that means to them. It is also to recognize the oral-systemic health connection, and empower my patients to be able to stay healthy in all aspects of their lives, according to their wants and needs.

I understand that life is complicated, and always want my patients to bring whatever problems or concerns they have to me. Most of all, I do not discriminate and lay no judgement on whatever my patients bring to me. It is simply about consent and respect. If a person seeking healthcare does not consent to receiving advice or does not consent to you giving them your opinion on something, then they should not have to deal with that topic of discussion.

So by this point, you might be asking where I’m going with this or what started us down this path. (So read on!)

For Example: Barriers to Dental Care for People with Bulimia

Fear is an intimidatingly motivating, real force and fear of judgement can act as a very large barrier to a person accessing the health care that they need or want. And in dentistry, a particular fear-of-judgement barrier-issue that comes up a lot (yes—I wrote a lot) is when people who have or have had the eating disorder bulimia want to seek dental treatment, but are either ashamed to out themselves as bulimic or fear the judgement that a dentist or hygienist might lay upon them. Though there are many different forms of bulimia, a common eating disorder characterized by binge eating followed by purging, the form where people force themselves to vomit as their purging has a particularly detrimental affect on oral health. When a person vomits, bile and stomach acid come up the esophagus and are expelled via the mouth. This bile and stomach acid has an extremely low ph (high acidity), which eats through and burns the mucous lining of the esophagus and throat. When the bile and stomach acid reaches the mouth, it has a similar affect wherein it can burn, cause gum sores, and rapidly erodes the enamel protecting one’s teeth, which often leads to extensive decay and discoloration.

The short of the matter is—people who have bulimia or who have had bulimia often need very extensive dental care to get their oral health back on the healthy track. I do not think this is any reason to be ashamed, and once again would like to state that I do not judge anyone who seeks cosmetic or restorative treatment in my office, for any reason. And with all of my heart, I encourage all other healthcare professionals to take a similar cue, educate themselves on the diverse needs of ALL of their patients, and offer no unsolicited judgement on your patients’ lifestyles, present or past.

Embarrassment isn’t worth sacrificing one’s health—we can’t create the barriers and we shouldn’t heed to them!

Have a great day.

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