Hassan Shariff analyses the impact of diet resolutions within the dental environment.

With each new year, members of the population consider changing lifestyle habits to improve their holistic health. The SMART model advocates its users to ensure their goals, or New Year’s resolutions are: specific, measurable, achievable, realistic and time-based, in order to aid behavioural change (Gale, 2020). Oscarrson et al. (2020) stated changes to weight or body are one of the primary New Year’s resolutions the general population will aim to implement. This article considers the impact of sudden dietary changes within the dental environment.

The World Health Organisation (2022) has proposed determinants of health which reflect behaviours patients may wish to change, or that health care professionals may provide interventions for. These include smoking, alcohol consumption and dietary choices. The National Health Service (2022) has advocated a balanced diet in order to improve systemic health. This same message has been endorsed by Public Health England (2021) through campaigns such as Better Health, which increase patient awareness of the risks which present with consistent exposure to minimally nutritious food items. Such risks include: coronary heart disease; diabetes mellitus and bowel cancer (National Health Service, 2019).

However, it is not the awareness of health risks which acts as the sole indicator for the motivation to change in terms of diet. Social pressures can dictate patient decisions, including the influence from television, cinema and social media applications such as Instagram or TikTok. Pedalino & Camerini (2022) suggested exposure to poor posting practices from social media influencers is associated with body dissatisfaction. For those who are experiencing body dissatisfaction, changes in diet may be prevalent. This is evidenced by Hao et al. (2022) who found that students with low self-image were likely to have restrained eating habits.

It should be considered that diet related goals may influence mood within the dental team but could also impact patient compliance. Awareness of this will prevent ignorance and encourage empathy, increasing both the staff and patient experience. Wells et al. reported in (1998) that a rapid change to a low-fat diet could result in adverse mood effects, including a rise in anger. For members of the population who opt for severe calorie restriction in order to achieve their goals, an increased likelihood of depressive symptoms may present. Zhang et al. (2015) proposed the pathway for the manifestation of psychiatric symptoms in these patients is a detrimentally affected neuroendocrine process, which results in impaired serotonin regulation.

Following General Dental Council (2013) standards, dental care professionals are expected to work effectively within their teams. To facilitate this, members should be sensitive to their colleagues experiencing mood fluctuations during dietary changes. An environment which encourages body positivity and reinforces the self-confidence of individuals, will prevent triggers from affecting staff eating habits. Dye (2016) suggested it was the internalisation of messages within society and from media which negatively facilitated restrained eating habits. It was also suggested that educational programmes could increase critical thinking within individuals, to reduce the impact of society on body image. Consequently, practice managers could consider implementing continuing professional development courses for staff to understand the impacts of both media and diet on holistic health. On education, general staff discussions may gravitate towards self-compassion. O’Dougherty et al. (2011) stated that depending on the context of the conversation, group discussions had the ability to influence body dissatisfaction positively or negatively. As such, conversations which elevate a specific body type or image should be avoided within the work environment.

Our approach with patients, however, will inevitably differ. Patients experiencing mood fluctuations may present as unengaging. Following the General Dental Council (2013) standards, the dental team will need to consider the causative factors behind minimal engagement and provide tailored advice when using the preventative approach. This embodies the holistic approach to healthcare and reflects the National Health Service (2022) core values. For example, providing standardised dietary advice to a patient with restrictive eating habits may have negative health effects, particularly when the root cause of the issue is unknown (Gugglberger, 2018).

Nevertheless, patients may not believe disclosing dietary habits is necessary or relevant to the dental environment. Whilst not applicable to short-term dietary changes, patients with eating disorders have been suggested to conceal their condition out of shame (Vandereycken & Humbeeck, 2008). Despite this, dental care professionals can curate a body positive environment within the dental practice. A non-direct route could be through the use of posters and leaflets easily accessible to patients in waiting rooms. However, it is important that these materials are formulated with comprehendible language, thus increasing engagement in those with limited health education. Failure to do this could worsen pre-existing health inequalities (Protheroe, et al., 2015).

Our direct approach with patients can also be considered. Whilst dental care professionals are obligated to approach conversations regarding diet, caution should be taken to avoid the use of triggering terms. Further research is required in the field. However, Chen & Couturier (2019) suggested nutritional education can be misinterpreted by patients and result in obsessive behaviour if clinicians have emphasised certain dietary elements as being unhealthy.

One could question if practitioners should be describing foods as “healthy” versus “unhealthy,” or, “good,” versus “bad.” These terms may promote a negative relationship with food items where patients feel guilty if they believe they have eaten badly. A similar reaction may be documented when using the term “clean diet,” as patients may begin to denominate some foods as dirty and internalise these feelings if they digress from their diet (British Heart Foundation, 2022). Lavy (2018) utilised their dietitician based experience to suggest food items should be considered objectively in terms of nutrients. It was further stated that patients should be reminded they can access an array of food items to meet their nutrient requirements and excluding certain items is not always necessary. Dental care professionals will be able to incorporate this suggestion into their preventative advice and subsequently improve the patient experience.

The societal pressure to change within a new year can be an intense period for any individual. However, those within the dental profession have the ability to improve the lives of their team members and simultaneously their patients. Whilst the General Dental Council (2018) currently do not include education on restrictive diets within their recommended continuing professional development topics; with managerial support in dental practices, dental care professionals will be able to communicate in a manner which truly embodies holistic care.

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