Ulrica Gidlund

Optimizing Dental Care in Eating Disorders: Integrating Oral Health into Recovery

My research focuses on optimizing dental care for patients with eating disorders by addressing both clinical and psychosocial aspects. The overarching goal is to reduce suffering and stigma associated with oral health problems in this vulnerable group and to establish oral rehabilitation as an integral component of multidisciplinary treatment.

Research Goals
The main aim is to develop effective and compassionate treatment strategies that can be implemented in routine dental care and aligned with psychiatric treatment plans. By bridging medical and dental disciplines, this work seeks to support patients’ recovery, self‑esteem, and quality of life, not only after but also during active illness.

Key Insights from Our Research

• Patients with eating disorders frequently present with severe dental erosion, caries, and tooth loss. Current clinical guidelines often recommend postponing dental treatment until after psychiatric recovery, which can worsen oral health outcomes.
• Many patients describe their oral health problems as a visible and lasting reminder of their illness, deeply affecting daily life, confidence, and social participation.
• Gaps in professional knowledge, limited individualized support, and weak integration between psychiatric and dental care often contribute to feelings of isolation and unmet dental needs.
• Providing early and well‑coordinated oral health interventions throughout all stages of the disorder can strengthen identity, rebuild hope, and promote recovery.

Clinical Relevance and Application
This research advocates for individualized, patient‑centered dental care as part of a comprehensive recovery plan. By integrating clinical experience, patient perspectives, and data from ongoing randomized and observational studies, the program addresses current knowledge and treatment gaps to enhance both oral and overall health outcomes.

The translational research program aims to determine how oral rehabilitation influences oral‑health‑related quality of life, oral function, and psychosocial well‑being in patients with eating disorders. It also seeks to define evidence‑based clinical criteria for when and how oral rehabilitation should be provided within integrated psychiatric‑dental care pathways. The work is directly relevant to the development of national, evidence‑based guidelines for this high‑risk and underserved population.

A core clinical problem today is the lack of standardized care pathways and the tendency to delay dental treatment until psychiatric stabilization, leading to avoidable suffering and worsening disease progression. Through a multidisciplinary, life‑course approach, the project combines clinical data from randomized and observational studies with large‑scale epidemiological evidence. By synthesizing outcomes across five complementary studies, the program will establish the scientific foundation for early detection, rehabilitation, and long‑term follow‑up of oral complications in eating disorders.

The ultimate goal is to ensure that dental care becomes a recognized and evidence‑based element of multidisciplinary treatment, improving oral and general health, reducing stigma, and promoting sustainable recovery.

Scientific Context and Significance
Eating disorders are complex psychiatric conditions linked to a three‑fold increase in mortality and affecting multiple organ systems. Global prevalence estimates (8.6% in females, 4.1% in males) reflect a growing public health challenge and highlight the need for coordinated medical‑dental interventions. Oral complications—including erosion, caries, salivary dysfunction, mucosal lesions, and orofacial pain, are among the most frequent and visible manifestations of these disorders.

Our previous studies have demonstrated that poor oral health often persists as a psychosocial marker of illness history, contributing to continued stigma even after remission, and that many patients experience delayed or inadequate dental rehabilitation. The 2024 SBU report on oral health and mental illness underscored the extensive evidence gaps in dental care for psychiatric patients, and the absence of clinical guidelines on when and how specialized oral rehabilitation should be delivered.

Building on our earlier findings and publications, this research program directly addresses these gaps through five integrated studies that collectively span clinical, functional, and epidemiological domains. Together, they position Karolinska Institutet and Folktandvården Stockholm at the forefront of developing evidence‑based, patient‑centered dental care for patients with eating disorders.

Our work has been recognized and supported by: