Knowledge of eating disorders among dental professionals and students: a Malaysian cross-sectional study

Background: Eating disorders (EDs) are serious mental health conditions characterized by disordered eating behaviors and excessive concern about body weight, shape, or food intake, affecting an individual's psychological, physical, and oral health. Oral health professionals are often the first to recognize these signs and symptoms, thus playing a crucial role in early detection and timely intervention. Aim: To assess the knowledge of dental students and professionals regarding the psychological, physical, and oral health implications of EDs. Material and Methods: A cross-sectional study was conducted using a structured and validated questionnaire among 193 clinical-year dental students (DS) and 40 practicing dental professionals (DP) in Malaysia, selected through a convenience sampling method. The questionnaire consisted of three sections: demographic data, and assessments of knowledge and awareness regarding the psychological, physical, and oral health manifestations of EDs. Differences in participants' knowledge was assessed using Fisher’s exact test and the Chi-square test. A p-value of <0.05 was considered statistically significant. Results: Participants showed poor knowledge of certain EDs symptoms, including gender predilection (DS: 34.7%, DP: 35.0%), low body weight (DS: 41.5%, DP: 52.5%), parotid gland enlargement (DS: 28.5%, DP: 25.0%), and poor oral hygiene (DS: 36.3%, DP: 47.5%). Good level of knowledge was noted for associations with stress and anxiety (DS: 89.6%, DP: 90.0%), and mirror checking (DS: 78.2%, DP: 65.0%). Moderate knowledge was observed for social withdrawal (DS: 51.3%, DP: 50.0%), knuckle bruises, (DS: 51.3%, DP: 57.5%), low self-esteem (DS: 69.4%, DP: 72.5%), nail erosion, dental caries, hypersensitivity, angular cheilitis, and oral pain/burning(DS: 59.6%, DP: 55.0%). Significant differences between DS and DP were found for mirror checking (p<0.05), oral candidiasis (p<0.05), and symptoms such as burning sensation, taste changes, and unexplained oral pain (p<0.05). Conclusions: DS and DP demonstrated varying levels of knowledge about EDs, with poor levels of knowledge on certain key physical and oral manifestations. Therefore, integrating education on EDs into dental training is essential to support early diagnosis and timely referral.