Dentistry and Mental Health Flashcards
Medical Model of Psychiatry Social Model Role of trauma Vulnerability Common oral problems Simple guide to treating patients with mental health problems
Medical model
Impairment located within individual
Diagnosed by doctor
Pt should undergo medical tx required
Failure to do so may be seen as lack of insight
Social model
Issue located within society NOT the individual
Industrialisation
Workhouses in victorian era
Madhouses etc
Bedlam
Hospital in London
Management was corrective and harsh
Poor and marginalised were “cared” for
Institutions became more therapeutic overtime
Psychiatry and psychopharmacology examples
Psychotropic drugs
Anxiety Phobias Affective disorders psychotic disorders Eating disorders Alcohol Misuse
Antidepressants, hypnotics, anti psychotics
Factors contributing to MH problesm
genetics < 10% Growing up in a city Migrant populations Trauma Moving schools a lot
Trauma - Freud
Relationship problems can cause mental health problems
Distraction from real life
Truth trust consent
most important aspects
Truth
Calm
Direct
Clear MH - diagnoses, meds, self harm, non prescribed drugs, alcohol, smoking, liver problems
Past DH
Honesty
Tx plan - factual, clear, achievable, self esteem
Trust
Reliable Consistent Flexible Vulnerability Mental health worker Risk assessment (self harm, risk to others, self neglect)
Consent
Criteria
Ways of achieving
Assess capacity - understand, retain, weigh up and communicate decision
Fluctuating capacity
Defer non urgent Tx
Do in patient’s best interests
Consideration of
Appt timings
3rd person involvement
Reminders
Empathy
Risks
Past history
To others
To self
Self neglect –> increased caries and PD risk
Effects of psychotic drugs
Xerostomia Hypersalivaiton Parafunction Methadone Tardive dyskinesia
Effects of drugs and alcohol
Increased risk of oral cancer Increased caries risk with methadone Tooth surface loss Alcohol related erosion Attrition due to parafunction with stimulants Dental trauma Increased risk of blood borne disease