Dentistry and mental illness 1 Flashcards
what happened in rosehan study
8 ‘normal’ people pretend to hear voices and admitted to mental hosp, diagnosed manic depression/ scizophrenia
only other patients suspected
released after 7-52 days
responsibilities of
a. psychiatrists
b. psychiatric nurses
c. psychiatric social workers
d. clinical psychologists
responsibilities of
a. psychiatrists: medical doctors specialising in psychiatry
b. psychiatric nurses: work with patients and families in community
c. psychiatric social workers: welfare rights, community facilities, powers under the mental health act
d. clinical psychologists: psychological (mental) management and treatment (not medical)
ratio of UK adults suffer from mental disorder
1/7
55% female (but men don’t admit/ know?)
5 models of psychiatric disorders
- historical (witchcraft/demons)
- biomedical (physiological, biochemical)
- extreme forms of normal behaviour
- psychological models (experiences/responses)
- biopsychosocial (all of above)
explain relationship between mental illness and oral health
- less likely to prioritise going to dentist/ brushing teeth
- more likely to have dental anxiety/ phobia
- poor diet
- vomiting (eating disorders/ alcohol)
4 professional barriers of dentists to mentally ill pts
- lack of knowledge
- bad attitude
- low tolerance (restrictive UDAs, pts unreliable and unco-operative)
- poor communication
8 signs/ symptoms of anxiety
- temporal differences (morning/ evening)
- anxious/ irritable/ can’t concentrate/ relax
- adverse reaction to stress
- lack of interest/ apathy
- loss of appetite/ weight
- exacerbation/ amplification of pain
- lack of insight
2 oral manifestations of depression
-chronic facial pain
-oral ulcers (helped by tricyclic antidepressants)
(inc factitious ulceration from chewing teeth/lips
symptoms/ oral symptoms of bipolar/ mania
-extreme elation or depression (mood, thought, behaviour)
-unpredictable
-hyperactivity, excessive participation
-depression
ORAL SYMPTOMS: xerostomia (from medication)
symptoms of anxiety
unpleasant feeling/mood unease fearful anticipation inability to concentrate acute or chronic panic attacks specific focus, eg phobia of dentist drills
dental relavance of alcohol abuse
- inc bruxism
- craniofacial trauma
- wine/ vodka etc causes caries
- problems with absorption/ metabolising nutrients –> poor overall health
- hard to manage pts
- increased tolerance of LA/ other drugs
what is involved in CAGE questionnaire
Cut: have you ever thought about cutting down drinking
Annoyed: have you felt annoyed by others criticising your drinking
Guilt: have you felt guilty about your drinking
E: eye opener. have you had a drink first thing in the morning to steady your nerves
cocaine stats and oral effects
900 000 users in UK (4% London)
- bruxism, rhinitis, sinusitis
- perforation of septum and palate
cannabis effects
- psychological effects ( paranoia)
- chronic inflammation of oral mucosa
- adverse effects on gingiva
- xerostomia: caries, perio, plaque
- c albicans
meth effects
- hyper-alert, paranoia, anxiety, dperession, mood swings
- reduced motor function
- impaired verbal learning
- social, psychological, physical problems
- xerostomia, caries, bruxism, bad taste, perio
