Dentistry and Mental Illness 1

Question 1

Name 3 affective disorders?

Answer 1

Depression
Anxiety
Bipolar / mania

Question 2

What study was done which shows it is not easy to diagnose mental illness?

Answer 2

8 normal people presented at 12 psychiatric hosps “hearing voices”
all 8 were admitted and they behaved normally after that
diagnosed with schizophrenia / manic depression
only the patients in the hospital were suspicious

Question 3

Who works with mental illness?

Answer 3

psychiatrists
psychiatric nurses
psychiatric social workers
clinical psychologists

Question 4

What is the incidence of mental illness in the UK?

Answer 4

1/7 suffer from mental disorder (55% female)

3/10 with poor mental health

Question 5

What are the 5 models of psychiatric disorders?

Answer 5

Historical - witchcraft, demons
Biomedical - physiological / biochemical
Psychological - experiences and associated responses
Extreme forms of normal behaviour
Biopsy chosocial - all of the others

Question 6

What is the relationship between GDP/GP visits and mental health?

Answer 6

Inverse

Question 7

What are the professional barriers to mental health?

Answer 7

Poor knowledge
Poor attitudes
Low tolerance
Poor communication
Poor diagnostic reliability
Poor cultural variation in interpretation

Question 8

Describe depression?

Answer 8

Lack of insight
Temporal differences - morning or eve
Anxious, irritable - cant concentrate / relax
Adverse reaction to stress
Lack of interest, lethargy, apathy
Sleep disturbances
Decreased apatite , weight loss
Exacerbation of pain

Question 9

What are the oral manifestations of depression?

Answer 9

Chronic facial pain

Oral ulcers - onset with emotional problems and marked decrease after treatment with tricyclic antidepresants

Question 10

Describe biploar / mania?

Answer 10

Extreme elation and depression - mood, thought and behaviour, unpredictable, hyperactive, excessive, depressed
ORALLY - xerostaemia

Question 11

Describe anxiety?

Answer 11

Unpleasant feeling / mood, unease, fearful, inability to concentrate. Acute or chronic, pain attacks, specific focus - eg needles

Question 12

How does substance abuse affect emotional stability?

Answer 12

Decreased self image, depression, lack of motivation, mechanism for getting analgesics

Question 13

Describe the effects of alcohol?

Answer 13

Alcohol is most widely used substance
Chronic, progressive and potentially fatal
Increased tolerance of LA and drugs
Nutritional deficiency - problems with absorption and metabolism
Increased bruxism and craniofacial trauma

Question 14

Describe the effects of cannabis?

Answer 14

Effects in cardiovascular, respiratory, and immune systems
Chronic inflammation of the oral mucosa
Adverse effects on gingivae
Xerostaemia, Caries, Perio and plaque (C. albicans)

Question 15

Describe the effects of cocaine?

Answer 15

> 900,000 users in UK (snort or smoke)
Bruxism, rhinitis, sinusitis
Perforation of the septum and palate
Often mix cocaine with sugar so increased caries

Question 16

Describe “meth mouth”?

Answer 16

Oral, inhaled, snorted, smoked, injected
Hyper alert, paranoia, anxiety, depressed, mood swings
Decreased motor function and impaired verbal learning
Social, psychological and physical issues
Xerostaemia, caries, bruxism, halotosis, perio
Care when prescribing analgesics!

Question 17

What is dependence?

Answer 17

Compulsion to use
Physically unpleasant withdrawal - further use for relief
Increased tolerance
Neglect other interests - substance use is most important

Question 18

What is addiction?

Answer 18

In addiction to dependence: poor compliance

Substances mask dental pain, dental fear and low pain threshold (tolerance to drugs)

Question 19

What is the treatment for mental illness?

Answer 19

Counselling

After illicit drug use - no treatment for >6 hrs because of ischaemia, dysarrhythmia, hypertension, MI

Question 20

Why is mental health in dentists quite poor?

Answer 20

Drug of choice
Less control
Stress