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Year 3 Human Disease > Dentistry and mental illness 2 > Flashcards

Dentistry and mental illness 2 Flashcards

1
Q

2 examples of dysphoria

A

ethnic dysphora

gender dysphoria

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2
Q

physical/ oral manifestations of anorexia/ bulemia

A 
vomiting --> tooth erosion
use vinegar/ lemon to reduce hunger
thickened knuckles (Russells sign)
lanugo hair (baby hair)
pale, cold peripheries
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3
Q

signs of acute scizophrenia

A

delusions, hallucinations, interrupted thought processes

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4
Q

signs of chronic scizophrenia

A
  • slowness, apathy, lack of drive, social withdrawal
  • abnormal use of language (sentences, new words)
  • inability to explain abstract ideas eg proverbs
  • over-inclusiveness (eg everyone out to get them)
  • delusions, hallucinations (auditory, visual)
  • incongruous mood, eg laugh at inappropriate times
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5
Q

oral effects of scizophrenia

A

increased DMFT
tooth brushing not a priority
more likely to be edentulous due to trauma from fights etc

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6
Q

4 treatment options for mental illness

A
  • drugs
  • electro convulsive therapy (electric shock to frontal lobe, now rarely used)
  • psychotherapy (councelling, underlying causes)
  • behaviour therapy eg CBT (desensitisation, flooding, relaxation, thought processes)
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7
Q

types of drugs used for mental illness

A

psychotropic: mental symptoms
neuroleptic: antipsychotic, major tranquilisers
- anxiolytic: minor tranquilisers

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8
Q

what % of population have dental phobia

A

3-4%

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9
Q

6 factors associated with oral health and access to care

A
  • type, severity, stage of illness
  • side effects of medication (xerostomia, dyskenesia/ dystonia)
  • mood, motivation, self-esteem (poor compliance)
  • lack of perception of OH problems
  • habit/ lifestyle (diet, SES, substance abuse)
  • lack of information (knowledge/ attitudes)
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10
Q

body dysmorphic disorder and relevance to dentistry

A

belief in cosmetic defect in someone of ordinary appearance –> not satisfied with surgical outcomes
associated with environmental work/ home stressors

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11
Q

define MUS

A

medically unexplained symptoms

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12
Q

what to ask when a pt presents with MUS 5

A
  • somatic symptoms of anxiety/ depression (eg weight loss)
  • previous history of MUS
  • evidence of precipitation by stress
  • family/ past psychiatric history
  • evidence that symptoms respond to psychological interventions
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13
Q

how to treat unexplained symptoms 8

A
  • admit uncertainty, go through test results
  • ask about specific concerns
  • give positive explanation of symptoms
  • copy clinic letters
  • stress potential for recovery, expectations
  • discuss stressors
  • encourage activity
  • reframe and reattribute stress and symptoms
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14
Q

issues with managing MUS 5

A
  • clinical duty of care v patient autonomy
  • competent pts can refuse tx (assume capacity unless proven otherwise, best interest checklist)
  • lasting powers of attourney (people appointed to act for individual should mental incapacity occur)
  • provision of living wills/ advance decisions
  • ill tx/ neglect of a person who lacks capacity –> max 5 yr prison sentence
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15
Q

what is included in best interests checklists (MCA sections 4) 5

A
  • consider all relevant circumstances (decision maker is aware)
  • regaining capacity: can decision be delayed until then
  • permitting and encouraging participation: finding appropriate means of communication or using others to help person participate in decision-making process
  • considering person’s wishes, feelings, beliefs, values (esp written statements of person when they had capacity)
  • taking in to account views of other people (family, informal carers, anyone with an interest in persons welfare/ appointed to act on his/ her behalf
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16
Q

purpose of mental capacity act 2005 and where it covers

A

framework for people who may not be able to make decisions (learning difficulties/ dementia/ poor mental health –> who can make decisions and how to go about this)
covers england and wales

17
Q

differences between competency and capacity

A

competency: ability to consent for yourself (understand/ remember info about clinical circumstances, weigh up choices, believe info applies to you)
capacity: individual (ability to understand, remember, use info to make decisions, communicate decision)

18
Q

what is needed for consent

A

competency AND capacity

19
Q

5 considerations of DCP in dealing with pts with mental health problems

A
  • prevent/ control disease (manage symptoms, maintain oral health, comfort, function)
  • environment (staff, waiting time, prep, encouragement, distraction)
  • appropriate medical/ social histories (opportunities to disclose, stop masking of symptoms)
  • patient control: stop signals, provide/ offer pain relief
  • dentist a EDUCATOR: expectations, preconceptions, OH, diet councelling, future appointments
20
Q

4 models to adapt tx for pts with mental issues

A
  • modelling (pt learns by imitation)
  • biofeedback (listening to body response and controlling, eg muscle tension, HR, blood pressure
  • token economy: +ve reinforcement. tokens for good behaviour, exchanged for something meaningful
  • behaviour contracts: +ve reinforcement, plan of behaviours. often used for schoolchildren
21
Q

define addiction

A

physical and psychological dependency

associated with tolerance and withdrawal, relapse

22
Q

define abuse

A

pathologic behaviour associated with drugs despite associated social, psychological or physical probs

23
Q

define dependence

A

continued substance use due to physical or psychological need
tolerance/ withdrawal

24
Q

define tolerance

A

need for increased quantities of a substance to achieve desired results

25
Q

define withdrawal

A

psychological/ physiological symptoms developed after drug use is stopped

26
Q

5 principles of mental capacity act

A
  • person assumed to have capacity unless established otherwise
  • person not to be treated as unable to make a decision unless all doable steps to help them have been taken without success
  • person not to be treated as unable to make a decision merely because they make an unwise decision
  • act/ decision in BEST INTEREST of person
  • consideration of less restrictive option

Year 3 Human Disease (28 decks)

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