Dentistry and Mental Illness Flashcards
what is the epidemiology of metal illness in the UK?
1 in 7 adults, 55% female
what are the models of psychiatric disorders ?
historical - witchcraft, demons
biomedical model - physiological/biochemical dysfunction
extreme forms of normal behaviour
psychological models - experiences and associated responses
biopsychosocial - all of above
how does mental illness correlate with oral health ?
more mentally ill — less likely to see GP/GDP
more missing teeth, poor oral hygiene, increased caries
describe the symptoms of depression
temporal differences anxious, irritable, lack of concentration, lack of interest, lethargy, apathy, sleep disturbance, loss of appetite and weight, exacerbation/amplification of pain, lack of insight
what are the oral manifestations of depression ?
chronic facial pain, oral ulcers, factitious (chewing) ulceration
describe bipolar disorder/mania
extreme elation and depression, unpredictable, hyperactivity, excessive participation
what are the oral symptoms of bipolar disorder ?
xerostomia
describe anxiety
unpleasant feeling/unease/fearful anticipation
acute or chronic, panic attacks
specific focus
what is the relevance of alcoholism to dentistry ?
tolerance and dependency - inc local anaesthetics and other drugs
nutritional deficiency - problems with absorption and metabolism
increased bruxism, craniofacial trauma
increased bleeding
what is the relevance of cocaine use to dentistry ?
bruxism, rhinitis, sinusitis, perforation of septum and palate
what is the relevance of cannabis use to dentistry ?
effect on cardiac, respiratory and immune systems, chronic inflammation of oral mucosa, adverse effects on gingivae, xerostomia, C. albicans
what is meant by dependence ?
compulsion to use,
physically unpleasant withdrawal,
increased tolerance,
neglect other interests
what is meant by addiction ?
in addition to dependence
poor compliance,
financial issues,
dental phobia
what is body dysmorphic disorder ?
belief in a cosmetic defect in someone of ordinary appearance
what is the definition of an eating disorder ?
psyhcopathological relationship with food
what are the symptoms of eating disorders ?
poor oral health, thickened knuckles (Russell’s sign), Lanugo hair, pale peripheries
what is OCD ?
ritual performances/obsessive doubts, time consuming, severe inner struggles in an attempt to resist
what is pica ?
craving non-food substances
describe acute schizophrenia
delusions, hallucinations, interrupted thought process
describe chronic schizophrenia
apathy, lack of drive, social withdrawal, abnormal use of language, inability to explain abstract ideas, over inclusiveness, delusions, hallucinations, incongruous mood
what are the treatment for mental illness ?
Drugs, ECT, psychotherapy, behaviour therapy
what types of drugs are used to treat mental illness ?
psychotropic (symptoms), neuroleptic - antipsychotic, major tranquillisers, anxiolytic - minor tranquillisers
what factors are barriers to oral health care ?
type, serenity of illness, side effects of medication, mood, motivation, self esteem, lack of perception go OH problems, habits, lifestyle, lack of information
what are the details of the best interests checklist ?
consider all relevant circumstances, reigning capacity, permitting and encouraging participation, considering the persons wishes, feelings, beliefs and values, taking into account the views go other people
what year was the mental capacity act introduced ?
2005
what is the mental capacity act ?
a framework for people with learning difficulties, dementia or poo mental health who may not be able to make decisions
define competency
the ability to consent for yourself, to understand and remember appropriate information about the clinical circumstance, to weigh up choices
define capacity
the individual is able to understand the information, remember the information related to the decision, use information as part of the decision making communicate the decision by any means
what are the 5 principles of the mental capacity act ?
a person is assumed to have capacity unless established otherwise
a person is not to be treated as unable to make a decision unless all practicable steps have been taken to help them to do so without success
a person is not to be treated as unable to make a decision merely because they make an unwise decision
decisions made for others must be in their best interests
decisions must be least restrictive of the persons rights and freedom of action
