Dentistry and Mental Illness

Question 1

what is the epidemiology of metal illness in the UK?

Answer 1

1 in 7 adults, 55% female

Question 2

what are the models of psychiatric disorders ?

Answer 2

historical - witchcraft, demons
biomedical model - physiological/biochemical dysfunction
extreme forms of normal behaviour
psychological models - experiences and associated responses
biopsychosocial - all of above

Question 3

how does mental illness correlate with oral health ?

Answer 3

more mentally ill — less likely to see GP/GDP

more missing teeth, poor oral hygiene, increased caries

Question 4

describe the symptoms of depression

Answer 4

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

Question 5

what are the oral manifestations of depression ?

Answer 5

chronic facial pain, oral ulcers, factitious (chewing) ulceration

Question 6

describe bipolar disorder/mania

Answer 6

extreme elation and depression, unpredictable, hyperactivity, excessive participation

Question 7

what are the oral symptoms of bipolar disorder ?

Answer 7

xerostomia

Question 8

describe anxiety

Answer 8

unpleasant feeling/unease/fearful anticipation
acute or chronic, panic attacks
specific focus

Question 9

what is the relevance of alcoholism to dentistry ?

Answer 9

tolerance and dependency - inc local anaesthetics and other drugs
nutritional deficiency - problems with absorption and metabolism
increased bruxism, craniofacial trauma
increased bleeding

Question 10

what is the relevance of cocaine use to dentistry ?

Answer 10

bruxism, rhinitis, sinusitis, perforation of septum and palate

Question 11

what is the relevance of cannabis use to dentistry ?

Answer 11

effect on cardiac, respiratory and immune systems, 
chronic inflammation of oral mucosa,
adverse effects on gingivae, 
xerostomia,
C. albicans

Question 12

what is meant by dependence ?

Answer 12

compulsion to use,
physically unpleasant withdrawal,
increased tolerance,
neglect other interests

Question 13

what is meant by addiction ?

Answer 13

in addition to dependence
poor compliance,
financial issues,
dental phobia

Question 14

what is body dysmorphic disorder ?

Answer 14

belief in a cosmetic defect in someone of ordinary appearance

Question 15

what is the definition of an eating disorder ?

Answer 15

psyhcopathological relationship with food

Question 16

what are the symptoms of eating disorders ?

Answer 16

poor oral health, thickened knuckles (Russell’s sign), Lanugo hair, pale peripheries

Question 17

what is OCD ?

Answer 17

ritual performances/obsessive doubts, time consuming, severe inner struggles in an attempt to resist

Question 18

what is pica ?

Answer 18

craving non-food substances

Question 19

describe acute schizophrenia

Answer 19

delusions, hallucinations, interrupted thought process

Question 20

describe chronic schizophrenia

Answer 20

apathy, lack of drive, social withdrawal, abnormal use of language, inability to explain abstract ideas, over inclusiveness, delusions, hallucinations, incongruous mood

Question 21

what are the treatment for mental illness ?

Answer 21

Drugs, ECT, psychotherapy, behaviour therapy

Question 22

what types of drugs are used to treat mental illness ?

Answer 22

psychotropic (symptoms), neuroleptic - antipsychotic, major tranquillisers, anxiolytic - minor tranquillisers

Question 23

what factors are barriers to oral health care ?

Answer 23

type, serenity of illness, side effects of medication, mood, motivation, self esteem, lack of perception go OH problems, habits, lifestyle, lack of information

Question 24

what are the details of the best interests checklist ?

Answer 24

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

Question 25

what year was the mental capacity act introduced ?

Answer 25

2005

Question 26

what is the mental capacity act ?

Answer 26

a framework for people with learning difficulties, dementia or poo mental health who may not be able to make decisions

Question 27

define competency

Answer 27

the ability to consent for yourself, to understand and remember appropriate information about the clinical circumstance, to weigh up choices

Question 28

define capacity

Answer 28

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

Question 29

what are the 5 principles of the mental capacity act ?

Answer 29

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