Impact of mental health on dental care Flashcards
What is the medical model?
Impairment is located within the individual
Requires doctors diagnosis
Pt should undergo medical tx prescribed = failure to do so = lack of insight = confirms diagnosis
What is the social model?
Issue is within society, not the individual
Industrialisation
Workhouses
Madhouses
Behaviour can not be accommodated within society
Types of psychotropic drugs?
Antidepressants
Hypnotic/anxiolytic
Antipsychotic
Mood stabilisers
Why do people have mental health problems?
Genetic Growing up in a city Repeatedly moving schools Migrant populations Trauma
Hearing voices features?
Used in diagnosis of mental health problems
Psychotriopic drugs prescribes to manage voices - successful but side effects
Failure to take meds is seen as part of illness
Side effects of hearing voices?
Tremor
Lack of sexual function
Insomnia
What is the trauma theory?
Supports the concept that trauma, esp in childhood, may cause mental ill health, including hearing voices
What may trauma cause?
Dental phobia
Vulnerability
How to manage a pt with mental health issues?
Tell them the truth
Direct (minimise small talk, humour)
Clear medical history (mental health diagnosis, medication, self harm history, use of non prescribed drugs, smoking, alcohol, liver problems, hospital admissions)
Past dental history
Tx plan: factual, clear, achievable, self esteem
How to gain their trust?
Be reliable, consistent, flexible, vulnerability, mental health worker, risk assessment (self harm, risk to others, self neglect)
How to assess pt capacity?
Assessment of capacity; - Understand the info - Retain the info - Weigh in the balance - Communicate the decision Fluctuating capactity Defer non urgent tx Best interests
Why do they have poor attendance?
Chaotic lifestyle Lack motivation Anxiety/phobia Agoraphobia Paranoia
What to take into account with pts with mental health problems?
Appt timings
Involve a 3rd person
Reminders
Empathy
Effects of psychotropic drugs?
Xerostomia Hypersalivation Parafunction Tardive dyskinesia = strange facial expressions Methadone
How do drugs and alcohol impact your OH?
Increased risk of oral cancer
Increased caries with methadone/dry mouth
TSL - alcohol related erosion, attrition due to parafunction with stimulants
Dental trauma (falling down, assault)
Increased risk of blood borne diseases
