Mental And Emotional Disorders Flashcards
What is a mental disorder?
- Characterized by a clinically significant
disturbance in an individual’s cognition,
emotional regulation, or behavior. - Associated with distress or impairment in
important areas of functioning
What are the signs and symptoms of depression?
- Decrease interest in pleasure/ activities
- Marked change in weight
- Insomnia or hypersomnia
- Display total lack of home care
What are the medical management for depression
- SSRI first line medication
- Selective serotonin reuptake inhibitor
What are the dental management for depression?
- Xerostomia from medication
- Increased caries and periodontal disease
- Possible burning mouth syndrome or facial pain
syndrome - Limit epinephrine
What are the five D of despression ?
- Distress
- Disregard
- Distance
- Defeat
- Dysfunction
What is bioplar disorder?
Variation in moods from mania to major depression or a combination at different times
What is the medical management for bipolar disorder?
- Mood-stabilizing drugs: lithium, valproic acid, lamotrigine, carbamazepine + antidepressant
- Electroconvulsive therapy
What are the dental management for Bipolar depression?
- Lithium causes xerostomia and stomatitis
- Lamotrigine causes xerostomia, ulcers, enamel hypoplasia
- Avoid NSAIDs and erythromycin
What is schizophrenia diagnosis?
exhibit two or more for at least one month
What is the medical management for schizophrenia?
Tricyclic antidepressants-Dry mouth, cardiac dysrhythmias, hypotension, blurred
vision; limit epinephrine
* Monoamine oxidase inhibitors- Not combatable with many other drugs; limit epinephrine
* SSRI medications-Selective serotonin reuptake inhibitors
* Atypical antidepressants- Some may cause seizures
* Antipsychotic drugs- Produce dry mouth
What are the dental management for schizophrenia?
- Consult prior to treatment
- Patient take care of their mouth
- Do not treat unless under physican care
- schedule morning appointments
- Caregiver or partner should be presnt
- Should be more frequent recare intervals consider 3 months
What are the different manifestations of somatoform disorders
Somatization Disorder
* Blindness, deafness, paralysis, inability to speak or walk.
Conversion Disorder
* Nervousness, restless or tense related to preoccupation with having or getting a
serious disease or condition
Illness Anxiety Disorder
(Hypochondriasis)
* Distress in social and occupational activities
Pain Disorder
* Attempts to hide perceived flaws with styling, makeup or clothes
Body Dysmorphic Disorder
* Infliction of self-harm by physical, thermal, or chemical injury
Factitious Disorder
* Infliction of self-harm by physical, thermal, or chemical injuryFactitious Disorder
What is anxiety disorders?
- Emotional pain or a feeling that all is not well, or disaster is pending
- Natural response in humans
What are the different pathology for anxiety disorders ?
- Excessive and uncontrollable
- No stimulus
- Results in physical and affective symptom
What are three types of anxiety disorders?
PHOBIAS
* Dental phobias, needle phobias
* May cause muscle tension, increased
heart rate, fast breathing, sweating,
stomach cramps.
PANIC DISORDER
* Sudden onset adrenergic surge
* Fight or flight response
* Intense fear often confused with
medical illness
* Same symptoms as anxiety coupled
with fear of dying or fear of going
crazy
G E N E R A L I Z E D A N X I E T Y
D I S O R D E R
* At least six symptoms of
anxiety lasting for 6+ months
What are the medical management for anxiety ?
- Based on cause of anxiety and severity
- Psychotherapy for severe cases
- Behavioral therapies
- Biofeedback
- Hypnosis
What medications are used with anxiety?
Antidepressants: tricyclic and SSRI
* MAO inhibitors, benzodiazepines, antihistamines, beta receptor antagonists, sedative hypnotics
What are the dental management for anxiety?
- Open communication
- Maintain respectful demeanor
- Identify and clarify thoughts and feelings about the dental
healthcare environment - Encourage questions
- Provide reassurance
- Schedule additional appointment time
- Nitrous oxide administration for relaxation
- Headphones to block out noises
- Frequently check in with the patient to ask how they are doing
- Oral Consideration: Medication-induced Xerostomia
What is PTSD?
Develops after exposure to a
traumatic event
What are the medications for PTSD?
- Psychotherapy (talk)
- Antidepressants
- Coping strategies
What are the dental management for PTSD?
- Establish communication and trust
- May have increased dental disease due to lack of home care
- Palliative care for oral
- manifestations
What are some oral manifestations for PTSD?
Aphthous ulcers
* Lichen planus
* TMJ dysfunction
* Bruxism
* Myofascial pain
* Glossodynia
* Geographic tongue
What is the diffence between anorexia and bulima?
Anorexia: Self-starvation →
weight loss, Highest mortality
other than opioid
use disorde.
Bulimia: Alternate dieting or
eating only low calorie “safe foods”
with binge eating on “forbidden” high
calorie foods
What are the eating disorders signs and symptoms?
Severe weight loss
* Deny being hungry
* Physically active
* Constipation
* Cold intolerance
* Amenorrhea
* Bradycardia
* Hypothermia
* Hypotension
* Bony protrusions
* Dry, scaly skin (xerosis)
* Alopecia or excessive hair
loss (hypertrichosis)
* Fragile nails
* Peripheral edema
What are the medical management for eating disorders?
Primary goal of treatment:
* Gain weight
* Address cause
- Combination of therapy and supervised weight gain: Cognitive behavioral therapy, Interpersonal psychotherapy.
- Medications: Fluoxetine (Prozac) to
help with depression and underlying cause of condition
Dental Management & Oral Considerations of eating disorders
Caries prevention
* Take intraoral photographs
* Increase biofilm removal
* Increase topical fluoride
* Use baking soda after vomiting to neutralize pH
* Education about system effects; referral to physician
* Perimolysis: dental erosion without bacterial
involvement / constant exposure to a low pH
* Palatal bruising from pressure to induce vomiting
* Enlarged parotid gland (engorgement)
* Xerostomia
