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BDS4 Special Care > Mental Health > Flashcards

Mental Health Flashcards

1
Q

What are the features of dental anxiety?

A

Normal state
- Managed with communication and trust
- Can develop into panic disorder
- Extremely difficult with mental health issues superimposed on top of this

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2
Q

What % experience a mental disorder in their life time?

A

50%

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3
Q

What are some of the comorbidities of mental health disorders?

A

Obesity

Asthma

COPD

Hypertension

Life expectency- can be reduced by 10-20 years (schizophrenia, schizoaffective, bipolar)

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4
Q

What are the dental impacts of mental health disorders?

A

More susceptible to oral disease:
poor OH
poor diet
dental phobia
difficulty registering
costs
difficulty in access
adverse orofacial side effects caused by antipsychotics and antidepressants- xerostomia

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5
Q

What is the issue with mental health training for dentists?

A

No current training on dealing with mental health emergencies

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6
Q

What are the general impacts of good mental health?

A
  • Improved educational attainment- better job
  • Greater productivity
  • Less sickness absence
  • Better physical health
  • Reduced mortality
  • Reduced risk of suicide
  • Increased social interaction
  • Reduced risk taking behaviour- smoking, drugs, alcohol
  • Increased resilience
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7
Q

What are some examples of protective factors against mental health issues?

A
  • Genetics
  • Family background (loving safe environment)
  • Personality
  • Age
  • Gender
  • Marital status
  • Social support
  • Socioeconomic factors- access to resources
  • Reduced inequality
  • Employment- purposeful activity
  • Community factors- participation
  • Self esteem
  • Autonomy
  • Altruism
  • Emotional and social literacy
  • Physical health
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8
Q

What are some of the causes in children of poorer mental health?

A
  • Parental use of alcohol, tobacco and drugs during pregnancy
  • Maternal stress during pregnancy
  • Parental poor mental health
  • Low birth weight
  • Impaired cognitive function and language development as a child
  • Unemployed parents
  • Child abuse
  • Use of cannabis (at young age)
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9
Q

What are some of the causes of poorer mental health in adulthood?

A
  • Lower income
  • Debt
  • Violence
  • Stressful life events- bereavement
  • Unstable housing
  • Fuel poverty
  • Unemployment
  • Suicide
  • Personality traits
  • Abuse experience
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10
Q

What are the features of generalised anxiety disorder?

A
  • Regular uncontrollable worries about things in every day life
  • Individual to each person
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11
Q

What are the features of panic disorder?

A
  • Frequent panic attacks without clear cause or trigger
  • Constant fear of having another panic attack (can be a trigger)
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12
Q

What is a phobia?

A

Extreme fear or anxiety triggered by particular situation or object

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13
Q

What is a social anxiety disorder?

A

Fear or anxiety triggered by social situations
- Parties, workplaces, talking to others

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14
Q

What are the features of PTSD?

A

Development anxiety problems after going through traumatic experience
- Flashbacks
- Nightmares
- Reliving fear and anxiety of traumatic event

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15
Q

What is OCD?

A

Occurs when anxiety causes repetitive thoughts, behaviours, urges, obsessions

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16
Q

What is health anxiety?

A

Obsessions and compulsions related to illness
 Researching symptoms and thinking they have them

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17
Q

What is body dysmorphia disorder?

A

obsession and compulsions relating to physical appearance

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18
Q

When does perinatal anxiety occur?

A

During pregnancy or first year after giving birth

19
Q

What are the symptoms of depression?

A
  • Low mood
  • Diminished interest in activities
  • Weight gain or loss
  • Psychomotor agitation or retardation
  • Fatigue
  • Inappropriate guilt
  • Difficulty concentrating
  • Recurrent thoughts of death
  • Sleep issues
20
Q

What are the causes of depression?

A
  • Stressful events- bereavement, relationship breakdown
  • Personality traits- low self-esteem, overly self-critical
  • Genetics
  • Life experience
  • Family history
  • Giving birth
  • Loneliness
  • Alcohol and drugs
  • Illness
21
Q

What are the dental impactions of depression

A
  • Less likely to seek treatment
  • Chronic facial pain
  • TMD
  • Burning mouth- oral dyaesthesia
  • Somatoform issues- spots/lumps, dry mouth, excess salivation, halitosis, disturbed taste
22
Q

What is a tardive dyskinesia?

A

Involuntary movements of tongue, lips, face, trunk, extremities
 Associated with antipsychotics (atypical), neuroleptics
 Mild- patient may be unaware
 Does not respond to removal of medication

23
Q

What is psychosis?

A

Loss of contact with reality
 Auditory/visual/gustatory/olfactory hallucination
 Delusions- believing things that are not true (belief not shared by others- conspiracy to harm patient)

24
Q

What are some of the causes of psychosis?

A
  • Schizophrenia
  • Bipolar- mood disorder, episodes of low mood or elation
  • Severe depression
  • Trauma
  • Stress
  • Drug/alcohol misuse
  • Side effects of prescribed medicine
  • Brain tumours
25
Q

What is bipolar?

A

Severe mood swings (out with cyclothymic mood changes)
- Lasts weeks or months

26
Q

What are the different phases of bipolar?

A

Low mood/depressive phase- intensely low feeling, depressed, despairing

High/mania- elation, overactivity, grandiose delusions, spending issues

Hypomanic- mood is high but not as extreme

Manic- mixture of depression and mania (restless)

27
Q

How common is bipolar?

A

Affects 1 in 50
-> Usually starts between age 15-25 (rarely after 50)

28
Q

What are the dental implications of bipolar?

A

Depression phase- decline in OH, increased caries/periodontal disease

Mania- NCTSL due to overzealous OH

29
Q

What is schizophrenia?

A

Disorder of mind affecting how patient thinks, feels, behaves
-> Fundamental distortions of thought and perception

30
Q

What are the epidemiological features of schizophrenia?

A

 Affects 1 in 100 people
 M=F
 Usually occurs between 15-35 (rare before age 15)

31
Q

What are the symptoms of schizophrenia?

A
  • Hallucination- hearing voices (rude, critical, abusive, irritating), discomfort in body, feeling of being touched or hit
  • Delusion- unrealistic thoughts and beliefs that patient is completely sure of (can be inexplicable- not related to culture, background or religion)
  • Paranoia- person feels persecuted or harassed (spied on by government, partner being unfaithful)
  • Ideas of reference- patient sees special meaning in ordinary day to day events (connection to radio or TV- feeling someone is telling them to do things)
  • Thought disorder- difficulty concentrating (issues finishing tasks, working, studying)
  • Issues with memory
  • Feeling of being controlled- thoughts suddenly disappear, thoughts are not their own, body is being taken over
  • Loss of motivation/energy
  • Loss of interest in life
  • Isolation
  • Stop taking care of themselves- washing, tidying
  • Issues with social interaction
32
Q

How is schizophrenia treated?

A
  • Medication- tablet form, capsules, syrup, depot injection
  • CBT
  • Counselling
  • Supportive psychotherapy
33
Q

What are the dental implcations of schizophrenia?

A
  • Haloperidol/phenothiazines can cause orthostatic hypotension (raise slowly from supine position in chair)
  • Xerostomia- long term use of neuroleptics (candidiasis, caries, parotitis)
  • Oral pigmentation
  • Extrapyramidal symptoms- facial dyskinesia, issues swallowing, issues speaking, uncontrollable grimacing (dystonia)
  • Haloperidol and clozapine- hypersalivation
34
Q

What is schizoaffective disorder?

A

affects thoughts, emotions and actions
- Combination of psychoses and Bipolar
- Clear symptoms present for most of the time for more than 2 weeks

35
Q

What are the types of schizoaffective disorder?

A

SD manic type- psychotic and manic symptoms in one episode

SD depressive type- psychotic and depressive symptoms

Mixed- both manic ad depressive symptoms, psychotic symptoms are independent

36
Q

What are the signs/symptoms of annorexia nervosa?

A
  • Worrying about weight
  • Calorie counting- eating less, excluding certain food groups
  • Excess exercise
  • Being below safe weight
  • Smoking or chewing gum to keep weight down
  • Checking weight/appearance in mirrors obsessively
  • Withdrawal from social situations that involve eating
  • Wearing baggy clothes
  • Water loading before being weighed
  • Avoiding mealtimes
  • Loss of interest in sex
  • OCD symptoms- sticking to rigid routines and times, difficulty in spending money, need to study or work all the time
37
Q

How common is AN in 15 year olds?

A

Girls- 1/150

Boys- 1/1000

38
Q

What are the features of bulimia nervosa?

A
  • worry more and more about their weight
  • binge eat
  • make themselves vomit and/or use laxatives or other ways to get rid of calories
  • have irregular menstrual periods
  • feel tired
  • feel guilty
  • stay a normal weight, in spite of their efforts to diet
39
Q

What is ARIF?

A

avoidant/restrictive food intake disorder (not caused by worry about weight and body image)

40
Q

What are the psychological signs and symptoms of eating disorders?

A
  • Psychological- poor sleep
  • issues concentrating, depression
  • loss of interest in others
  • obsession about food and eating (and cleaning/washing etc)
41
Q

What are the physical signs and symptoms of eating disorders?

A
  • finding it harder to eat (stomach shrunk)
  • Feeling tired, weak, cold (metabolism slows)
  • Constipation
  • Changes in hair- falls out
  • Dry skin
  • Not growing to full height/loss of height
  • Brittle bones- OP
  • Unable to ger pregnant
  • Damage to liver
  • Death
42
Q

What are the implications of vomiting seen in eating disorders?

A
  • Erosive tooth wear
  • Sialosis
  • Palpitations- disturbed salt balance in blood
  • Feeling weak and tired
  • Weight swings
  • Damaged kidneys
  • Epileptic fits
  • Issues with getting pregnant
43
Q

What are some of the effects of laxatives used by patient with eating disorders?

A
  • Persistent stomach pain
  • Swollen fingers
  • Issues going to toilet without using laxatives (damage caused by medication to bowel muscles)
  • Weight swings- loss of fluid on purging
44
Q

What are the dental implications of eating disorders?

A

NCTSL
-> Loss of vertical dimension
-> Dento-alveolar compensation
-> affects quality of dentine for bonding
-> Use of resin-based materials

Xerostomia

Sensitivity

BDS4 Special Care (9 decks)

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