Mental health

Question 1

People who use cannabis have the tendency to what in regard to dentist?

Answer 1

• Attend dentist less reg
• Increased caries rate because of xerostomia
• Increase hunger following cannabis action on hormone leptin
• Increased levels of periodontal disease
• Increase gingival enlargement
• Oral leukoplakias
• Oral cancer

Question 2

How can cannabis use lead to acute medical issue?

Answer 2

• Cannabis acts on cardiovascular system to induce tachycardia with widespread vasodilation
• If pt given adrenaline containing local anaesthetic during tachycardia period can lead to acute medical issue

Question 3

What is Schizoprenia?

Answer 3

• Psychiatric diagnosis
• Experience both disorder of perception like hallucinations and thought like delusions

Question 4

What are the potential causes of Schizoprenia?

Answer 4

• Imbalance of neurotransmitters in brain such as dopamine, serotonin and glutamate
• Genetic predisposition
• Drug misuse like LSD and cocaine
• Stress or bereavement

Question 5

What is the management of Schozprenia?

Answer 5

• Drug therapy
• Talking therapies
• Leaning life skills and coping mechanisms such as cooking, art or music
• Exercise

Question 6

What is Clozapine?

Answer 6

• a-typical antipsychotic
• Not first line of management for schizoprenia

Question 7

What are some risks of Clozapine?

Answer 7

• Neutropenia and potentially fatal agranulocytosis
• Myocarditis and cardiomyopathy
• Hypersalivation

Question 8

How does smoking cessation and Clozapine use relate?

Answer 8

• Recent studies shown levels of clozapine in plasma can change significantly upon withdrawal of tobacco smoke
• Can be dangerous and lead to toxicity in pt in withdrawal
• Need to liase with consultant psychiatrist if wanting to quit smoking

Question 9

Why are implants not justified in cases?

Answer 9

• Poor oral hygiene
• Smoking increases risk of failure of implants
• Implant is long process and can’t tolerate one tooth removed then not tolerate surgical procedure
• If quality of bone is not good

Question 10

How can you describe soft tissue lesions?

Answer 10

• Location
• If crosses midline
• Diameter
• Thickness
• Appearance with margin note
• traumatic or non traumatic

Question 11

What can cause gastric secretions?

Answer 11

• GORD
• Sickness as side effect of disease process of medications
• Bulimia nervosa
• Anorexia nervosa

Question 12

Intra-orally how might anorexia nervosa or bulimia nervosa present?

Answer 12

• Exposed dentine resulting in hypersensitivity
• Dry mouth
• NCTSL esp on palatal/lingual aspect of anteriors
• Ulceration and infections due to nutritional deficiency related
• Increased levels of keratin present in oral soft tissues in response to trauma from purging or from acidic nature of vomit

Question 13

How might anorexia / bulimia nervosa present extra orally?

Answer 13

• Sialadenosis
• Damage to nails or increased keratosis of fingers if used to purge

Question 14

What advise can you give pt if suspected anorexia nervosa?

Answer 14

• Reduce intake of acidic drinks
• Have acidic drinks with meal if going to
• Use straw
• Avoid swirling acidic drink inside mouth
• Reduce fresh druit or citrus containing foods
• Alcoholic drinks like White wine or cider have erosive potential

Question 15

What advise can you give post-vomiting?

Answer 15

• After self induced vomiting chew gum, rinse mouth with water or milk
• Rinse with antacid preparation
• Avoid abrasive toothpastes
• Gentle tooth brushing with desensitising toothpaste and soft brush