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Special Care > Mental Illness > Flashcards

Mental Illness Flashcards

1
Q

Individuals with poor mental health are at increased risk of which oral diseases?

A

Caries
Periodontal disease
NCTSL- erosion and attrition

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2
Q

What signs might suggest that someone is having a mental health crisis?

A

Withdrawn
Isolated
Not talking much
Change in their demeanour

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3
Q

Who is most at risk of poor mental health?

A

Parental use of alcohol, tobacco or drugs
Maternal stress during pregnancy
Low birth weight
Poor parental mental health
Parental unemployment
Child abuse and adverse experiences
Use of cannabis

Lower income and debt
Violence
Stressful like events
Unemployment
Housing
Experience of abuse

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4
Q

What is generalised anxiety disorder?

A

Regular and uncontrollable worries about many different things in life.
- excessive and persistent state, where the triggers don’t usually match the level or reaction that occurs.

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5
Q

What are the symptoms of generalised anxiety disorder?

A

Muscle ache
GI problems
Irritability
Difficulty concentrating
Difficulty sleeping
Chronic fatigue

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6
Q

What is the treatment for generalised anxiety disorder?

A

CBT

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7
Q

What is a panic disorder?

A

Regular or frequent panic attacks without clear cause or trigger.

Can occur in the absence of any threat.

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8
Q

What is a phobia?

A

Extreme fear or anxiety triggered by a particular situation or a particular object.

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9
Q

What could help overcome a phobia?

A

Behaviour management
- Systemic desensitisation
- Control signals
- Tell show do
- Communication
- Acclimatisation

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10
Q

Give examples of some mental health disorders.

A

PTSD
OCD
Social anxiety disorder
Health anxiety
Body dysmorphic disorder
Perinatal anxiety

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11
Q

What is clinical depression?

A

Characterised by depressed or sad mood, diminished interest in activities that used to be pleasurable, weight gain or loss, fatigue, inappropriate guilt and difficulties concentrating, as well as recurrent thoughts of death.

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12
Q

What causes depression?

A

Breakdown of a long term relationship
Close family death
Alcohol and drugs
Loneliness
Terminal diagnosis
Failing exams

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13
Q

What are the dental implications of depression?

A

Poor OH
Caries
Periodontal disease
Dental neglect- low attendance
Won’t seek treatment
Chronic facial pain
Oral dysaesthesia
TMD
Dry mouth
Disturbed taste sensation

Be aware that some of these may not actually be reality.

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14
Q

What is Tardive Dyskinesia?

A

Involuntary movements of the tongue, lips, face, trunk and extremities.

Can be caused by some antipsychotic medication.

Haloperidol
Risperidone

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15
Q

What is Psychosis?

A

Person loses some contact with reality.

Might involve seeing or hearing things that other people cannot see or hear and believing things that are not true.

Hallucinations and delusions.

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16
Q

What is Bipolar disorder?

A

Manic depressive illness- states of high mania (very happy and do things they wouldn’t usually do, i.e. spend lots of money) and very low depressive episodes (trouble sleeping, sad, withdrawn, trouble concentrating, tired, suicidal thoughts).

17
Q

What is Schizophrenia?

A

Fundamental and characteristic distortion of thinking and perception.

18
Q

What are positive symptoms of Schizophrenia?

A

Hallucinations
Delusions
Paranoid delusions
Ideas of reference
Muddled thinking
Feelings of being controlled- someone is controlling their thoughts, someone has taken over their body.

19
Q

What are negative symptoms of Schizophrenia?

A

Withdrawal or lack of function
Lose interest in life
Can’t concentrate
Stop looking after themselves
Feel uncomfortable with people

20
Q

What are the dental implications of Schizophrenia?

A

Haloperidol and Phenothiazines may cause orthostatic hypotension- patients should be raised slowly and carefully assisted from the dental chair

Xerostomia

Tardive dyskinesia

Facial dyskinesias

Haloperidol and clozapine can cause hyper salivation

21
Q

What is an eating disorder?

A

Severe persistent disturbance in eating behaviour associated with distressing thoughts and emotions

22
Q

What is the difference between Anorexia Nervosa and Bulimia Nervosa?

A

Anorexia- self starvation and weight loss caused by dieting driven by intense fear of gaining weight or becoming fact.
- restricting type or binge-eating/purging and then fasting.

Bulimia- Binge eating a large amount of food in a. short period of time and then vomiting it back up.

23
Q

What are the signs and symptoms of anorexia?

A

No period
Dizzy/faint spells
brittle hair/nails
Cold intolerance
Muscle wasting
GORD
Constipation
Depression
Anxiety
Fine soft hair

24
Q

What are the signs and symptoms of Bulimia?

A

Frequent bathroom trips after meals
Large amounts of food disappearing
Chronic sore throat
GORD
Palatal caries/erosion
Bleeding in vomit
Halitosis
Dizzy/faint spells

25
Q

What are the dental implications of eating disorders?

A

Dental erosion- palatal and occlusal surfaces
Angular Cheilitis
Glossitis
Candidiasis
Oral ulceration
SIalosis
Xerostomia
Dentinal hypersensitivity

26
Q

What considerations must you make if someone has an eating disorder?

A

Be careful with what pain killers you advise

Calculate maximum dosage of LA

Leave complex treatment to after patients have recovered

IV sedation and GA contraindicated

27
Q

How can we, as GDPs, help a patient with an eating disorder?

A

Offer a safe space for patient to open up about condition.

Do not do diet diaries or talk about food.

Explain findings of the examination- offer explanations as to what that could be from and ask the patient if they re aware of anything that could be causing this.
- If they do disclose this to you, signpost them to the GP.

Offer regular appointments to review the dentition and carry out essential dental treatment only.

Can use the SCOFF questionnaire to determine if they have an eating disorder.

28
Q

What considerations must you make for someone with a mental health condition?

A

They love chaotic lives- might be late, might not turn up.

Likely to be anxious- give more time for appointments.

Polypharmacy- be aware of drug interactions.

Poor OH- this might not be a priority for them at the moment.
- self-neglect.

Poor co-operation.

Assess if they have capacity at that time- are they having a psychotic episode?

29
Q

What considerations must you make when you are treatment planning for someone with a mental health condition?

A

Be realistic

Keep complex treatment until the patient is recovered

Consider whether the episode is acute or chronic

Ask what the patient wants

Consider mood and motivation of the patient
- often require constant motivation.

Consider 1 stage endodontic treatment- might not come back.

Be mindful of providing prevention to patients- floss, alcohol mouthwash, wooden sticks can all be used for sinister purposes.

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