psychiatric illness

Question 1

What percentage of people will experience some form of mental disorder in life?

Answer 1

Almost 50%

Question 2

Name 4 groups of people more at risk of poor mental health in childhood

Answer 2

Any from:
- parental use of alcohol, tobacco and drugs during pregnancy
- maternal stress during pregnancy
- poor parental mental health
- parental unemployment
- child abuse

Question 3

Name 4 groups of people more at risk of poor mental health in adulthood

Answer 3

Any from:
- lower income and debt
- violence
- housing
- unemployment
- suicide
- stressful life events

Question 4

What is generalised anxiety disorder (GAD)?

Answer 4

Having regular or uncontrollable worries about many different things in everyday life

Question 5

What is panic disorder?

Answer 5

Having regular or frequent panic attacks without a clear cause or trigger

Question 6

What is a phobia?

Answer 6

An extreme fear or anxiety triggered by a particular situation or object

Question 7

What is depression?

Answer 7

A mental disorder characterised by depressed or sad mood, diminished interest in activities that used to be pleasurable, weight gain or loss, fatigue, difficulties concentrating as well as recurrent thoughts of death

Question 8

Name 3 dental implications of depression

Answer 8

Chronic facial pain
Burning mouth or sore throat (oral dysaesthesia)
TMD

Question 9

What are some other oral complaints from depression?

Answer 9

Discharges in the mouth
Dry mouth despite normal salivary flow
Spots or lumps
Halitosis
Disturbed taste sensation

Question 10

What is Tardive dyskinesia and who is mostly affected?

Answer 10

Involuntary movements of the tongue, lips, face, trunk and extremeties
Affects 15-20% of patients who have been receiving antipsychotics

Question 11

What is psychosis?

Answer 11

When people lose some contact with reality
May involve seeing or hearing things that others cannot see or hear (hallucinations) and believing things that are not actually true (delusions)

Question 12

Name 3 causes of psychosis

Answer 12

Schizophrenia
Bipolar disorder
Severe depression

Question 13

Give 2 examples of positive symptoms

Answer 13

Hallucinations
Delusions

Question 14

What are negative symptoms?

Answer 14

A withdrawal or lack of function that you would not usually expect to see in a healthy person

Question 15

Name 4 dental side effects of psychosis drugs

Answer 15

Postural hypotension
Facial dyskinesias - with difficulties speaking and swallowing
Hypersalivation
Xerostomia

Question 16

What are eating disorders and who is mostly affected?

Answer 16

Severe persistent disturbance in eating behaviour associated with distressing thoughts and emotions
Affects 5% of the population
More common in females
Often develops ni adolescence

Question 17

Name 4 eating disorders

Answer 17

Any from:
- anorexia nervosa
- bulimia nervosa
- binge eating disorder
- avoidant restrictive food intake disorder
- rumination disorder

Question 18

What is anorexia nervosa?

Answer 18

Self starvation and weight loss resulting in low weight for height and age
BMI <18.5
Driven by intense fear of gaining weight or becoming fat

Question 19

What is bulimia nervosa?

Answer 19

Alternate dieting with binging on forbidden foods
Patient can be underweight or obese
Binges can be followed by vomiting, fasting, laxative misuse and exercise

Question 20

What are the oral signs of bulimia nervosa?

Answer 20

Caries
Erosion
Sialosis
Mouth ulcers
Halitosis

Question 21

Name 4 dental implications of eating disorders

Answer 21

Any from:
- angular cheilitis
- glossitis
- candidiasis
- oral ulceration
- sialosis
- xerostomia
- dental hypersensitivity
- caries
- periodontal disease
- erosion

Question 22

How can you help a pt with an eating disorder as a dentist?

Answer 22

Offer safe space for pt to open up
Do not lecture or scrutinise
Offer simple facts on what may have caused the dental problems
Know how to signpost for help if pt opens up
Offfer support and regular appointments to review the dentition
SCOFF questionnaire - sick, control, one stone, fat, food

Question 23

What is Prilocarpine HCl used for?

Answer 23

To enhance salivary secretions in pts with some functional salivary glands

Question 24

Name 4 salivary substitutes

Answer 24

Glandosane - acidic so avoid in dentate patients
Saliva orthana
Biotene Oral Balance gel
BioXtra gel

Question 25

What does xerostomia affect?

Answer 25

Chewing
Swallowing (dysphagia)
Speech (dysarthria)
Taste (dysgeusia)
Quality of life