SCD - young people

Question 1

Define anorexia nervosa:

Answer 1

An inability to maintain body weight through the intentional restriction of food and drink

-can be accompanied by increased physical activity

Question 2

What are the 2 types of anorexia nervosa?

Answer 2

1. The restriction of food intake is the sole behaviour
2. Bingeing/purging where food restriction is accompanied by regular episodes of binge eating or purging behaviour

Question 3

What is bulimia nervosa?

Answer 3

Persistent preoccupation, irresistable food craving and self-induced vomiting/laxative and periods of starvation

Question 4

Who are most effected by binge eating disorders?

Answer 4

Mostly overweight and obese individuals - they do not purge

Question 5

What is the principle dental effect of eating disorders?

Where in the oral cavity is mostly effected and what is a typical presenting symptom?

Answer 5

Erosion - mainly from self-induced vomiting common with around 80% of bulimia and eating orders

Mostly effects the palatal and labial surfaces of upper teeth and pain from exposed dentine is a typical complaint

Question 6

What is parotid gland hypertrophy and when can they present?

Answer 6

Symmetric, painless soft swelling of the hard palate

Typical in anorexia and bulimic patients and those with sialadenitis

Question 7

List 3 main preventative target areas for patients with eating disorders:

Answer 7

1. Dietary advice
2. OHI
3. High content fluoride regime

Question 8

What are 3 common mental health problems which present in early life?

Answer 8

1. Schizophrenia
2. Obsessive-compulsive disorder (OCD)
3. Bipolar disorder

Question 9

Define Schizophrenia:

What is associated with an increased risk of developing schizophrenia?

Answer 9

The loss of contact with reality that may involve delusions, hallucinations, lack of insight and abnormalities of behaviour

Heavy cannabis use

Question 10

List 5 side effects of antipsychotic medication:

Answer 10

1. Xerostomia
2. Hypersalivation
3. Agranulocytosis
4. Tardive dyskinesia e.g. facial grimacing
5. Smoking

Question 11

List 4 factors of the dental management for a patient with schizophrenia:

Answer 11

1. OHI
2. Diet advice
3. Fluoride supplementation
4. Effects of smoking and medication

Question 12

How can a diagnosis of OCD be made?

Answer 12

The individual must realise that their obsessions or compulsions are unreasonable or excessive

Question 13

What % of people with Tourette’s syndrome have OCD?

Answer 13

Around 35-50%

Question 14

What are 2 types of treatment for OCD?

Answer 14

Fluoxetine and or exposure-based psychotherapy

Question 15

Define Bipolar disorder:

Answer 15

A mood disorder defined by the presence of one or more episodes of abnormally elevated mood - clinically referred to as ‘mania’

Question 16

What is a big factor in the cause of Bipolar Disorder?

Answer 16

Strong genetic element - % of obtaining condition increase when parents have Bipolar Disorder

Question 17

List 4 signs and symptoms of a manic episode:

Answer 17

1. high/euphoric mood
2. Racing thoughts and speech
3. Extreme irritability
4. Irrational thoughts and behaviour

Question 18

List 4 signs and symptoms of a depressive episode:

Answer 18

1. Lasting sadness and anxiousness
2. Feeling hopeless and pessimism
3. Sleeping too much or unable to sleep
4. Thoughts of death or suicide/attempts

Question 19

What are 3 areas of managing bipolar disorder?

Answer 19

1. Medication e.g. lithium and sodium valproate
2. Education
3. Psychotherapy

Question 20

Give 3 typical oral health implications in patients with Bipolar Disorder:

Answer 20

1. Poor oral hygiene
2. Increased/excessive dental caries
3. Xerostomia - greatest concern as drug treatment is lifelong

Question 21

List 3 ways to manage xerostomia:

Answer 21

1. Artificial saliva
2. Mouthwashes
3. Topical Fluoride