Dental Care for the Patient with Bipolar Disorder
In the healthcare field we meet and treat a variety of people who have very common goals for themselves. Some strive for better health in prevention while some look to treat immediate concerns. With that in mind, we occasionally deal with clients who have psychiatric illnesses who may not have priority in their oral health. For that matter I think it is important for me as a dental hygiene student to become aware of the different mental illnesses that we may run into in our field. I recently learned about Bipolar disorder in my Special Needs course and found interest in reading up on it. I found an article that is fitting for our field. This article is titled "Dental Care for the Patient with Bipolar Disorder" and it is written by a dentist in Canada.
Dr. Clark wrote this article in the Journal of Canadian Dental Association with the purpose to acquaint the dental clinician with features of bipolar disorder and to highlight its oral findings and how to manage this type of client. A characteristic of bipolar disorder is the feeling of extreme elation (manic) and depression. This type of extreme mood behavior is common to occur a couple times a year, but in rapid cyclers they can experience these extreme mood swings at least four times a year. Days may pass with little or no sleep. Their speech is often loud and fast and they can change topics rather quickly. These manic episodes typically first occur in teen years and can become worse in their twenties. This disorder can become very distracting for their social and occupational functioning. Poor insight and judgment can lead to substance abuse and thoughts of suicide.
The author states that the common way to medically manage bipolar disorder is by a three step approach. Pharmacotherapy, psychotherapy, and life adjustment skills are said to help manage this disorder. The pharmacotherapy approach is used more widely in the dental setting for a way to manage this type of patient. The patient is prescribed oral medications to help stabilize their mood. The different types of medications can have side effects on the oral cavity such as xerostomia. During these depression stages the patient may exhibit a low priority in their homecare and caries and/or periodontal disease may become an issue. He also states that during their manic phase they may also be overzealous with their homecare and cause cervical abrasion from brushing too hard.
In summary Dr. Clark states to always consult with the patient's physician and psychiatrist prior to treating a patient with bipolar disorder. He also discussed the need for preventive dental education and that our ability to contribute to their feeling of self-worth can be a very rewarding experience for us.
Personal reflection:
I found this topic interesting because it can be a mental illness that is difficult to diagnose. In our field we see so many types of people. If we can recognize some signs of bipolar disorder and help those who are not aware then we can do our part in prevention. In Special Needs I learned that 10-15 % commit suicides so if I can heighten my awareness to the signs and symptoms then just maybe I can help in prevention of at least one suicide attempt. It is important for us to be aware of any medications as well not just for the side effects, but for awareness if the patient does not want to reveal they have bipolar disorder. We may need to modify our communication with the patient and maybe all they need is someone to listen.
Additional information:
http://www.youtube.com/watch?v=sl95tsiLvyM
APA Citation:
Clark, D.B. (2003) Dental Care for the Patient with Bipolar Disorder. Canada: Journal of Canadian Dental Association
Dr. Clark wrote this article in the Journal of Canadian Dental Association with the purpose to acquaint the dental clinician with features of bipolar disorder and to highlight its oral findings and how to manage this type of client. A characteristic of bipolar disorder is the feeling of extreme elation (manic) and depression. This type of extreme mood behavior is common to occur a couple times a year, but in rapid cyclers they can experience these extreme mood swings at least four times a year. Days may pass with little or no sleep. Their speech is often loud and fast and they can change topics rather quickly. These manic episodes typically first occur in teen years and can become worse in their twenties. This disorder can become very distracting for their social and occupational functioning. Poor insight and judgment can lead to substance abuse and thoughts of suicide.
The author states that the common way to medically manage bipolar disorder is by a three step approach. Pharmacotherapy, psychotherapy, and life adjustment skills are said to help manage this disorder. The pharmacotherapy approach is used more widely in the dental setting for a way to manage this type of patient. The patient is prescribed oral medications to help stabilize their mood. The different types of medications can have side effects on the oral cavity such as xerostomia. During these depression stages the patient may exhibit a low priority in their homecare and caries and/or periodontal disease may become an issue. He also states that during their manic phase they may also be overzealous with their homecare and cause cervical abrasion from brushing too hard.
In summary Dr. Clark states to always consult with the patient's physician and psychiatrist prior to treating a patient with bipolar disorder. He also discussed the need for preventive dental education and that our ability to contribute to their feeling of self-worth can be a very rewarding experience for us.
Personal reflection:
I found this topic interesting because it can be a mental illness that is difficult to diagnose. In our field we see so many types of people. If we can recognize some signs of bipolar disorder and help those who are not aware then we can do our part in prevention. In Special Needs I learned that 10-15 % commit suicides so if I can heighten my awareness to the signs and symptoms then just maybe I can help in prevention of at least one suicide attempt. It is important for us to be aware of any medications as well not just for the side effects, but for awareness if the patient does not want to reveal they have bipolar disorder. We may need to modify our communication with the patient and maybe all they need is someone to listen.
Additional information:
http://www.youtube.com/watch?v=sl95tsiLvyM
APA Citation:
Clark, D.B. (2003) Dental Care for the Patient with Bipolar Disorder. Canada: Journal of Canadian Dental Association