🌟 PERIODONTICS-PSYCHIATRY RELATIONSHIP
📌 POINTS TO PONDER
🔹Psychosomatic disorder in the oral cavity may be caused by either the development of habits that injure the periodontium, or the direct effect of the autonomic nervous system.
🔹Psychosocial factors can modify the periodontal status through behavioural changes regarding oral hygiene, smoking, dietary intake, bruxism and drug use.
🔹Four basic approaches used to deal with stress are as follows:
– Removal or alteration of the source of stress
– Learning to change how you see stressful event
– Reducing the effect on your body that stress has
– Learning alternative ways of coping.
🔹Jacobson’s progressive muscle relaxation (JPMR), breathing exercises and guided imagery are simple ways of relieving stress and achieving well-being as a whole.
📣 Classification Of Parafunctional Habits
I. According to the cause, these are classified in three ways:
- Tooth to tooth function, e.g. bruxism.
- Tooth to soft tissue, e.g. digit – sucking.
- Tooth to foreign object, e.g. chewing of pens and pencils.
II. According to Sorrin and Cheek, the habits are classified into:
💠Neurosis:
- Lip biting
- Fingernail biting
- Tongue thrusting
- Pencil/pen biting
💠 Occupational habits:
- Holding of nails in the mouth by cobblers, upholsterers and carpenters.
- The pressure of a reed during the playing of musical instruments.
💠Miscellaneous habits:
- Mouth breathing
- Thumb sucking
- Pipe/cigarette smoking
- Incorrect methods of toothbrushing
📌VIVA VOCE
Q1. What is General Adaptation Syndrome? Who described this phenomenon?
Ans. General Adaptation Syndrome (GAS) is a set of non-specific physiologic reactions to stress. Response to prolonged stress is a part of the individual’s adaptive mechanism which may lead to clinical signs and symptoms called the GAS. This phenomenon was described by Selye.
Q2. What are the possible ways by which the stress affects the periodontium?
Ans. The stress affects the periodontium possibly by:
(a) Altered behaviors, such as poor oral hygiene; smoking and
(b) Impaired immune function.
These factors altogether makes an individual more susceptible for periodontal disease.
Q3. Which psychiatric medications cause halitosis?
Ans. Following are the psychiatric medications causing halitosis:
🔸Antianxiety: Lorazepam, Hydroxyzine, Chlordiazepoxide, Diazepam, Alprazolam.
🔸Anticonvulsants: Carbamazapine, Lamotrigine.
🔸Antidepressants: Amitriptyline, Desipramine, Doxepin, Imipramine, Amoxapine, Fluoxetine, Bupropion, Clomipramine, Fluvoxamine.
🔸Antipsychotics: Clozapine, Haloperidol, Pimozide, Trifluoperazine, Chlorpromazine.
🔸Sedatives: Flurazepam.
Q4. Which muscles and joints are involved in Bruxism?
Ans. Muscles involved in bruxism are the muscles of the face and jaw, especially the masseter. The joint involved is the temporomandibular joint.
Q5. How are parafunctional habits classified according to the cause?
Ans. According to the cause,parafunctional habits are classified in three ways:
(a) Tooth to tooth function, e.g. bruxism;
(b) Tooth to soft tissue, e.g. digit – sucking;
(c) Tooth to a foreign object, e.g. chewing of pens and pencils.
Q6. Which stage of Freud’s places great importance on the relationship of the oral cavity to the psyche?
Ans. Freud’s Oral Stage of Psychoanalytic Theory
Q7. Which is the most common condition associated with mouth breathing.
Ans. Gingivitis
Q8. Define Psychosomatic dentistry.
Ans. Psychosomatic dentistry is defined as the relationship of the mental well being to the health and integrity of the oral tissues
Q9. Who coined the term “Stress”?
Ans. Selye
Q10. Which oral health problems are associated with anxiety disorders?
Ans. Dry mouth; Lichen planus; Canker sores.
📌 MCQs
💡 Which of the following is a parafunctional habit?
A. Bruxism
B. Chewing of pencil
C. Holding of nails in the mouth by cobblers/carpenters
D. All of the above
Answer : D
💡Who coined the term “Stress”?
A. Hippocrates
B. Selye
C. Carranza
D. Genco
Answer: B
💡Psychosocial factors can modify the periodontal status through behavioural changes regarding:
A. Oral hygiene
B. Smoking
C. Dietary intake
D. All of the above
Answer : D
💡Which of the following is not an oral adverse effect of psychiatric medications?
A. Xerostomia
B. Altered taste sensation
C. Pain in teeth and MPDS
D. All of the above
Answer: C
💡Depression affects oral health by:
A. Neglect of oral hygiene
B. Altered immune mechanism
C. Increase smoking
D. All of the above
Answer : D
💡Which of the following drugs cause gingival enlargement?
A. Alprazolam
B. Phenytoin
C. Lithium
D. Amitriptyline
Answer: B
💡Which of the following is a consequence of bruxism?
A. Excessive tooth wear
B. Widening of occlusal surfaces
C. Injury to periodontium
D. All of the above
Answer : D
💡Which of the following is not a consequence of tongue thrusting?
A. Loss of proximal contact
B. Pathological tooth migration
C. Tooth mobility
D. Deep bite
Answer : D