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                                                        DR. DAN PETERSON

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BIPOLAR AND DENTAL HEALTH

"The prevalence of dental disease is 
extensive due in this disorder"*

     Bipolar disorder is a psychiatric illness, formerly known as manic-depressive disorder, that causes spells of elated and depressed mood swings with intervals of normal moods.  

    

     Their most common complaint is dry mouth and loss of taste.  Those with the highest  amount of decay and gum disease had the longest history of lithium use and the greatest number of hospital admissions for dipolar disorder.  

     People who have Bipolar disorder are at the high risk of developing:

Cause Oral symptoms
Manic Phase Toothbrush/dental floss scratches and cuts on gum tissue

Toothbrush abrasion of teeth

Depressive Phase Disregard of oral care

High decay, missing and filled teeth 

Severe periodontal disease due to neglect, increase in smoking, changed immune response 

Medications Effects Dry mouth causing them to drink large quantities of sugared drinks

Bruxism

Gum disease

Intense craving for foods high in sugar

High Lactobacillus count

Swelling /infections of mouth and tongue

    This disorder may make the individual uncooperative and irritable during dental treatment, appear unappreciative and have numerous complaints that are inconsistent with findings.

     It is important to:

bulletProvide a complete medical/dental history
bulletGive permission for the dentist to consult with psychiatrist about mental status, medication regiment, drug and alcohol abuse history
bulletPreventive dental education is of the highest important  to obtain and follow
bulletArtificial salivary products should be prescribed
bulletScaling and root planing will be needed for gum disease
bulletCavities will need to be controlled
bulletRestorative
bulletGood anesthesia levels must be obtained before procedures are performed
bulletDental exams and cleaning with fluoride should be done every 3 months 
bulletCosmetic dentistry that could enhance self esteem should be considered
bulletBeware of drug interactions 

Treatment

Important factors to provide is education, trust and respect.

Aggressive preventive dental education program that includes the use of artificial salivary products, antiseptic mouthwash and daily fluoride mouth rinses.

February 06, 2008

General Dentistry Sep/Oct 2004 and Impact April 2005 pg25-27.

*Bipolar 1 Disorder, Psychopathology, medical management and dental implications; Arthur Friedlander, Ida Friedlander, Stephen Marder; JADA, Vol 133 Sept 2002 pgs 1209-1217

Resources

Here are some Web sites for more information about mental illness: 

National Institute of Mental Health 

Rethink (formerly the National Schizophrenia Fellowship), www.rethink.org 

National Mental Health Association, www.nmha.org 

Depression and Bipolar Support Alliance, www.ndmda.org 

Anxiety Disorders Association of America, www.adaa.org 

National Mental Health Consumer Self Help Clearinghouse, www.mhselfhelp.org

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          If you have any questions please e-mail me at: drdpeterson@scottsbluff.net
                                                                                 308-436-3491 Office number

PLEASE NOTE: The information contained herein is intended for educational purposes only.  It is not intended and should not be construed as the delivery of dental/medical care and is not a substitute for personal hands on dental/medical attention, diagnosis or treatment.  Persons requiring diagnosis, treatment, or with specific questions are urged to contact your family dental/health care provider for appropriate care.
This site is privately and personally sponsored, funded and supported by Dr. Peterson.  We have no outside funding.
Confidentiality of data including your identity, is respected  by this Web site. We undertake to honor or exceed the legal requirements of medical/health information privacy that apply in Nebraska.

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