SCHIZOPHRENIA
Demographics
I chose to do my mock case study on schizophrenia because I have never known anyone that had this particular disorder. However, I have had friends and family who have had to deal with bipolar disorders and depression and I know how difficult these conditions can be to deal with. I wanted to know more about schizophrenia so that if I have patients with this condition in the future I will be more prepared to treat them in a manner that will make them comfortable with receiving treatment.
Additional Information
The American Psychiatric Association website has info about schizophrenia but also some information on the toll that these diseases can take on caregivers: http://www.psychiatry.org/schizophrenia
National Institute of Mental Health website: http://www.nimh.nih.gov/health/topics/schizophrenia/index.shtml?utm_source=publish2&utm_medium=referral&utm_campaign=www.kpbs.org
This video had some interesting interviews with psychiatrists and people living with schizophrenia: http://www.youtube.com/watch?v=48YJMOcykvc
References
Kunz, Brenda. (2014). DH 24 Unit 13: Schizophrenia. Lecture PowerPoint Week 13.
Little, James W., Falace, Donald A., Miller, Craig S., & Rhodus, Nelson L. (2008). Dental Management of the Medically Compromised Patient (7th ed.). St. Louis: Mosby Elsevier.
Wilkins, Esther M. (2013). Clinical Practice of the Dental Hygienist (11th ed.). Philadelphia: Lippincott Williams & Wilkins.
Demographics
- Mr. Barnes is a 23 year old Caucasian man
- Mr. Barnes is approximately 6’1” and lean. He
looks a bit disheveled: his clothes are a bit wrinkled and his hair looks
unwashed. He also seems to be moving a
bit slowly and doesn’t seem to have much facial expression.
- Mr. Barnes is fairly quiet and a bit lethargic
but seems to be in good spirits.
- Mr. Barnes is currently living with his parents
and his two younger sisters. He mentions
that he is going to start taking college classes at the local community college
next term and that he is excited because some of his friends also attend, so he
will be able to see them more often.
- Mr. Barnes was diagnosed as having schizophrenia
about two years ago.
- He has also circled yes to alcohol and drug use
on his health history, and when I ask him to tell me a bit about this he
mentions that he used to drink quite a bit and smoke marijuana when he was in
college but that he stopped after he moved in with his parents.
- Mr. Barnes has not been to the dentist in about
three years
- Occlusal composite fillings on # 3, 12, 19, 30
- Generalized demineralization on the cervical
thirds of his teeth
- # 1,16,17,32 extracted several years ago
- Bilateral linea alba and wear facets on the
cusps of his molars due to bruxism
- Xerostomia
- Gingival description: gingiva is edematous with
rolled margins and slightly bulbous papillae
- I contact his physician prior to the appointment
to obtain more information about his current status, medication, and to verify
that he is capable of giving valid consent to treatment
- I ask Mr. Barnes non-judgmental, open-ended
questions about his diagnosis and the medications he is taking. He explains
that he was diagnosed about two years ago and is taking Risperidone for his
schizophrenia
- I ask if he has any concerns about his mouth or
his oral health. He says that he has noticed that his mouth has been very dry
since he began taking his medication and that it can be uncomfortable. He asks
if there is anything that will help with the dryness. I tell him about Biotene,
let him know that he can find it at many local stores, and give him a sample to
take home
- I explain that I noticed he had moderate plaque
along his gingival margin and calculus interproximally and discuss his need for
improved home care and regular maintenance appointments
- I also recommend a night guard to help with his
bruxism
- Schedule short (30 min) appointments at a time
when the patient is not experiencing an active phase
*medications can cause restlessness - 2-3 month re-care appointments
- Patient can be placed in a supine position. Make
sure patient is comfortable.
*medications can cause muscular rigidity, muscle contractions, and resting tremors - Advise patient to remain sitting before getting
out of the chair as some medications may cause dizziness when changing
positions
- Check medical history and vitals at every
appointment
- Review medications for oral side-effects and
interactions with anesthesia, etc.
*side-effects from meds may require appointment modifications
- Assess risk vs. benefit of local anesthesia/Use
the cardiac dose if using epinephrine (drug interactions)
- Do not use nitrous oxide-oxygen sedation
- Do not use ultrasonic
*some medications can cause a decrease of white blood cells which lead to a greater susceptibility to infection; other medications can cause difficulty swallowing - Drug interactions (carefully review medical
history and look up all meds for possible interactions)
- Bass brushing method and C-shape method of
flossing
- Saliva substitutes (Biotene) for xerostomia
- Xylitol gum or candy
- Non-alcoholic mouth rinse
I chose to do my mock case study on schizophrenia because I have never known anyone that had this particular disorder. However, I have had friends and family who have had to deal with bipolar disorders and depression and I know how difficult these conditions can be to deal with. I wanted to know more about schizophrenia so that if I have patients with this condition in the future I will be more prepared to treat them in a manner that will make them comfortable with receiving treatment.
Additional Information
The American Psychiatric Association website has info about schizophrenia but also some information on the toll that these diseases can take on caregivers: http://www.psychiatry.org/schizophrenia
National Institute of Mental Health website: http://www.nimh.nih.gov/health/topics/schizophrenia/index.shtml?utm_source=publish2&utm_medium=referral&utm_campaign=www.kpbs.org
This video had some interesting interviews with psychiatrists and people living with schizophrenia: http://www.youtube.com/watch?v=48YJMOcykvc
References
Kunz, Brenda. (2014). DH 24 Unit 13: Schizophrenia. Lecture PowerPoint Week 13.
Little, James W., Falace, Donald A., Miller, Craig S., & Rhodus, Nelson L. (2008). Dental Management of the Medically Compromised Patient (7th ed.). St. Louis: Mosby Elsevier.
Wilkins, Esther M. (2013). Clinical Practice of the Dental Hygienist (11th ed.). Philadelphia: Lippincott Williams & Wilkins.