Psychotic disorders: Schizophrenia

The Psychotic disorders are very important in Dentistry. ¿Why is it so important? These kind of patients use to take antipsychotics such as Haloperidol, chlorpromazine, fluphenazine and another therapies. So we have to take care with the medical interactions and the behaviours that I'm about to talk.    


They are characterized by a loss of contact with the reality. The patient use to see or believe things that don't match what they see the others.

The psychotic chronic disorder more representative is the Schizophrenia. A chronic disorder requires a minimum of six months to make this diagnosis. Today I want to talk about it.

The Schizophrenia has an unknown cause and the psychotic symptoms get impairs. There is just 1% of the population that is affected. The average age of onset is 25 years old.


There are examples in the film world; the shining and in shutter island. The first example is more aggressive and the second one is more paranoid. The last one is a real story about the mathematician John Forbes Nash Jr. life. that I recommend you to watch this three good movies if you want to learn more about Schizophrenia. 

We have to divide the symptoms in positive and negative. The positive symptoms are:

• Hallucination: hear voices talking, insulting or giving orders. There is also visual, tactile or olfactory hallucinations.
• Delusions: incorrigible beliefs without a real base. They can be of greatness, nihilists, persecution, somatic...
• Extravagant behaviour: repetitive, disorganized and aggressive behaviours. 
• Thoughts disorder: the level of thought guiding idea is lost, there is a breakdown of normal associations. Blocks can also affect the speech.

 

 

 The negative symptoms are:

• Affective flattening: unchanging facial expressions with spontaneous movement, poor gesticulation, poor eye contact, sudden laughing or crying and monotone voice.
• Alogia: lack of reasoning, extravagant answers an also invention of words.
• Lethargy and apathy: neglect of hygiene, work or school, lack of energy and inability to enjoy things.

The schizophrenia involves 3 phases: the "shoots" with an initial prodomal phase, an active phase with symptoms and hallucinations and at the end a residual stage with negative symptoms.


Practice:


The main problem is that psychotic disorders are usually in the relationship with therapeutics; if the patient is unbalanced, may grow restless, suspicious or openly hostile, and even because something related to the delusions like a chip or microphone hidden in this mouth. Some of them aren't able to make decisions about their health. Antipsychotic drugs may produce orthostatic hypotension so we have to take care when they are getting up. In addition, most antipsychotics cause hypersalivation, dry mouth, which can worse the health of their mouth. That means that these patients will be more likely to have decays and periodontitis. 

Nowadays we can control this disorder that's why we have to take care and ask about the medication. The most important thing is to treat everybody as a HUMAN, that's what we are. WE AREN'T JUST TEETH. 

Soap teeth

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Hello,

These pictures show my work from the 1rst grade. Each student had to make 3 teeth using soap and present it to the teacher. I decided to make a quarter of the mouth, with 8 teeth in total. Once finished, I used pink plasticine to imitate the gums.

Here we can see the canine on the right, then the 2 premolars, and finally the first molar on the left.  

The lab

Hey,

My name is Lydia and I'm studying Dentistry at Barcelona. My objective is simple; transmit my passion. Since I was a little girl I loved this branch of the Medicine. These pictures are from mmy previous year. 

Each student has his own minilab, mine is this one. The university gives to us a tray with the material for the practices.  

Next step is to prepare the dummy. It's like a puzzle where you have to introduce the fake dentures in the dummy. 

This is me. In this practice we have to show how we do the absolute isolation. It looks useless but is very important to protect all the teeth from any dangers.   

The last picture is the result of the absolute isolation. It can appear uncomfortable for the patient but is not as bad as it looks. On one hand this system permits to separate the saliva and the teeth to treat. Why is that so important? The saliva is a powerful liquid that contains a lot of bacteria. So with this system the bacteria can't go inside the tooth by the hole. On the other hand the isolation prevents the passage of the instruments into the throat. When we are working with somebody's mouth we use small instruments that can be easily elusive with gloves. 

There is also another reason, the protection of the infectious patient, dentist and assistant. Through the saliva the bacteria can be transmitted from patient to the dentist or the assistant and vice versa. If you do the good technique it dries all and retracts the soft tissues. 

You never realize how dangerous can be if we don't take care of this technique.