As a registered dental hygienist, each work day will bring about new experiences and obstacles to overcome. Some of these hurdles will be pleasant and some will be more detailed oriented. As a working professional it is up to you to handle these instances will grace and proficiency in a timely and mature manner.
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As such, working with the public includes many avenues to navigate because each person is a unique pathway. Psychology can help us better traverse these pathways with more resiliency. One issue that many dental hygienists may come across in his or her career are people with mood disorders. Mood disorders may include: major depressive disorder, mania, or bipolar disorder. Knowing the causes, symptoms, and treatments of these disorders can help any working professional give adequate care and can ensure that the patient will come back for another visit to maintain their health.
Mood disorders are a mixed group of mental complexions characterized by extreme exaggeration and disturbance of mood. Major depression and other mood disorders, such as bipolar depression, can heavily affect a patient’s dental health. The drugs used to treat these conditions can have significant side effects that dentists and dental hygienists should be aware of when treating a patient with such diagnosis. The dentist or dental hygienist should refer patients found with signs and symptoms of mood disorders for medical evaluation and treatment (Little, 2004). The most common diagnosis of mood disorders is what is called major depressive disorder. Major depressive disorders are diseases which are simply referred to as depression and represent a class of mood disorders. One of the main and more popular symptoms of people with depression is the lack of social activities, however, some patients with major depressive disorders can manifest common physical symptoms ranging from digestive and circulatory problems to libido and even respiratory issues. This lack of social interaction also leads itself to lack of personal care resulting in poor oral health care. The causes of mood disorders may exist from chemical imbalances in the brain due to genetic factors but could also stem from prescribed medication like the drug Reserpine (Yamada, Patent Issued for Therapeutic Agent for Mood Disorders, 2016). People with major depressive disorder feel extremely useless, worthless, and lonely making it hard for them to function normally, and studies have shown that women are twice as likely to suffer from depression. The reason for this is not quite agreed upon. Some believe that it is because women undergo more stress than men in areas of inequality in the workplace, abuse, and unhappiness in marriage. It is also noted that men more often turn to drugs or alcohol to cope with stress whereas women develop depression to deal with stress (Feldman, 2018).
Mood disorders are estimated to be one of the most serious causes of ill health in the general public. According to the National Comorbidity Survey, depression affects at least one-sixth of the population with the prevalence of major depression as the most common disorder. Although studies claim that one-sixth of the population has depression, many people with depression suffer without being diagnosed or medicated. Statistically, only a small amount of people actively seek treatment (Patel, 2004). With that said, it can be assumed that many dental patients could be dealing with depression. Some common symptoms of depression include: fatigue, lack of energy, trouble sleeping, trouble concentrating, loss of appetite, or pains that will not go away. As a dental hygienist it may be hard to spot these types of symptoms, but one important part of being a dental hygienist is to get to know your patients through rapport. Simple conversations with them before a cleaning may eventually open them up to deeper, more personal conversations, and as a trained professional it is up to you to recognize these certain signs (Watson, 2015). One simple way to get a patient to open up is to ask questions.
Ask questions that should have a positive answer such as, Seen any good movies lately? Any questions that normally require a positive response is a great way to gauge your patient’s mood. Try asking more than one and if all answers are responded to with negativity then it is time to really start paying attention (Melinda Smith, 2018). Also, for many people who suffer from mood disorders, the side effects of medication results in xerostomia (dry mouth), which can further exaggerate the severity of many oral diseases. With dry mouth the reduction of saliva can increase the degree of dental deteriorations, mucosal dryness, and dysphagia (difficulty swallowing). The result of dry mouth might also lead to a higher number of cavities because many will resort to candy or sugary beverages for lubrication. Dry mouth coupled with caffeine or smoking may also lead to yeast infections, fissuring of the oral commissures, and even trouble speaking (Clark, 2003). These are all physical signs to be aware of while examining the public.
Being a dental hygienist, you should use reassurance, motivation, and your knowledge of education about improving dental health to enhance the sense of identity and self-esteem for patients with mood disorders. Using positivity and knowledge of patient care will contribute in some way to their psychological rehabilitation. Also, as a dental hygienist, it is part of your job to detail treatment planning that encompasses the maintenance of oral health, as well as what preventions to take to avoid oral diseases. However, before prescribing any treatment, it is imperative to consult with the patient’s primary doctor to confirm with or update any new information about medications that the patient might be taking. It is also important to note that patients with mood disorders may be uncooperative for even simple routine procedures. When a person is going through a depressive episode, they may not be aware of their lack of personal hygiene; showers may not be taken, teeth may not get brushed, and clothes may not be washed. These episodes tend to lead to more problems with cavities or periodontal issues. Contrastingly so, during manic periods (opposite of the depressed state) a result in an extreme use of teeth cleaning and over flossing may be associated with an increase in oral abrasions, as well as mucosal or gingival lacerations (Clark, 2003).
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