Why does patient mental health matter? part 5: chronic orofacial pain as a consequence of psychiatric disorders

Abstract

This is the final article in a series looking at psychiatric presentations in dentistry. Recently, the oral health of people with severe mental illness (SMI) has gained significant media attention after the Office of the Chief Dental Officer for England published a statement on the importance of prioritizing oral health for people with SMI. Furthermore, a consensus statement has set out a 5-year plan to improve oral health in people with SMI. In Part 4, we discussed how a psychiatric disorder can result in dental pathology by contributing to risk factors associated with tooth surface loss. This article explores chronic orofacial pain symptoms and their link with psychiatry, considering the role of the primary dental care team in early recognition of psychiatric disorders. Given the range of chronic orofacial pain subtypes, we will present two separate fictionalized case-based discussions to explore their presentation. CPD/Clinical Relevance: The primary care dental team has a role in recognition of psychiatric conditions and subsequent chronic orofacial pain.

College News

“…The dental professional is responsible for ensuring optimal oral health but should also be alert to possible severe mental illness in individuals attending with unusual dental presentations. [8][9][10][11] They must also be aware that people with psychosis are a high-risk group for poor oral health including oral cancer. Finally, commissioners need to prioritise dental access for people with severe mental illness as a vulnerable group, for instance ensuring the availability of free or subsidised care.…”

“…They can adopt a whole-person approach in managing the impact of poor oral health on severe mental illness, particularly in relation to social avoidance from poor oral health outcomes related to bad breath and poor aesthetics. And they can be aware of dental presentations of severe mental illness which can alert to a possible diagnosis, and provide immediate onward referral to mental health services if severe mental illness is suspected from dental presentations [8][9][10][11].…”