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Professor of Oral Surgery, King's College London; Honorary Consultant in Oral Surgery, King's College Hospital NHS Foundation Trust and Guy's and St Thomas' NHS Foundation Trust, London
Until recently, dentists were not trained in psychology and access to education in psychiatry and mental health remained limited within the dental curriculum. A major obstacle for integrating mental health initiatives into primary healthcare services is the lack of consensus on a definition of mental health. Currently, there is widespread use of the term ‘mental health’ as a euphemism for ‘mental illness’. Mental health can be defined as the absence of mental disease, or it can be defined as a state of being that also includes the biological, psychological or social factors which contribute to an individual's mental state and ability to function within the environment. This lack of consensus on the definition of mental health has implications for research, policy and practice.
Mental health issues will impact significantly upon many aspects of patients' health, including: seeking care, presentation, compliance with treatment and providing additional complexities in delivering routine care. Significant issues can arise in relation to routine care but, as dental procedures become more complex in their delivery and maintenance, the impact of undiagnosed mental health issues are likely to increase in prevalence and impact not only on individual patients but also their treating clinicians.
CPD/Clinical Relevance: This case report provides an account of a case where early identification of the patient's mental health status may have prevented significant post-treatment sequelae.
Article
Dental implants are widely acknowledged as an important treatment modality in the restoration of the failing or missing dentition. In that regard, there has been a considerable increase in the number of dental implants placed over the last 30 years with over four million implant fixtures placed annually in Europe.1 Success rates for implant treatment can vary widely,2 but are frequently reported as between 90% and 97% based on 5-year survival data.3 It is well documented that the level of implant success reported is dependent on the assessment criteria used.4 This can be highly variable, with the nature of the success criteria having a significant influence on the results reported.5
Success criteria for dental implants were previously aligned to survival rate, with assessment based on prosthesis stability, radiographic bone loss, and absence of infection in the peri-implant soft tissues.6 The importance of restorability, soft tissue aesthetics and patient satisfaction have since been acknowledged as key factors in the assessment of success.7
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