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Why does patient mental health matter? Part 4: non-carious tooth surface loss as a consequence of psychiatric conditions Emma Elliott Emily Sanger David Shiers Vishal R Aggarwal Dental Update 2024 50:1, 707-709.
Honorary Research Consultant, Psychosis Research Unit, Greater Manchester Mental Health NHS Trust, Manchester; Honorary Reader in Early Psychosis, Division of Psychology and Mental Health, University of Manchester; Honorary Senior Research Fellow, School of Medicine, Keele University, Staffordshire
This is the fourth 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 3, we discussed how a psychiatric disorder can result in dental pathology primarily through self-neglect. This article explores tooth surface loss and the potential link with psychiatry, considering the role of the primary dental care team in early recognition of psychiatric presentations. A fictionalized case-based discussion is used to explore this concept.
CPD/Clinical Relevance: This article emphasizes the role of the primary care dental team in recognition of psychiatric conditions, such as eating disorders.
Article
Recently, the oral health of people with severe mental illness (SMI) 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.1 Two authors (VA and DS) have also been involved in a consensus statement2 that sets out a 5-year plan to improve oral health of people with SMI.
Tooth wear is pathological tooth surface loss (TSL) that is not attributable to dental caries.3 This wear is often multifactorial in origin and can be as a consequence of erosion, attrition, abrasion or abfraction.3 The presence of these factors over time, and the fact that more people are dentate for longer, results in tooth wear compounding by age; in 2008, 4% of 16–24-year-olds had some moderate tooth wear compared with 44% of those aged 75–84 years.4 In contrast, in 1998, only 1% of 16–24-year olds had moderate tooth wear. Consequently it has been noted that younger adults are experiencing a greater increase in tooth wear prevalence than any other adult age group.4
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