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Abstract

Mental health is a broad general term that consists of a person’s overall psychological, emotional, and social well-being. Our mental health is affected by our surroundings and the stressors the environment around us can place on us, our genetic makeup, past experiences, and chemical imbalances in our brains. Over the past few decades, there has been a growing awareness and acknowledgement of various mental health conditions within our society that can affect an individual’s functioning capacity. As the study of human behavior progresses, more mental health disorders are identified based on specific presentations which can help aid in identifying, treating, and preventing or minimizing the condition. Due to the extensive training in anesthesia, oral and maxillofacial surgeons often receive referrals from general dentists and specialist for the treatment of patients who require sedation for behavioral management. For perspective 20% of all adults and 17% of all children experience mental illness each year according to the national alliance on mental illness. This chapter aims to describe the most common behavioral health disorders that a patient may present within an oral and maxillofacial surgery office, focusing on the clinical presentation of these disorders, assessment of these patients to determine if they are candidates for office-based procedures, and their clinical management.

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References

  1. Seligman LD, Hovey JD, Chacon K, Ollendick TH. Dental anxiety: an understudied problem in youth. Clin Psychol Rev. 2017;55:25–40.

    Article  PubMed  Google Scholar 

  2. Chanpong B, Haas DA, Locker D. Need and demand for sedation or general anesthesia in dentistry: a national survey of the Canadian population. Anesth Prog. 2005;52(1):3–11.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  3. Humphris G, Crawford JR, Hill K, Gilbert A, Freeman R. UK population norms for the modified dental anxiety scale with percentile calculator: adult dental health survey 2009 results. BMC Oral Health. 2013;13(1):29.

    Article  PubMed  PubMed Central  Google Scholar 

  4. White AM, Giblin L, Boyd LD. The prevalence of dental anxiety in dental practice settings. J Dent Hyg. 2017;91(1):30–4.

    PubMed  Google Scholar 

  5. De Jongh A, Fransen J, Oosterink-Wubbe F, Aartman I. Psychological trauma exposure and trauma symptoms among individuals with high and low levels of dental anxiety. Eur J Oral Sci. 2006;114(4):286–92.

    Article  PubMed  Google Scholar 

  6. Randall CL, Shaffer JR, McNeil DW, Crout RJ, Weyant RJ, Marazita ML. Toward a genetic understanding of dental fear: evidence of heritability. Community Dent Oral Epidemiol. 2017;45(1):66–73.

    Article  PubMed  Google Scholar 

  7. Armfield JM, Stewart JF, Spencer AJ. The vicious cycle of dental fear: exploring the interplay between oral health, service utilization and dental fear. BMC Oral Health. 2007;7(1):1.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Schuller AA, Willumsen T, Holst D. Are there differences in oral health and oral health behavior between individuals with high and low dental fear? Community Dent Oral Epidemiol. 2003;31(2):116–21.

    Article  PubMed  Google Scholar 

  9. Sohn W, Ismail AI. Regular dental visits and dental anxiety in an adult dentate population. J Am Dent Assoc. 2005;136(1):58–66.

    Article  PubMed  Google Scholar 

  10. Locker D. Psychosocial consequences of dental fear and anxiety. Community Dent Oral Epidemiol. 2003;31:144–51.

    Article  PubMed  Google Scholar 

  11. TanDon S, Duhan R, ShaRMa M, VaSuDeVa S. Between the cup and the lip: missed dental appointments. J Clin Diagn Res. 2016;10(5):ZC122.

    PubMed  PubMed Central  Google Scholar 

  12. Dailey YM, Humphris GM, Lennon MA. Reducing patients’ state anxiety in general dental practice: a randomized controlled trial. J Dent Res. 2002;81:319–22.

    Article  PubMed  Google Scholar 

  13. Eli I. Dental anxiety: a cause for possible misdiagnosis of tooth vitality. Int Endod J. 1993;26:251–3.

    Article  CAS  PubMed  Google Scholar 

  14. Wardle J. Fear of dentistry. Br J Med Psychol. 1982;55:119–26.

    Article  CAS  PubMed  Google Scholar 

  15. Lee HS. Recent advances in topical anesthesia. J Dent Anesth Pain Med. 2016;16(4):237–44.

    Article  PubMed  PubMed Central  Google Scholar 

  16. de Freiras GC, Pozzobon RT, Blaya DS, Moreira CH. Efficacy of benzocaine 20% topical anesthetic compared to placebo prior to administration of local anesthesia in the oral cavity: a randomized controlled trial. Anesth Prog. 2015;62(2):46–50.

    Article  PubMed  PubMed Central  Google Scholar 

  17. McPherson JS, Dixon SA, Townsend R, Vandewalle KS. Effect of needle design on pain from dental local anesthetic injections. Anesth Prog. 2015;62(1):2–7.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Pogrel MA. Broken local anesthetic needles: a case series of 16 patients, with recommendations. J Am Dent Assoc. 2009;140(12):1517–22.

    Article  PubMed  Google Scholar 

  19. Acham S, Truschnegg A, Rugani P, Kirnbauer B, Reinbacher KE, Zemann W, et al. Needle fracture as a complication of dental local anesthesia: recommendations for prevention and a comprehensive treatment algorithm based on literature from the past four decades. Clin Oral Investig. 2019;23(3):1109–19.

    Article  PubMed  Google Scholar 

  20. Aravena PC, Barrientos C, Troncoso C, Coronado C, Sotelo-Hitschfeld P. Effect of warming anesthetic on pain perception during dental injection: a split-mouth randomized clinical trial. Local Reg Anesth. 2018;11:9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  21. Gümüş H, Aydinbelge M. Evaluation of effect of warm local anesthetics on pain perception during dental injections in children: a split-mouth randomized clinical trial. Clin Oral Investig. 2020;24(7):2315–9.

    Article  PubMed  Google Scholar 

  22. Hogan ME, Perampaladas K, Machado M, Einarson TR, Taddio A. Systematic review and meta-analysis of the effect of warming local anesthetics on injection pain. Ann Emerg Med. 2011;58(1):86–98.

    Article  PubMed  Google Scholar 

  23. Wahl MJ, Schmitt MM, Overton DA, Gordon MK. Injection pain of bupivacaine with epinephrine vs. prilocaine plain. J Am Dent Assoc. 2002;133(12):1652–6.

    Article  CAS  PubMed  Google Scholar 

  24. Guo J, Yin K, Roges R, Enciso R. Efficacy of sodium bicarbonate buffered versus non-buffered lidocaine with epinephrine in inferior alveolar nerve block: a meta-analysis. J Dent Anesth Pain Med. 2018;18(3):129–42.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Campanella V, Libonati A, Nardi R, Angotti V, Gallusi G, Montemurro E, et al. Single tooth anesthesia versus conventional anesthesia: a cross-over study. Clin Oral Investig. 2018;22(9):3205–13.

    Article  PubMed  Google Scholar 

  26. Kwak EJ, Pang NS, Cho JH, Jung BY, Kim KD, Park W. Computer-controlled local anesthetic delivery for painless anesthesia: a literature review. J Dent Anesth Pain Med. 2016;16(2):81–8.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Collado V, Faulks D, Nicolas E, Hennequin M. Conscious sedation procedures using intravenous midazolam for dental care in patients with different cognitive profiles: a prospective study of effectiveness and safety. PLoS One. 2013;8(8):e71240.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  28. Chen Q, Wang L, Ge L, Gao Y, Wang H. The anxiolytic effect of midazolam in third molar extraction: a systematic review. PLoS One. 2015;10(4):e0121410.

    Article  PubMed  PubMed Central  Google Scholar 

  29. Averley PA, Girdler NM, Bond S, Steen N, Steele J. A randomised controlled trial of paediatric conscious sedation for dental treatment using intravenous midazolam combined with inhaled nitrous oxide or nitrous oxide/sevoflurane. Anaesthesia. 2004;59(9):844–52.

    Article  CAS  PubMed  Google Scholar 

  30. Venchard GR, Thomson PJ, Boys R. Improved sedation for oral surgery by combining nitrous oxide and intravenous midazolam: a randomized, controlled trial. Int J Oral Maxillofac Surg. 2006;35:522–7.

    Article  CAS  PubMed  Google Scholar 

  31. Schrier L, Zuiker R, Merkus FW, Klaassen ES, Guan Z, Tuk B, et al. Pharmacokinetics and pharmacodynamics of a new highly concentrated intranasal midazolam formulation for conscious sedation. Br J Clin Pharmacol. 2017;83(4):721–31.

    Article  CAS  PubMed  Google Scholar 

  32. Collado V, Hennequin M, Faulks D, Mazille MN, Nicolas E, Koscielny S, Onody P. Modification of behavior with 50% nitrous oxide/oxygen conscious sedation over repeated visits for dental treatment a 3-year prospective study. J Clin Psychopharmacol. 2006;26(5):474–81.

    Article  CAS  PubMed  Google Scholar 

  33. Albert PR. Why is depression more prevalent in women? J Psychiatry Neurosci. 2015;40(4):219.

    Article  PubMed  PubMed Central  Google Scholar 

  34. Nemeroff CB, DeVane CL, Pollock BG. Newer antidepressants and the cytochrome P450 system. Am J Psychiatr. 1996;153(3):311–20.

    Article  CAS  PubMed  Google Scholar 

  35. Smischney NJ, Pollard EM, Nookala AU, Olatoye OO. Serotonin syndrome in the perioperative setting. Am J Case Rep. 2018;19:833.

    Article  PubMed  PubMed Central  Google Scholar 

  36. O’Neil A, Berk M, Venugopal K, Kim SW, Williams LJ, Jacka FN. The association between poor dental health and depression: findings from a large-scale, population-based study (the NHANES study). Gen Hosp Psychiatry. 2014;36(3):266–70.

    Article  PubMed  Google Scholar 

  37. Kisely S, Sawyer E, Siskind D, Lalloo R. The oral health of people with anxiety and depressive disorders–a systematic review and meta-analysis. J Affect Disord. 2016;200:119–32.

    Article  PubMed  Google Scholar 

  38. Kessler RC, Chiu WT, Demler O, Walters EE. Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry. 2005;62(6):617–27.

    Article  PubMed  PubMed Central  Google Scholar 

  39. Masiran R, Aziz MFA. Hypertensive bipolar: chronic lithium toxicity in patients taking ACE inhibitor. BMJ Case Rep. 2017;2017:bcr2017220631.

    Article  PubMed Central  Google Scholar 

  40. Attri JP, Bala N, Chatrath V. Psychiatric patient and anaesthesia. Indian J Anaesth. 2012;56(1):8.

    Article  PubMed  PubMed Central  Google Scholar 

  41. Kilpatrick DG, Resnick HS, Milanak ME, Miller MW, Keyes KM, Friedman MJ. National estimates of exposure to traumatic events and PTSD prevalence using DSM-IV and DSM-5 criteria. J Trauma Stress. 2013;26(5):537–47.

    Article  PubMed  PubMed Central  Google Scholar 

  42. Knowles KA, Sripada RK, Defever M, Rauch SA. Comorbid mood and anxiety disorders and severity of posttraumatic stress disorder symptoms in treatment-seeking veterans. Psychol Trauma. 2019;11(4):451–8.

    Article  PubMed  Google Scholar 

  43. Müller J, Ganeshamoorthy S, Myers J. Risk factors associated with posttraumatic stress disorder in US veterans: a cohort study. PLoS One. 2017;12(7):e0181647.

    Article  PubMed  PubMed Central  Google Scholar 

  44. Richardson LK, Frueh BC, Acierno R. Prevalence estimates of combat-related post-traumatic stress disorder: critical review. Aust N Z J Psychiatry. 2010;44(1):4–19.

    Article  PubMed  PubMed Central  Google Scholar 

  45. Olff M. Sex and gender differences in post-traumatic stress disorder: an update. Eur J Psychotraumatol. 2017;8(sup4):1351204.

    Article  PubMed Central  Google Scholar 

  46. Nissen LR, Karstoft KI, Vedtofte MS, Nielsen AB, Osler M, Mortensen EL, et al. Cognitive ability and risk of post-traumatic stress disorder after military deployment: an observational cohort study. BJPsych Open. 2017;3(6):274–80.

    Article  PubMed  PubMed Central  Google Scholar 

  47. Sartor CE, Grant JD, Lynskey MT, McCutcheon VV, Waldron M, Statham DJ, et al. Common heritable contributions to low-risk trauma, high-risk trauma, posttraumatic stress disorder, and major depression. Arch Gen Psychiatry. 2012;69(3):293–9.

    Article  PubMed  PubMed Central  Google Scholar 

  48. Lancaster CL, Teeters JB, Gros DF, Back SE. Posttraumatic stress disorder: overview of evidence-based assessment and treatment. J Clin Med. 2016;5(11):105.

    Article  PubMed Central  Google Scholar 

  49. Friedlander AH, Rosenbluth SC, Lee UK, Chang TI, Guze BH, Zeidler MR. The importance of recognizing an association between obstructive sleep apnea and post-traumatic stress disorder. J Oral Maxillofac Surg. 2018;76(11):2251–3.

    Article  PubMed  Google Scholar 

  50. Cipriani A, Williams T, Nikolakopoulou A, Salanti G, Chaimani A, Ipser J, et al. Comparative efficacy and acceptability of pharmacological treatments for post-traumatic stress disorder in adults: a network meta-analysis. Psychol Med. 2018;48(12):1975–84.

    Article  PubMed  Google Scholar 

  51. De Oliveira Solis AC, Araújo ÁC, Corchs F, Bernik M, Duran ÉP, Silva C, Lotufo-Neto F. Impact of post-traumatic stress disorder on oral health. J Affect Disord. 2017;219:126–32.

    Article  PubMed  Google Scholar 

  52. Muhvić-Urek M, Uhač I, Vukšić-Mihaljević Ž, Leović D, Blečić N, Kovač Z. Oral health status in war veterans with post-traumatic stress disorder. J Oral Rehabil. 2007;34(1):1–8.

    Article  PubMed  Google Scholar 

  53. Wright EF, Thompson RL, Paunovich ED. Post-traumatic stress disorder: considerations for dentistry. Quintessence Int. 2004;35(3):206–10.

    PubMed  Google Scholar 

  54. Gupta MA, Simpson FC. Obstructive sleep apnea and psychiatric disorders: a systematic review. J Clin Sleep Med. 2015;11(02):165–75.

    Article  PubMed  PubMed Central  Google Scholar 

  55. Zhang Y, Weed JG, Ren R, Tang X, Zhang W. Prevalence of obstructive sleep apnea in patients with posttraumatic stress disorder and its impact on adherence to continuous positive airway pressure therapy: a meta-analysis. Sleep Med. 2017;36:125–32.

    Article  PubMed  Google Scholar 

  56. Nayak SS, Kamath AT, Gupta K, Roy A, Roy S, Chatterjee A. Posttraumatic stress disorder among patients with oral and maxillofacial trauma in a South Indian population. Spec Care Dentist. 2019;39(4):399–405.

    Article  PubMed  Google Scholar 

  57. Umholtz M, Cilnyk J, Wang CK, Porhomayon J, Pourafkari L, Nader ND. Postanesthesia emergence in patients with post-traumatic stress disorder. J Clin Anesth. 2016;34:3–10.

    Article  PubMed  Google Scholar 

  58. Seal LJ. A review of the physical and metabolic effects of cross-sex hormonal therapy in the treatment of gender dysphoria. Ann Clin Biochem. 2016;53(1):10–20.

    Article  CAS  PubMed  Google Scholar 

  59. Tollinche LE, Walters CB, Radix A, Long M, Galante L, Goldstein ZG, et al. The perioperative care of the transgender patient. Anesth Analg. 2018;127(2):359.

    Article  PubMed  PubMed Central  Google Scholar 

  60. Berli JU, Knudson G, Fraser L, Tangpricha V, Ettner R, Ettner FM, et al. What surgeons need to know about gender confirmation surgery when providing care for transgender individuals: a review. JAMA Surg. 2017;152(4):394–400.

    Article  PubMed  Google Scholar 

  61. Maine M, Goldberg MH. The role of third molar surgery in the exacerbation of eating disorders. J Oral Maxillofac Surg. 2001;59(11):1297–300.

    Article  CAS  PubMed  Google Scholar 

  62. Blitz M, Rosen DS. Eating disorders and the oral and maxillofacial surgeon. Oral Maxillofac Surg Clin. 2010;22(4):511–7.

    Article  Google Scholar 

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Eltejaye, A., Park, E.S. (2022). Psychiatric and Behavioral Disorders. In: Meara, D.J., Gutta, R. (eds) Oral and Maxillofacial Surgery for the Medically Compromised Patient. Springer, Cham. https://doi.org/10.1007/978-3-030-82598-0_8

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