Bipolar I disorder: psychopathology, medical management and dental implications.

Abstract

BACKGROUND:

The authors review the clinical features, epidemiology, pathophysiology, medical management, dental findings and dental management of patients who have bipolar I disorder, or BD, previously known as manic-depressive disorder.

TYPES OF STUDIES REVIEWED:

The authors conducted a MEDLINE search for the period 1995 through 2001 using the key terms "bipolar disorder," "epidemiology," "pathophysiology," "treatment" and "dentistry." The articles they selected for further review included those published in English in peer-reviewed journals; they gave preference to articles reporting randomized, controlled trials.

RESULTS:

BD is a psychiatric illness characterized by extreme mood swings. Mania is accompanied by euphoria, grandiosity, racing thoughts and lack of insight. Depression is characterized by marked sadness or loss of interest or pleasure in daily activities. The unpredictable mood swings can distress the person, can impair social function and quality of life and are associated with a significant increase in the risk for substance abuse and suicide. BD is common in the United States, with a lifetime prevalence rate of 1.6 percent and recurrence rate of more than 50 percent.

CLINICAL IMPLICATIONS:

The prevalence of dental disease usually is extensive because of poor oral hygiene and medication-induced xerostomia. Preventive dental education, saliva substitutes and anticaries agents are indicated. To avoid adverse drug interactions with the usually prescribed psychiatric medications, special precautions should be taken when administering certain antibiotics, analgesics and sedatives.

• Authors: Arthur H Friedlander, Ida K Friedlander, Stephen R Marder
• Journal: Journal of the American Dental Association (1939) (J Am Dent Assoc) Vol. 133 Issue 9 Pg. 1209-17 (Sep 2002) ISSN: 0002-8177 [Print] England
• PMID: 12356252 (Publication Type: Journal Article, Review)

Chemical References

• Antidepressive Agents
• Antimanic Agents
• Lithium Carbonate

Topics

• Antidepressive Agents (adverse effects, therapeutic use)
• Antimanic Agents (adverse effects, therapeutic use)
• Bipolar Disorder (complications, drug therapy, epidemiology, psychology)
• Dental Care for Chronically Ill
• Dental Caries (etiology)
• Drug Interactions
• Humans
• Lithium Carbonate (therapeutic use)
• Periodontal Diseases (etiology)
• United States (epidemiology)
• Xerostomia (etiology)