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An Official Publication of the Indian Association of Oral and Maxillofacial Pathologists


 
RESEARCH ARTICLE Table of Contents   
Year : 2003  |  Volume : 7  |  Issue : 1  |  Page : 19-20
 

Dental and psychological approach in mentally retarded patients


Department of Oral Pathology, P.M.N.M. Dental College & Hospital, Bagalkot, Karnataka, India

Correspondence Address:
Kate Brave
Department of Oral Pathology, P.M.N.M. Dental College & Hospital, Bagalkot, Karnataka
India
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Source of Support: None, Conflict of Interest: None


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   Abstract 

In this article the authors talk about the management of mentally retarded patients by varied training and management programmes such as IQ testing. family counselling and social skill training programmes. The authors find that by employing different methods of psychological management, marked improvement in management and regression of dental lesions in the mentally retarded patients were noticed.


Keywords: Dental Management, Mental retardation


How to cite this article:
Brave K, Brave V R. Dental and psychological approach in mentally retarded patients. J Oral Maxillofac Pathol 2003;7:19-20

How to cite this URL:
Brave K, Brave V R. Dental and psychological approach in mentally retarded patients. J Oral Maxillofac Pathol [serial online] 2003 [cited 2019 Oct 13];7:19-20. Available from: http://www.jomfp.in/text.asp?2003/7/1/19/41001



   Introduction Top


Health of an individual and health of a society are recognized as being interrelated. Not only is a healthy human being necessary for a healthy society, a healthy society is necessary for a healthy human being. This broad concept has prompted the World Health Organization to redefine health as "a state of complete physical, mental and social well being and not merely the absence of disease or infirmity".

Psychiatrists point out that mental health problems alone make up 8.1 % of the global burden of disease, which is higher than cancer, which is 5.8%, or heart disease, which is 4.4%. Psychologists quote that the poor, especially poor women are more prone to anxiety and stress. Anxiety is a universal human experience, which only assumes medical significance if it is disproportionate to external events or if it persists long after precipitating factors have been resolved. Symptoms of anxiety can be divided into two groups:

A) Psychological

b) Somatic:[Table 1]

Persistent anxiety is distressing, interferes with the course of the physical disorder and requires specific treatment.

Speaking on the need to create mental health awareness Dr. Harish Shetty says, "Mental health still receives step motherly treatment in the Indian health scenario." Certain illnesses like depression, which render people defunct but can be easily treated, are being ignored.

People with a depressive illness cannot merely "pull themselves together" and get better. Without treatment, symptoms can last for weeks, months or years. Appropriate treatment however can help most people who suffer from depression".

We would like to stress attention on mentally retarded patients who besides presenting other generalized complaints also have dental problems. Patients with dental lesions were referred to psychologist for management and guidance. As put forth by dental surgeons poor oral hygiene was prevalent in all the mentally retarded cases.

Angular cheilosis was next in order of frequency followed by candidiasis. The commonest cause assigned by dental surgeons was gross neglect and undernourishment leading to poor resistance. Sometimes the patients were subjected to continuous therapy or treatment leading to flare up of fungal infection like candidiasis.


   Discussion Top


The American Association of Mental Retardation defines mental retardation as "Mental Retardation is characterized by significant sub average intellectual functioning, related limitations in two or more applicable adaptive skill areas such as, communication, home living, community use, health and safety, leisure, self-care, social skills".[Figure 1],[Figure 2],[Figure 3],[Figure 4]

A family may suspect mental retardation if motor skills, language skills and self help skills are developing at a slower rate as compared to one's peers. Degree of impairment in mental retardation ranges from profoundly impaired to borderline retardation. Causal factors fall under several categories such as Trauma, Infection, Chromosomal abnormalities. Genetic abnormalities. Metabolic, Toxic, Nutritional, and Environmental

The patients who were referred by dental surgeons were managed with the help of varied training and management programmes as will be discussed under the following headings.

I - IQ testing (intelligence quotient)

II - Family COLHISCIling

III - Social skill t ainingprogramme

IQ Testing

The first step employed was IQ testing. With the help of an IQ test mental sub normality is detected and graded. The IQ test readings of the patient ranged from and IQ of 50 to an IQ of 25 respectively. Thus the patients were classified as mild to severe degree of retardation. Mentally subnormal patients are also referred to special schools where training is given such that they can perform daily activities without much assistance. Those with an IQ of 30 or below require constant supervision.

Family Counselling

Family members / Guardians / Relatives from close-knit bonds with the patient and his environment. Thus family counselling is undertaken as a therapeutic technique. It helps to develop skills in active daily living (ADL), without reinforce patients, making them perform self-help much assistance. Family member; Guardians can encourage patients in the form of praise, approval and small gifts for performing the desired activities.

Social Skills Training Programme

A large body of research has begun to appear that demonstrates the nature and extent of deficiencies in social skills present among the mentally ill. According to Hughes C. Rodi MS, et al. in their article published in American Journal of Mental Retardation in the year 1999 Nov.; 104 (6): it was pointed out that mentally retarded students rarely interacted with any of the approximately 500 general education students present in the survey which was markedly noted in our study group.

According to Bell, Crawford and Aiello the possession of social skills is related to successful community adjustment. Thus social skills training programme is undertaken as a font of intervention. It includes,

- Modelling of appropriate social behaviours

- Role play of training material

- Performance feedback from trainee

It also involves co-operation from the patients along with their family members. It aims at training individuals deficient in various skills such as speaking one's name, interacting with people, communication etc.


   Results Top


By employing different methods of psychological management, marked improvement was noticed in the patients. The dental surgeons reported easy management and also regression of dental lesions to a great extent.


   Conclusion Top


Oral lesions showed marked degree of improvement during and after treatment by various methods discussed as reported by dental surgeons. Hence psychological intervention is necessary in dealing with patients of mental retardation.


    Figures

  [Figure 1], [Figure 2], [Figure 3], [Figure 4]
 
 
    Tables

  [Table 1]



 

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