| dc.description.abstract | In 2000, the World Health Organisation (WHO) ranked Major Depressive Disorder (MDD) as the
fourth most common cause of disability and premature death worldwide. Within the next five
years, it is predicted to become second only to ischaemic heart disease. With up to 12% of men
and 24% of women experiencing MDD in their lifetime, it is most important the condition and its
oral implications are understood.
MDD is defined as a psychiatric illness with a minimum duration of two weeks. During this time
sufferers experience anhedonia which is defined as loss of pleasure or interest in activities
previously enjoyed, dysphoria whereby demonstrating feelings of helplessness, sadness,
irritability, anxiousness, anger or a combination of both. The impact of the condition can be vast
and vary greatly. A large amount of research has been conducted into the systemic effects of
MDD, however, less focus and clarity surrounds the involvement of the oral cavity. Currently,
debate is still ongoing with regard to the relationship between depression and certain oral
conditions.
As has been well documented by Friedlander and Norman (2002), the dental issues and
treatment needs of patients change as they age. MDD is predominantly reported to affect those
around the ages of 18-45. If depression occurs in later years, usually over 65, it is classified as
Later Life Depression (LLD). As population demographics evolve and life expectancy increases, this
form of the condition becomes a significant public health concern. Already, it is the most
prevalent psychiatric disease amongst those over 65.
For the purposes of this paper, MDD and LLD shall be examined separately. Although
symptomatically the conditions bare close resemblance, distinct oral differences need to be
explored. For example, LLD raises the likelihood of issues such as root caries, denture
dissatisfaction, gingival recession and limited manual dexterity.
Currently, there is a dearth of information in relation to this topic accessible to dental care
professionals. This review of current literature will aim to discuss in detail, the different issues
arising from MDD and LLD in relation to dentistry. This will include an explanation of subjects such
as periodontitis, caries, parafunctional habits, orofacial pain, dysgeusia and globus sensation, and
xerostomia. Changes in behaviour will also be examined and the impact of antidepressant
medication discussed. | en |
