Obsessive compulsive disorder in dental setting

Abstract

Globally, 20% of children and adolescents suffer from a disabling psychologic illness. Among these, Obsessive Compulsive Disorder (OCD) is listed by the World Health Organization (WHO) as one of the 10 most disabling conditions, with prevalence rates of OCD in children ranging between 1 to 3%. Pediatric dentists are in a unique position to diagnose psychological problems in children and adolescents due to their ongoing relationship with children and their parents that starts at a very early age. Timely diagnosis of psychological illness can result in early intervention as well as better patient management for the dentist too. The purpose of this case report is to highlight a case of OCD in an adolescent girl diagnosed in a dental setting.

The Behavior of Patients with Obsessive-Compulsive Disorder in Dental Clinics

“…All cases (except two cases [ 7 , 13 ]) reported at least one obsessions or compulsions symptom according to the NIMH. Fear of germs and contamination was reported in the works of Ahuja et al [ 6 ], Chandna et al [ 8 ], Michael [ 11 ], and Vieira et al [ 12 ]. Unwanted forbidden or taboo thoughts involving sex, religion, or harm were not reported.…”

“…Excessive cleaning or handwashing was reported in the work of Michael [ 11 ]. Ordering and arranging things in a particular way, repeatedly checking things, and compulsive counting were reported in the works of Ahuja et al [ 6 ] and Chandna et al [ 8 ]. All patients had OCD with no other psychological disorder except for one patient who was schizophrenic [ 7 ].…”

“…Out of the eight evaluated case reports, seven showed low risk of bias, while one case report [ 10 ] showed moderate risk of bias. The overall scores for case reports were as follows: 75% for studies of Ahuja et al [ 6 ], Castellanos-Cosano et al [ 7 ], and Chandna et al [ 8 ]; 87.5% for studies of Fontenelle and Leite [ 9 ], Michael [ 11 ], Vieira et al [ 12 ], and Oulis et al [ 13 ]; and 62.5% for the study of Herren and Lindroth [ 10 ]. Of the five analyzed cross-sectional studies, four articles were scored as low risk of bias, while one article [ 17 ] showed moderate risk of bias.…”

Non suicidal self injury resulting in dental trauma in an adolescent

“…Pediatric dentists are in a unique position to diagnose psychological problems in children and adolescents due to their enduring relationship with children and their parents that is established at a very early age . NSSI may provide an early marker of underlying psychological distress .An innocuous, frequently encountered diagnosis of dental trauma may reveal more serious underlying psychologic problems with a high suspicion index for psychologic problems.…”

Obsessive Compulsive Disorder (OCD) In Childhood and Adolescence

“…CBT may be carried out on an individual or family basis and contains numerous elements, such as psychoeducation, hierarchy building, exposure with response prevention (EX/RP), cognitive strategies, reward programs, family/parent training, and relapse prevention [24]. Psychologic disorders of childhood and adolescence such as OCD largely remain undiagnosed until significant problems occur later in life related to impaired school or social functioning and early careers [25].…”