Question

Suzanne J. a 42 year old woman, is being treated for schizophrenia and has been prescribed an antipsychotic chlorpromazine (Thorazine). Her blood pressure is 140/90 mm Hg, and her pulse rate is 120 bpm. She has difficulty holding down a job and is currently living in a women's shelter. The shelter has a van that brings clients to your public health clinic for dental care. Suzanne has a history of noncompliance with her medication and has been brought to the clinic because she has been complaining of pain in her jaw. She has rampant cervical caries, and her oral hygiene is poor. When you attempt to take radiographs, she becomes upset and says that she does not want "that ray gun" pointed at her. Her caseworker is able to convince her to cooperate, but she is fearful, and her jaws keep opening and closing spasmodically throughout the procedure. When the dentist comes into the room, she becomes agitated, jumps up, and tries to leave the treatment room but loses consciousness and falls.

Which are possible explanations of the pain in Suzanne's jaw?
A. Infection from caries spreading to her jaw
B. Psychogenic shock and anxiety
C. Bruxing and TMJ dysfunction
D. Extrapyramidal side effects from antipsychotic medications

Answer 1

Possible explanations for the pain in Suzanne's jaw include _A. Infection from caries spreading to her jaw and . Extrapyramidal side effects from antipsychotic medications. Thus the correct option is D.

Step-by-step explanation:

The pain in Suzanne's jaw may be attributed to the presence of rampant cervical caries, as indicated by her poor oral hygiene and the observed caries. Caries, or tooth decay, can lead to infection when it spreads to the surrounding tissues, including the jawbone. This infection can cause localized pain, discomfort, and swelling in the affected area. Suzanne's history of noncompliance with medication may have contributed to the progression of her oral health issues, emphasizing the importance of addressing both her dental and mental health needs collaboratively.

Additionally, extrapyramidal side effects (EPS) from antipsychotic medications, such as chlorpromazine (Thorazine), could contribute to Suzanne's jaw pain and spasmodic movements. EPS are neurological side effects associated with the use of antipsychotics and can manifest as involuntary muscle movements, including spasms or tremors. Suzanne's fear and anxiety during the dental procedure may have exacerbated these side effects. Recognizing the potential impact of medication side effects on oral health is crucial in providing comprehensive care for individuals with mental health conditions.

In summary, Suzanne's jaw pain could be multifactorial, involving both dental issues, specifically caries-related infection, and extrapyramidal side effects from her antipsychotic medication. A holistic approach to her care, considering both her mental and oral health, is essential for addressing the complex interplay of factors contributing to her symptoms and ensuring comprehensive and patient-centered treatment.