Dental conditions in patients with bipolar disorder on long-term lithium maintenance therapy

Bipolar disorder (manic depressive disease) affects 1% of the United States population. These persons suffer from episodes of extreme elation followed by long periods of depression. Dental screening examinations of 40 patients consecutively admitted to the medical center with this diagnosis were performed. Poor oral hygiene, accumulations of supragingival and subgingival calculus, extensive dental caries, and numerous missing teeth were commonly identified. The majority of patients with bipolar disorder are treated with lithium carbonate. The physiological effects of lithium, and its interaction with drugs used in dentistry are reviewed, and disease-specific modifications in dental treatment are recommended.