216 Chapter 6 • Diabetes. It is well known that antipsychotics often have side effects, but they can also lead to the development of type 2 diabetes (metabolic problems). People with diabetes are more susceptible to mouth inflammation. Healing of inflamed gums often proceeds less well in these people. With both types of diabetes, blood sugar is often high, which can affect the mouth, leading to earlier cavities, dry mouth, fungal infections, and extra plaque, increasing the chance of gum inflammation (gingivitis and periodontitis). Inflammation in the mouth can also lead to complications in overall health. • Alcohol use. Alcohol is known to decrease saliva flow. As a result, the mouth becomes drier, and in a drier mouth, caries (tooth decay) and gum inflammation can develop more quickly. To add a fresh taste to drinks, citric acid is often added. With frequent use, food acids (both natural and added) cause tooth erosion, which is the wearing away of the tooth surface. Nutrition Many foods can affect the enamel of the teeth and molars. This is not a problem. The teeth naturally recover over time, with saliva playing a crucial role. Saliva neutralizes acids, providing protection. However, if someone eats too frequently in a day, the teeth do not have enough time to recover. Therefore, it is detrimental to dental health to eat or drink certain beverages all day long. Some antipsychotics (e.g., olanzapine and clozapine) are known to cause a feeling of hunger, leading patients to eat more. This often results in unhealthy eating habits, such as consuming a lot of soda and fast food. Foods like vegetables, fruits, nuts, and fish contain healthy nutrients, but many patients do not consume sufficient amounts. Deficiencies in these nutrients can cause symptoms in healthy individuals like the positive, negative, and cognitive symptoms seen in those with psychotic vulnerability.
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