著者

荒尾 宗孝 今泉 一郎 近藤 三男 伊藤 隆子 伊藤 幹子 栗田 腎一

出版者

Japanese Society of Psychosomatic Dentistry

雑誌

日本歯科心身医学会雑誌 (ISSN:09136681)

巻号頁・発行日

vol.16, no.1, pp.75-79, 2001-06-25 (Released:2011-09-20)

参考文献数

7

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A 45-year-old female patient was referred to us from the Department of Endodontics at Aichi-gakuin University School of Dentistry with a long and complex dental history. Her chief complaint was chronic pain in teeth which had been pulpectomied at other dental clinics. We chose brief psychotherapy and chemotherapy with the use of just one anti-anxiety drug. While at the Department of Endodontics, root canal treatment had also been performed on the teeth with chronic pain. First, we had her come to the hospital once a week and listened to her account of the degree of chronic pain and the related anxiety experienced. Her chronic pain decreased gradually and she started coming to our hospital once in two weeks instead. Finally, root canal filling and prosthodontic treatment were performed without any trouble. She has recently been coming to the hospital about once a month. We let her consult with us about her anxiety and ask questions related to the experience of chronic pain in teeth to prevent the recurrence of her state of fear.

著者

宮崎秀夫 荒尾 宗孝 岡村 和彦

出版者

新潟歯学会

雑誌

新潟歯学会雑誌 (ISSN:03850153)

巻号頁・発行日

vol.29, no.1, pp.11-15, 1999-07

被引用文献数

25

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The purpose of this study was to develop clinical classification of halitosis with corresponding treatment needs and was to tentatively classify halitosis patients according to the proposed classification. The classification consists of 3 classes (Ⅰ,Ⅱ,andIII) and 3 sub-classes in class I, that is, physiologic halitosis (Class1-a), oral pathologic halitosis (Class 1-b-1), extraoral pathologic halitosis (Class 1-b-2), Pseudo-halitosis (Class 2) and Halitophobia (Class3). Organoleptic scoring, volatile sulfur compounds (VSC) measurements using a portable sulfide monitor (Halimeter; RH-17 series, Interscan) and/or Gas Chromatograph (GC) were carried out for patients with bad breath complaint at the Breath Odor Clinic in the Dental School Hospital, Niigata University. All patients were examined 3 times in different days and diagnosed by average scores or values. There were 215 patients newly registered at the Clinic during the 1st year from April 1, 1998 to 31 March 1999. After excluding patients with incomplete data in their medical records, 210 patients (71 males and 139 females) were classified according to the proposed classification. Numbers (percentages) of patients with physiologic halitosis (Group 1), oral pathologic halitosis (Group 2), extraoral pathologic halitosis (Group 3), pseudo-halitosis (Group4), and halitophobia (Group5) were 43 (20.5%), 78 (37.1%), 7 (3.3%), 74 (35.2%), and 8 (3.8%), respectively. The mean organoleptic scores of patients in Groups 1 (2.1), 2 (2.6) and 3 (2.5) were higher than those in Groups 4 (1.3) and 5 (1.6). The mean VSC values of patients in Groups 1 (169.0ppb), 2 (235.3ppb) and 3 (210.4ppb) were higher than those in Groups 4 (100.5ppb) and 5 (108.9ppb). Relatively higher VSC values were found even in pseudo-halitosis and balitophobia groups although both had lower level of OLS.本論文の目的は、試案した口臭症の臨床病態分類を公表すること、新潟大学歯学部附属病院口臭クリニックに来院した初診患者をこのクライテリアにより分類することである。口臭は官能検査、ガスクロマトグラフィ、ポータブルサルファイドモニターを用い測定した。初診患者210名のうち、真性口臭症が61%(生理的口臭:21%、口腔由来の病的口臭:37%、全身由来の病的口臭:3%)、仮性口臭症が35%、口臭恐怖症が4%であった。分類されたグループ別に平均官能検査スコア(OLS)をみると、生理的口臭症は2.1と真性口臭症の中では低かったが、仮性口臭症(1.3)と口臭恐怖症(1.6)と比べると明らかに高値を示した。口腔由来の病的口臭グループの平均VSC濃度235.3ppbは、生理的口臭(169.0ppb)、仮性口臭症(100.5ppb)、口臭恐怖症(108.9ppb)に対し有意(p<0.01)に高かった。

著者

伊藤 幹子 木村 宏之 尾崎 紀夫 荒尾 宗孝 木村 有希 伊藤 隆子 栗田 賢一

出版者

Japanese Society of Psychosomatic Dentistry

雑誌

日本歯科心身医学会雑誌 (ISSN:09136681)

巻号頁・発行日

vol.21, no.1, pp.13-22, 2006-06-25 (Released:2011-09-20)

参考文献数

14

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In 1999, the authors organized a medical liaison group composed of dentists and a psychiatrist at the outpatient clinic of the Department of First Oral Surgery, Hospital of the School of Dentistry, Aichi Gakuin University, for the diagnosis and treatment of oral psychosomatic disorders. The practice has been for the dentists of the medical liaison group to examine each patient and diagnose his/her oral somatic disorder in the first stage of the examination, and the psychiatrist to examine each patient and make diagnosis according to DSM-IV or DSM-IV TR in the second stage.The subjects of this study were 13 patients with personality disorders (PD) among 268 patients examined during a 5-year and 4-month period from 2000 to 2004. The diagnoses by the dentists consisted of five cases of atypical facial pain, three of burning mouth syndrome, two of oral malaise, one of dental phobia, one of temporomandibular joint disorder, and one of halitophobia. Those by the psychiatrist consisted of six cases of pain disorder, two of conversion disorder, two of somatization disorder, one of hypochondriasis, one of specific phobia, and one of adjustment disorder. On DSM-IV Axis II, the diagnosis/suspicion results consisted of three cases of paranoid PD, two of avoidant PD, two of obsessive-compulsive PD, two of borderline PD, two of narcissistic PD, one of histrionic PD, and one of dependent PD. It was very difficult for us to manage the patients with borderline PD and narcissistic PD in cases of invasive treatment such as a tooth extraction. It has been found that the comorbidity of not only mental disorders but also personality disorders does need to be diagnosed and dentists ought to plan their therapeutic strategy for patients with personality disorders under the supervision of psychiatrists