著者

大津 光寛 長谷川 功 岡田 智雄 石井 隆資 佐藤 田鶴子

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.67-69, 2001-06-25 (Released:2011-09-20)

参考文献数

5

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We report the case of dental treatment for a patient of oral cenesthopathy followed by depression which appears to have been induced by the extraction of a tooth. The significance of the early discovery of depression in patients who require dental treatment and the adequate management of the mental status of such patients are discussed. This case suggests that the dental treatment that fails to take account of latent depression in a patient will not only obstruct improvement of the oral environment but also itself become a factor in making the depression worse.

著者

木村 浩子

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.22, no.2, pp.73-83, 2007-12-25 (Released:2011-09-20)

参考文献数

42

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Excessive clenching of the teeth due to physical or psychological tension or stress can result in excessive air swallowing.This study sought to investigate and evaluate the characteristics of such patients in terms of both their physical condition in the head and neck region and relevant psychological and social factors.The subjects consisted of 187 patients (57males and130females) having chief complaints of aerophagia symptoms who visited the psychosomatic medicine clinic at the head and neck department of the Tokyo Medical and Dental University.52.4%were in their twenties and thirties and 69.5%were female.The principal psychological and social stress factors tended to be study and work related among younger patients, and family problems among female patients.Most of the patients exhibited depression, anxiety, neurosis and a tendency towards autonomic imbalance, and also tended to complain of neck or shoulder pain, headache, oral or pharynx paresthesia and symptoms of quasi-temporomandibular arthrosis in the head and neck region.The degree of improvement of aerophagia symptoms and a tendency to change doctors too frequently in order to find more appropriate treatment were both considered to be related to depression.The explanation of habitual teeth clenching, the existence of psychological and social stress factors, the mechanism of air swallowing, and ways to control clenching was useful in helping patients to reduce their aerophagia symptoms.

著者

竹之下 美穂 吉川 達也 加藤 雄一 佐藤 智子 豊福 明

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.23, no.1-2, pp.46-50, 2008-12-25 (Released:2011-09-20)

参考文献数

11

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Atypical Odontalgia (AO) is a condition characterized by tooth pain with no apparent cause and hypersensitivity to stimuli in radiographically normal teeth. Patients complain of continuous pain even after extended endodontic treatment. This report presents two cases of AO in patients who visited our clinic in 2007 from the psychosomatic perspective. We examined their medical histories, treatment procedures and prescriptions as described in their medical records.(Case 1)Female, 39 years old. Chief complaint: Pain on the right maxillary second premolar. The patient felt pain on the right maxillary first molar and the crown of the tooth was removed. She subsequently changed clinics and the tooth was extracted. Laser therapy and a pulpectomy were provided on account of the pain but she again changed clinics because of the constant toothache. She visited our clinic while receiving treatment at a pain clinic. SAIDs and milnacipran were ineffective. The pain was alleviated by amitriptyline.(Case 2)Female, 38 years old. Chief complaint: Post extraction pain on the right maxillary molar and right orbital pain. The right maxillary molar was extracted after repeated root canal treatment (RCT) but the pain remained following tooth extraction and she next visited oral surgery. She was diagnosed as normal by the oral surgeon, and then visited our clinic. She refused to take antidepressants at first in spite of repeated counseling to do so, but did agree to take the medicines after three months. The pain was relieved by amitriptyline.It is very difficult to diagnose AO due to the very nature of dental treatment. Despite the reports that some antidepressants are effective against AO, dentists often have difficulty in treating AO patients due to individual variations in the response to medicines. Further, as the patients themselves believe that their pain is caused by dental problems, they sometimes refuse antidepressants. Patients are inclined to become angry or distrustful because of their prolonged pain and repeated dental treatment, so it is important both to prescribe appropriate medications and to be receptive and listen attentively to what they say.

著者

立花 哲也 鈴木 愛 高森 基史 伊能 智明 青木 美穂子 千葉 博茂

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.17, no.1, pp.21-25, 2002-06-25 (Released:2011-09-20)

参考文献数

17

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Lafutidine (FRG-8813) is a new H2-receptorantagonist that not only has a strong inhibitory effect on gastric secretion but also augments the gastric mucosa protection factor and dilate arterious in the gastric submucosa and enhances gastric mucosal blood flow via capusaicinsensitive afferent neurons.Its presence in the tongue too, suggests that lafutidine may be effective for patients diagnosed with glossodynia. This treatment was attempted with 50 glossodynia patients, who received lafutidine in doses of 10mg twice daily for 8 weeks.The pain amelioration rates (reduced and better) were 54.0%(27/50 cases) after 2 weeks, 60.0%(30/50 cases) after 4 weeks, 80.0%(40/50 cases) after 6 weeks, and 84.0%(42/50 cases) after 8 weeks. The pain level on VAS was 46.8mm on average before administration, and 12.1mm on average after 8 weeks.The administration of lafutidine exhibited good clinical efficacy, safety and utility in the treatment of glossodynia.

著者

大熊 浩 滝口 俊男 下川 千可志 内田 安信

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.9, no.2, pp.213-217, 1994-12-25 (Released:2011-09-20)

参考文献数

6

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The effects of the chewing gum containing the extract from Hovenia dulcis Thunb.(H.gum) on reducing alcoholic smell in the breath of men after drinking alcohol, that is, beer (concentration of alcohol; 4.5%, 500m1), whisky (45%, 50m1, 4-fold dilution), and sake (15%, 180ml), were examined.When H. gum was chewed after drinking alcohol, the expiratory alcohol (ethanol) concentration was significantly reduced, alcoholic smell in the breath was almost suppressed in sensory test, the flushing was suppressed, and immediate recovery from the intoxcation was observed. These results indicate that chewing H. gum accelerates alcohol metabolism, and reduces alcohol and other components of alcoholic smell in the breath.

著者

神作 愛 今井 崇雄 高橋 一郎 澤田 茂樹 山内 美智子 長谷川 英美 石井 和浩 米重 成人

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.12, no.1, pp.29-35, 1997-06-25 (Released:2011-09-20)

参考文献数

15

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The effects of the traditional Chinese (Kampo) medicines, Hochu-ekki-to, Yoku-kansan and Saiko-ka-ryukotsu-borei-to, were compared to those of imipramine, a tricyclic antidepressant, in a mouse model of despair. Mice were placed in a water tank, from which there was no escape, for 15 min. The tank contained a water-wheel and the number of wheel rotations counted as escape attempts and, in accord with previous reports, imipramine (10 mg/kg i.p.), given either acutely or daily for 3 days 10 min before testing, markedly increased the number of wheel rotations. The Kampo medicines were administered for 14 consecutive days in the drinking water prior to testing. Hochu-ekki-to (60, 150 and 300 mg/kg/day) also increased wheel rotations but the effect was not dose-dependent. Yoku-kan-san markedly increased the number of wheel rotations at lower doses (60, 150 mg/kg/day), but decreased the number at the highest dose (300 mg/kg/day). Saiko-ka-ryukotsu-borei-to also increased the number of wheel rotations at the lowest dose (60 mg/kg/day), but decreased the number of rotations at higher doses (150, 300 mg/kg/day). These results suggest that these Kampo medicines, like imipramine, may ameliorate despair in mice.

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

高橋 宏昌 豊福 明 池山 尚岐 斎木 正純 松永 亜樹 喜久田 利弘

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.23-26, 2006-06-25 (Released:2011-09-20)

参考文献数

10

被引用文献数

1

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The condition of having a normal physical sense of taste but finding flavors strange and unpleasant is known as phantogeusia and very difficulto treat. It has recently been reported that benzodiazepine (BZD) has not only anti-anxiety effects but also some influence on taste cognition. This study examined the efficacy and safety of ethyl loflazepate for use with phantogeusia patients. Four patients were prescribed ethyl loflazepate at a dosage of 1-2mg/day. The ethyl loflazepate was found to relieve phantogeusia and tolerated well. The onset of the response was usually observed within one week. The relief of phantogeusia following ethyl loflazepate treatment was independent of the response to treatment for depression. It is suggested that ethyl loflazepate may be effective in the treatment of phantogeusia in cases both with and without depression

著者

中野 良信 向井 竜也

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.2, pp.123-129, 2001-12-25 (Released:2011-09-20)

参考文献数

19

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This study examined alexithymia using the Minnesota Multiphasic Personality Inventory-Alexithymia Scale (MMPI-AS) in patients with various oral disorders.The subjects consisted of 581 patients (134 males: mean age 42.7±19.5, 447 females: mean age 46.5±18.9), including 321 with physical disorders [temporomandibular disorders (TMD), recurrent aphtha (RA) and etc.], 19 with vague complaint-complicated physical disorders, 177 with a single vague complaint (oral paresthesias, glossodynias etc.) and 64 with vague multiple complaints.The results were as follows:(1) patients with vague oral complaints scored significantly higher than patients with physical disorders.(2) Patients with glossodynia scored significantly higher than patients with oral paresthsia, TMD, or RA.(3) Female patients scored significantly higher than male patients.(4) Elderly patients scored significantly higher than younger or middle-aged patients, while the difference between the latter two groups was not significant.It is considered that dentists should also understand alexithymia as patients with some oral disorders are alexithymic.

著者

神野 成治 海野 雅浩 鈴木 長明

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.15, no.2, pp.191-195, 2000-12-25 (Released:2011-09-20)

参考文献数

10

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We report a case of psychogenic oro-facial pain with mysophobia and compulsive behaviors related to dental treatment.The patient was a 36-year-old housewife. She complained of spontaneous pain in all teeth of the upper and lower jaws. The pain had appeared suddenly in the upper incisors, around 2 years before her first visit to our hospital. In spite of dental treatment, the pain diffused to all of her teeth and gingiva. She also suffered from oral mysophobia and compulsive behaviors in the form of prolonged teeth brushing.There was no organic disease to cause her pain and no other abnormal findings were noted. The psychological tests showed that she was in a slightly depressive, anxiety state and had a psychosomatic disease type. The Yatabe-Guildford test and egogram showed her personality to be compulsive. We diagnosed her condition as psychogenic oro-facial pain with mysophobia and compulsive behaviors.We treated her with drug therapy and brief psychotherapy. The antidepressant agent (amitriptyline, clomipramine) and antianxiety agent (bromazepam) were effective for pain relief, but not for the compulsive behaviors. We also performed brief psychotherapy. She was alarmed that she had grown old when her dentist diagnosed the pain as being due to periodontal disease and afraid that the periodontal disease would worsen. This led her to clean her mouth very earnestly. The dentist suggested that her excessive brushing was bad for her at every dental examination, but she slipped into mysophobia and compulsive behaviors, avoiding food intake in order to keep her oral cavity clean and engaging in prolonged brushing. These behaviors were related to her compulsive personality. We recommended that she change her lifestyle and work outside her house, because a person of her personality type needed a social activity. Fourteen months later, she began to work again and her compulsive behaviors had diminished.This case suggested that her compulsive personality was a causal factor in her development of psychosomatic oro-facial pain and the dental treatment induced mysophobia and/ or compulsive behaviors. Psychosomatic agents and brief psychotherapy were effective.

著者

今村 知代

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.17, no.2, pp.89-95, 2002-12-25 (Released:2011-09-20)

参考文献数

22

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We recently treated two patients with tongue laceration and tongue ulcers due to automutilation.Case 1: A 7-year-old male visited us with the chief complaint of ulceration of the tongue. He had experienced repeated episodes of tongue ulceration since the age of about five. We applied a mandibular splint and advised the family to modify the family environment. Automutilation of the tongue decreased 4 months after the beginning of the intervention, and the lesion became treatable.Case 2: A 21-year-old male with tongue ulceration visited us with the chief complaint of acute weight loss associated with food intake disorder. His past history included autism and mental retardation. We explained the relationship between the habit of automutilation and psychogenic factors to the family and obtained their understanding and cooperation in treating the disease. The ulcers healed on day 14, and food intake disorder disappeared with the recovery of body weight.

著者

山崎 美佐子 永田 勝太郎

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.10, no.1, pp.42-46, 1995-06-25 (Released:2011-09-20)

参考文献数

7

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Euthanasia is to make a patient die intentionally in order to set him/her free from agony or pain according to his/her own will. In other word, it shows a citizen's desire on death and dying without any pain or agony. This problem has developed with the development of bioethics. In Japan, some miserable cases were judged properly. Especially the 6 'points on euthanasia which Nagoya high court showed were marked internationally and gave much influence to many cases on euthanasia in many countries. The case on euthanasia of Tokai university were found guilty, but was in more consideration of the doctor's circumstances. In Holland, the euthanasia has been admitted by the law, but the conditions are severe and the circumstances are not easy. It is still now under trials and errors internationally. But, now the time has come for every citizen to consider about his/her own death and dying by him/herself.

著者

中村 広一

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.15, no.2, pp.185-189, 2000-12-25 (Released:2011-09-20)

参考文献数

12

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A 26-year-old female patient with schizophrenia was referred to us by her psychiatrist, complaining of the breakage of half of her bridge in the 5+5 region. Denture treatment was suitable for this case, in view of the long span of missing tooth in the 3+3 region, the condition of the abutment tooth, her mental problem and financial standing. She persisted, however, in demanding the bridge and never accepted denture treatment. All efforts to make her understand the suitability of the treatment proved useless due to the failure of mutual understanding. Her demands for the prosthesis were often unreasonable and bizarre.The author gave her time to change her mind while performing other tooth treatment. Three years and 7 months after her first visit, her partial denture was completed. At first, she was not able to accept it because of her youth and for aesthetic reasons. Often, she revealed unreasonable and delusional reactions to her denture. However, she came to accept it a little more day by day and now wears it normally, although it remains unclear whether she is fully reconciled to its use in her heart.The greater part of the difficulty in managing this patient was due to the lack of mutual undertanding and her bizarre thoughts and behavior caused by her schizophrenia. On the basis of this case, it is suggested that dentists treating such schizophrenic patients should try to 1) recognize the patients' mental pathology but not become involved in that, 2) understand the patient's desire for a certain treatment but reject it firmly if it is unreasonable, 3) sustain the dentist-patient relationship with patience, 4) wait for improvement in the patient's delusions and behavior regarding dental treatment, and 5) bring the treatment to the appropriate goal by these means.

著者

中村 広一

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.3, no.1, pp.32-36, 1988-12-25 (Released:2011-09-20)

参考文献数

29

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Danger of overlooking organic diseases and difficulty of a dentist's situation in treatment under a diagnosis of masked depression are discussed in this article. We propose the utility of introducing the concept of psychogenic overlay into the diagnosis and treatment of dental patients suspected to be depressive.

著者

中村 広一

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.12, no.2, pp.119-122, 1997-12-25 (Released:2011-09-20)

参考文献数

5

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The management of two cases of schizophrenic patients with delusions is reported in this article. The first case was a 45-year-old man who was refered to our office by a psychiatrist. He had a cosmetic disturbance due to the dropping off and fracturing of the resin-faced cast crowns of the upper central incisors. During treatment, he suffered from a sensation of tightness on the tooth. He asserted that the sensation was caused by the temporary crowns, which he thought were too wide and long. The shapes of the crowns were, in fact, appropriate and the contact pressures between them and the adjacent tooth were loose. His sensation was therefore unfounded and seemed to be abnormal. His interpretation that the agony was caused by the crowns was judged to be a delusion. He demanded lighter and looser crowns. His claim, fouunded on this false belief, placed us in a dilemma. The author waited for such a time as when he would become mentally stable. During this wait, only reversible dental treatment, newly adjustments to the surface of the temporary crowns or trial sets of wax patterns, was repeated. In due course, with the progress of psychiatric treatment, he became calm and accepted his final prosthetic crowns.The second case was a 45-year-old male schizophrenic patient who attributed his toothache to the machinations of an acquaiatance. The pain was due to pulpitis of a right upper first premolar. It was clear that his belief was unfounded, and it was therefore judged to be a delusion. The author listened carefully to his assertion but did not give it special importance. The treatment of his teeth was completed without trouble by ordinary procedures with his consent.The evaluation of these two cases suggests that the dental treatment of delusional patients becomes more difficult when the delusion involves elements of dental practice itself and the patient demands inappropriate dental treatment because of the delusion.

著者

中村 広一

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.19, no.1-2, pp.23-26, 2004-12-25 (Released:2011-09-20)

参考文献数

8

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The case of a 61-year old male schizophrenic patient who complained of occlusal disturbance after upper denture repair by the author is reported. The author found no problem with the denture and considered the blaming of occlusal disturbance on the denture repair unreasonable and misguided. The subjective symptoms were treated as qualia rather than delusions. A good relationship was established by listening to the complaint. Medical interviews and explanations by the author, in his role as dentist, were repeated for three years and the patient was finally convinced of the truth.

著者

角田 博之 宮岡 等 高木 謙 角田 和之 高森 康次 永井 哲夫 中川 種昭 藤野 雅美 片山 義郎

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.18, no.2, pp.85-88, 2003-12-25 (Released:2011-09-20)

参考文献数

7

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“Adolescent paranoia” includes phobias of emitting foul odor from one's own body, fear of eye-to-eye confrontation and dysmorphophobia.A 21-year old man visited the department of dentistry of our hospital complaining of foul breath, whose concern about his odor was delusional. He also exhibited “egorrhea” symptoms, such as fear of eye-to-eye confrontation and monologue, and was diagnosed as having adolescent paranoia by a psychiatrist. The patient had started avoiding people, shut himself away in his room and talked to himself from the age of 15 or 16, after initially becoming concerned about his pimples. He also became concerned about foul breath and having suspicious eyes from the age of 17, felt that others were avoiding him, and became self-recriminatory. He later presumed that his thoughts were being expressed by his mouth contrary to his will.The self-rating questionnaire for assessing the severity of phobia of emitting foul breath received a high score of 36 out of 40. The questionnaire indicated the delusion of having halitosis, delusion of reference and poor social adaptability. He was, accordingly, diagnosed as suffering from Group III (severe) type of phobia of emitting foul breath. On the day of his first visit, he was also examined by a psychiatrist, and diagnosed as having adolescent paranoia and administered 1 mg of risperidone.This patient's symptoms suggested the possibility of schizophrenia. Thus it was preferable to pay attention to other symptoms of schizophrenia and the patient was therefore observed carefully.Dentists are likely to receive outpatients of this type who require immediate referral to psychiatrists. The case of this patient demonstrates the importance of an accurate differential diagnosis regarding complaints of emitting foul breath.

著者

大村 満晴 河村 晃代 難波 美保子 壷内 智郎 大町 耕市 岡崎 好秀 下野 勉

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.6, no.2, pp.148-154, 1991-12-25 (Released:2011-09-20)

参考文献数

6

被引用文献数

4

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Weinstein and Domoto reported that almost dental fear of adult's were based on the dental treatment during their childhood and so we can prevent these problem. We study for these problem from a point of veiw as prevention of dental fear. We reported about dental anxiety and fear for dental and non dental students with using a questionnaire before. This time we performed a dental fear survey by using a new questionnaire that had some questions concerning generalized anxiety. And tried to compare the results of dental fear survey that had achieved for Japanese residents in Seattle, U. S. A. and for native people in the U. S. A. Subjects were 3041 Japanese in Japan, 419 Japanese in the U. S. A.(Japanese residents) and 1019 Americans in the U. S. A.The results obtained were as follows;1. The proportion of the people who have some dental anxiety was 82% for Japanese, 82% for Japanese residents and 50% for Americans. The people who were hurt at the last visit to a dental office was 59%, 68% and 16% respectively. The people who did not feel comfortable asking questions about the dentists or the staff was 37%, 44%, and 10% respectively.2. In the data of Japanese in Japan, we found some differencse between high dental fear group and low dental fear group for all the categories of respondents.3. In the data of Japanese in Japan, a significant correlation between responses to questions for generalized anxiety and for dental anxiety was found.This study shows that dental anxiety is related not only to specific stimuli of dental treament, but also to anxiety of trust for the dental staff, to anxiety of unusual physical reactions, to anxiety for their own oral health and to generalized anxiety.Recently informed consent was noticed. So it is most important to make a comfortable situation a good relationship petween patients and dental staff. And in the study also in the clinic, we must not take up only reactions that have appeared when anxiety is over the physiologic limit. But, before that, the things, we should be interested in, are considering a lot of information about sociology, economics and anthropology around medicare and patients from the view point of prevention of dental fear with behavioral science.

著者

荻野 経子 大野 久仁代 星 佳芳 三宮 慶邦 扇内 秀樹

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.13, no.2, pp.99-104, 1998-12-25 (Released:2011-09-20)

参考文献数

8

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Recently, many cases have been reported of individuals who complain of having halitosis which no one else can smell and for which there is no local or systemic cause. We call this condition “Self-halitosis”. Self-halitosis can be caused by either psychosomatic or psychiatric disorders. We have been treating such patients with brief courses of psychotherapy without using drugs. For patients with psychiatric disorders, we emphasize the importance of psychiatric treatment, but such patients often refuse to be treated by a psychiatrist because they are convinced that they really do have bad breath.In this paper, we report a case of self-halitosis considered to have been induced by skin disease. The patient was a 31-year-old man and his symptoms were relieved by a brief course of psychotherapy.

著者

小林 雅文

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.9, no.1, pp.84-91, 1994-06-25 (Released:2011-09-20)

参考文献数

11

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Cervico-omo-brachial syndrome consists of symptoms that include pain and paralysis extending from the neck, shoulders and arms to the fingers, muscle contracture or hypertonia of these parts and the inhibition of movement at the cervical vertebrae. Although the cause is complicated, it may be produced principally by compression and/or stimulation of the spinal cord and/or nerve root, plexis or periphery. Little literature describes psychogenic intervention in this syndrome. This study describes a case of the syndrome which exhibited psychosomatic influence.Patient: 40 years old housewife.First examination: August 8, 1993Chief complaint: Sensory disturbance of the neck, shoulders and arms together with pain in the mandibular joint produced by “close-bite malocclusion” of metal crowns set on the right and left mandibular molars several years previously.History of present illness: Patient complained of dry mouth, thoracic compression and cardiopalmus in addition to the above-described syndrome, although doctors told her that no abnormal state was found from clinical, physiological and biochemical examinations. Her sickness had changed from stiffness to paralysis after a miscarriage in the previous year, and the paralysis has extended to the arms. The syndrome was not improved during 30 days of taking (p. o.) of tizanidine hydrochloride prescribed by a plastic surgeon.Status praesens: The author advised her to stop taking tizanidine. Her complaint of maladaptation of metal crowns (765 567) was foud to have almost no physical basis when examined orally, including by x-ray. The result of CMI questioning was III.However, the author counseled the patient to accept and bear with her complaint on two occasions for one hour each and also devoted one hour to reassuring the patient that her sickness would heal, making a combined total of 3 hours during the 3 months' therapy. The author also adjusted the occlusion 65 567 65 567 and set the new metal crown at 7 after root canal treatment.Etizolam (0.5mg/tablet) was administered 3 times (1 tablet p. o. every time) per day for 5 days in the first month and 10 days in the second month, and then alprazolam (0.4mg/tablet) was administered twice (1 tablet p. o. every time) per day for 5 days during final week of the second month. Her sickness disappeared for the most part. Three weeks after stopping alprazolam, (0.5mg/tablet) was administered twice (1 tablet each time) per day for 5 days in the third month. Sleeplessness was also improved considerably.Her sickness has not recurred to date, i. e. 7 months since the final treatment.