The personality, psychological state, and trigger factors of occurrence of thirty-seven patients with self halitosis were investigated by psychological tests and detailed interview. The results were as follows:
1) By the analysis of the patients' personality, twenty-seven (64%) patients were classified in the category of psychosomatic disorder, and the rest in neurosis.
2) The number of female patients in the areas III and IV of the CMI test is larger than that of the male patients. The Y-G test revealed that there were more female patients in the maladjustmentgroup than male patients. In MAS test, the patients with neurosis got more points in the anxiety scale than those with psychosomatic disorder.
3) In most cases, the precipitating factor of the disease was found to be a stressor of situational genesis, i. e. anthroscene. The mechanism of outbreak is speculated to be responded conditioning, and the symptoms were maintained by operant mechanism.
4) The above data indicated that self-halitosis had indication for behavioral therapy. In fact, all cases could overcome self-halitosis by taking behavioral therapy.

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Physical reactions during oral surgery were measured in 111 patients who were normal, other wise than the presence of oral diseases, 24 patients with psychosomatic diseases and 53 patients with hypertension, and the results obtained were analyzed. Plethysmogram, GSR, systolic pressure, diastolic pressure, pulse rate and RPP were measured as parameters of physiscal reactions. Easy and precise recording and analysis of the data could be attained by using a polygraph connected to a personal computer. When physical reactions were determined through the parameters, the effects of mental stress, pain stress and epinephrin could be observed because pulse rates, GSR and systolic pressure greatly varied at the time of anesthesia and tooth extraction. In comparison with the normal group, the psychosomatic group showed a larger alteration of plethysmogram during tooth extraction and of systolic pressure during anesthesia, while no marked changes in plethysmograms were seen throughout the measurement period in the hypertensive group. In this group, systolic pressure was found to increase before operation, and during and after the application of local anesthesia, pulse rates also increased at tooth extraction and after operation. These findings suggested that the hypertensive group tended to show marked and persistent physical reactions.

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In order to clarify the influence of tooth separation on the central nervous system, spontaneous motor activity and brain levels of monoamine-related compounds were measured in mice treated with experimental tooth separation. Under pentobarbital anesthesia, tooth separation of mice (ddY, male, weighing 26-28 g at acquisition) was performed by inserting a plastic plate of 1 mm thickness between the upper incisors and fixing it by adhesive resin. The measurements were carried out at 1, 2 and 3 days after treatment. The results obtained are summarized as follows.
1) Spontaneous motor activity in mice treated with tooth separation decreased significantly compared with that in control mice. 2) In several discrete regions of the brain, turnover of norepinephrine, dopamine and serotonin in treated mice changed significantly compared with that in control mice. These findings suggest that experimental tooth separation may act as a stressor to the central nervous system of mice.

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Orthodontic treatment with orthopedic appliances may result in failure because of lack of patients'cooperation unless they are used after sufficient motivation.We encountered a patient who developed school refusal after treatment with a maxillary forward protractor at a dental clinic without adequate motivation.
The patient was a girl aged 10 years and 2 month at her first visit to our department.She had consulted a dentist due to reverse occlusion, and was prescribed to wear a maxillary forward protractor, which is of the largest dimensions among orthodontic appliances.However, this appiance was poorly accepted by the patient, and as it induced bullying by her school mates, she began to refuse to go to school.This condition was not relieved even after discontinuation of the use of the appliance, and the patient was referred to our Department of Orthodontics.
Our examination suggested that there was no malpractice by the dentist but that his explanation was inadequate.After repeated consultations with the patient and her parents, we considered that correction of occlusion by application of a chin cap and an inter-maxillary anchorage will yield better results.The treatment was initiated immediately, and occlusion could be improved in 2 months.
The patient gradually began to go to school from immediately after this with more selfconfidence due to marked improvement in her appearance associated with the improvement of occlusion, and school refusal was resolved about 5 months after the initiation of the treatmemt. Presently, a chin cap is applied as a retainer during sleep for growth of the mandible.
This patient demonstrated that careless use of an orthodontic appliance which is poorly accepted by the patient causes considerable psychological as well as physical stress especially in children and adolescents even if the treatment is correct.

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This report surveys the experience in 36 patients (male 7, female 29) diagnosed as glossodynia. 15 cases (42%) were cured, 9 cases (25%) were in remission and 11 cases (30%) were no with change.
We introduced two cases from the group that cured completely.
Case 1 was a 52-year-old female with pain in margo linguae which had persisted over three years. Pain disappeared by antidepressants, and this case could be suspected as having depression.
Case 2 was a 64-year-old female with pain in dorsum linguae which had persirted over six years. This case could be suspected as having a hypochondriac state and a conversion histeria. The pain disappeard completely due to improvement in her interpersonal relations.
From our experience, we found it important to research from the interview of their life style, previous life history and interpersonal relations to psychosomatic approach for glossodynia.

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We now report about clinical and statistical observations on 19 cases of glossodynia in the past 4-years and 9-months.
The results were as follows:
1) The trend of the patients' age and sex corresponded with those of past reports.
2) We mainly used two treatments; drug therapy, and elimination therapy of irritation factors such as sharp tooth edge in oral cavity.
3) There were remarkable responses and changes in 7 out of 19 cases.
4) The 7 patients with no improvement had stopped treatment within only a month since their first visit.
5) We supposed that the low effects of treatment owed to little relationship between doctor and patient.

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We have reported that there was a close relationship between the stomatognathic dysfunction and the occlusion, as the occlusal treatments such as occlusal adjustment, bite plane therapy and/or occlusal restoration have acted effectively.
However, when we treat the patients with stomatognathic dysfunction, we often felt that they possessed personarity characteristics that mentally differed from that of general dental patients and some of them needed a psychosomatic approach.
Therefore we studied the relationship between the psychosomatic factors and the stomatognathic dysfunction through the occlusal examination and the personality test using a questionaire such as CMI test.
The results indicated that the patients of the stomatognathic dysfunction showed various changes of the occlusal condition and were more influenced by psychosomatic factors than the general dental patients. It also indicated that the change of occlusal condition and psychosomatic factors complexly had influence on the functional occlusion system, and at last caused the stomatognathic dysfunction.
Thus it was confirmed that psychosomatic factors played an important role in the functional occlusion system.

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The purpose of this study was to elucidate psychosomatic properties ofpatients with mandibular dysfunction using egogram questionaires, and to find a relationship tothe final prognosis by applying this questionaire. Egograms were drawn up from 40 patientswith mandibular dysfunction.
The results were as follows:
1) The patients' egograms showed a tendency of a bell-shaped curve with a peak being A (adult) and a low of C (child), particulary the FC (free child) as compared with the nomal subjects.
2) Each patient was classified and distributed according to structure analysis, and the results showed a similar pattern to those of the normal subjects.
3) As each patient was classified according to the basic positions, it was found that the “I am OK, you are OK” group had the largest population among both the patients and the normal subjects. The proportion of “I am not-OK, you are not-OK” group was larger among the patients than among the normal subjects.
4) There was no significant relationship between the structure analysis of the patients to their prognosis.
5) However, the basic position of the patients was related to their prognosis. Inthose patients who had a basic position of “I am not-OK, you are OK” the ratio of those patientswho did not improve markedly increased compared with the other patients.
6) There were no patients whose egogram changed from the result of our therapy.
These results suggested that patients with mandibular dysfunction did not have any characteristic properties in their egogram but that it was necessary to positively applypsychotherapy to those patients who did not have a complete prognosis of having a basic position of “I am not-OK, you are OK” group.

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The P-F study of 16 patients (8 males, 8 females) of neurotic halitosis taken at the beginning of therapy was studied in order to see their response to situations of frustration.
As compared to standard values of each scoring factor of the P-F Study, deviation was observed in the following responses of both male and female patients of neurotic halitosis:
1) Significantly high M' or avoidance of the expression of aggression despite feeling frustration.
2) Significantly low E or expression of aggression to the person or object which is source of obstacle.
3) Significantly high or tendency to rely on others for the solution of problems.
Aside of the results mentioned abovc it was slso seen that the GCR or group conformity rate was significantly higher than the standard values.
These tendencies as seen from the P-F study suggest the difficulty that patients of neurotic halitosis may face in social adaptation.

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The concept of cenesthopathy which was described by Dupré et al. in their literature in 1907 and introduced to our country by Murakami in 1942 have subsequently been studied by many researchers from various aspects.
We report this time on our experience of a case which developed oral cenesthopathy in the course of receiving treatment on temporomandibular arthrosis at a nearby physician's.
Patient: Female aged 44
Family history: Her father was killed in war and mother married again with her ex-husband's younger brother.
past history: Non-contributory except that she was admitted to a hospital for half a month due to pueumothorax about 2 years ago. No particular abnormality was observed in findings of clinical tests such as blood test.
Present illness: She has experienced difficulty in opening the mouth from a 12-13 years ago, for which she received massage and physicotherapy at a bone-setter and orthopedist. However, no remarkable improvement was seen, because of which she used to open her mouth forcibly. Subsequently, she visited a dentist for treatment of her anterior teeth in March 1985, and occlusal insufficiency was diagnosed. Orthodontic and occlusal treatments were started, but pain at the mandibular joint and dizziness began to develop after a while. From an occasion in June, 1986, when a hygienist said to her inattentively, “your jaw has blown out.” she felt that the mandibular moved backward. As sensation of the pharyngeal region being obliterated developed concurrently, she visited a surgeon in another hospital for emergency treatment.
Subsequently, the orthodontic treatment was continued for about 6 months, and an orthodontic appliance was removed at length in January, 1986, while the occlusal treatment was being continued. She felt her jaw moving lightly afterwards, for which she made telephone calls to a dentist frequently, but no notice was taken by the dentist of her complaint. Since increase in the sensation of the jaw moving lightly occurred together with sensation of the entire teeth moving also begun to occur, her mental state became unstable, for which she visited our department on March 2 of the same yaer.

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