It has been reported that chromogranin A (CgA) cg and amylase (Aml) in saliva could be useful indicators of stress in adults. This study sought to verify whether saliva chromogranin A and amylase may also be used as indices of stress in children. We measured the concentration of CgA and Aml in saliva collected from twenty-four children before and after dental treatment and also performed the Dental Sub-scale of the Children's Fear Schedule (CFSS-DS) examination on all children. The concentration of CgA ranged from 0.59 to 9.95 pmol/mg protein before treatment and 6.80-0.00 pmol/mg protein after treatment. The CgA values decreased in 79.2% of children, and significantly more so in boys than in girls. Children with a high CFSS-DS score also had a high CgA level before treatment and the drop was relatively large compared to children with a low score. We attempted two different methods to measure the Aml level but both produced unstable results. It is concluded that the CgA in saliva might be a useful indicator of stress in children during dental treatment.

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This study took State-Trait Anxiety Inventory (STAI) measurements at the times of first examination and reevaluation of treatment and examined the relationship between the change in the patient's anxiety level and various parameters. The subjects were 20 people diagnosed as having chronic periodontitis. Their anxiety was measured by STAI at the first examination before providing oral hygiene instruction and other initial treatment. STAI was performed again at the time of reevaluation. The parameters were age, length of treatment period, frequency of coming to hospital, and number of remaining teeth.
The results were as follows:
1. Significant differences were noted in state anxiety and trait anxiety between the times of first examination and reevaluation.
2. In simple regression analysis using the amount of change in anxiety level as the target variable, no significant difference was noted by any parameter.
3. In multiple regression analysis with changes of state according to age, length of treatment period, frequency of coming to hospital, and number of remaining teeth, a significant difference was observed according to length of treatment period and frequency of coming to hospital. No such influences were observed with respect to trait anxiety.
It appears from the foregoing that patients are less anxious and more motivated when sufficient explanation of the treatment is provided at the first examination and appropriate treatment is provided.

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The authors conducted an open-label trial to examine the efficacy of co-administration of fluvoxamine and loflazepate ethyl for oral psychosomatic patients. Twenty-two oral psychosomatic patients were treated with fluvoxamine, a selective serotonin reuptake inhibitor, in combination with benzodiazepine (loflazepate ethyl) for 4 weeks. The response was assessed by VAS, SDS and CGI. Sixteen of the 22 patients (72.7%) who completed the study reported significant improvements in their symptoms at the finish. Only minor and transient side-effects were observed. Both serotonin and GABA regulate the neuroanatomical circuits that mediate oral psychosomatic symptoms. It is suggested that co-administration of fluvoxamine and loflazepate ethyl may be a reasonable treatment for patients with oral psychosomatic disorders.

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[in Japanese]

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A case of splint therapy for a patient experiencing bruxism after dental treatment is reported.
A woman, aged 67 years, was referred to us by a dental general practitioner in April 2004. Her chie complaint was an involuntary grinding mandibular movement that she could not regulate by herself.
The abnormal movement began after metal crowns were set on her upper right molars in October 2003. She initially had the sensation that the crowns were too high for fitting the upper and lower teeth together in the right molar region and the mandibular grinding movement then appeared spontaneously.
The splint was made as a treatment strategy to reduce stimulation from the metal crowns during occlusion. The involuntary mandibular movement gradually disappeared, possibly due to the deprogramming effect of the splint therapy together with brief psychotherapy.

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