To carry out a review of previous study on glossodynia, all publications including conference proceedings and abstracts in the Japanese Journal of Psychosomatic Dentistry were searched (since 1986 up to 2006) to identify relevant literature.
Glossodynia is characterized by a spontaneous burning pain in the tongue or other oral sites, usually in the absence of clinical and laboratory findings. This condition is reported more often in women, especially 40-60 years-old. Typically, patients awaken without pain but note increasing symptoms through the day and into the evening. Patients report decreased pain with eating, and often complain oral disesthesia, dryness, and taste alternations and so on. There has been clear consensus on these clinical features among Japanese dentists. And various effective managements had been reported such as administration of antidepressants or benzodiazepines, in combination with brief psychotherapies.
Recent studies have pointed to dysfunction of several neurotransmitters and neural networks in the central nervous systems as a possible cause of glossodynia.
This review suggested the fact that grossodynia has been properly managed by specialists of Psychosomatic Dentistry in Japan.

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A questionnaire was distributed to dentists who are trustees of the J apanese Society of Psychosomatic Dentistry. All of the respondents are practitioners who treat patients suffering from psychosomatic dental disorders.
Approximately 60 percent of them reported the experience of requesting medical insurance fees for psychological testing and psychosomatic medical treatment. About 80 percent hold that dentists are essentially specialists in treating problems of the oral and maxillofacial region and, therefore, take a positive attitude towards the treatment of psychosomatic disorders of this region, also requesting related medical consultations when necessary.
The authors also criticize the changes related to psychosomatic medical treatment that came into effect in April, 2006.

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We investigated how and from which parts child patients acquire visual information from pictures of human faces, with particular reference to how this changes with the age of the child. We used the FreeView (trade name) eye movement measuring instrument to examine 90 children between the ages of 2 years 11 months and 12 years 11 months. They were divided into three age groups: group A (below 7 years), group B (7-9 years) and group C (10 years and above). We found that:
1. Eye movement toward the central part of the face (such features as the eyes, nose and mouth) increased with age in terms of the frequency of eye fixation, duration of fixation and the number of children observing all such facial features. The age-related difference was clear.
2. The distribution of fixation points across the distal area, including the hair, forehead, cheeks, ears and chin, was not evenly scattered at any age but tended to focus on the facial features.
3. The saccadic eye movements across the distal area corresponded substantially to observation of the facial features. This phenomenon was common to all age groups.
4. Saccadic eye movement to the background and the frequency and duration of fixation on points in the background decreased with age and by number of children. No great diffrence was observed, however, between groups B and C.

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The authors sent a questionnaire to 29 universities of dentistry to inquire into the present state of mental health education for dental students. We report and discuss the results. The subject of Basic Psychology was not included in the study.
It transpired that 25 universities (86%) provide lectures on mental health, most commonly, in the case of 13 universities (52%), in the 4th and 5th years. The total teaching time devoted to this subject ranged from 1, 075 minutes at the top to 150 minutes at the bottom and averaged 625 minutes.
The topics addressed included, in order of frequency, Medical Interviews (25 universities, 100%), Psychosomatic Disorders (22, 88%), and Depression and Dementia (19, 76%). Examination Procedures and Liaison Medicine were only taught at 10 universities (40%).
Such lecture courses appear under various names but we divided them according to five main fields of study: psychiatry, related medical fields, dentistry, psychosomatic medicine and others.
Both dental and medical doctors taught the subject at 10 universities (40%). Psychiatrists taught at 8 of these (32%). Only medical doctors taught it at 10 universities (40%). Psychiatrists taught at 7 of these (28%). Only dental doctors taught it at 4 universities (16%).
12 universities (41%) responded that they knew, and 17 (59%) they did not know, that psychiatry had been included in the list of required subjects for medical training since 2004.
All 29 universities answered that mental health education is necessary.
It is important that all the dentists receive such education and learn the diagnostic techniques needed to identify the various therapeutic options available. Much should also be expected of the practical use of consultative liaison psychiatry between dentists and psychiatrists.
The future goal has to be to guarantee a quality education that matches the highest standards in the world. We anticipate that the spread and development of mental health education will also contribute to society at large by informing people about mental health issues.

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We report a case of halitophobia in which improvement was observed after the cause of the oral odor was identified.A 27-year-old male came to our hospital complaining of oral odor.He had been worried about his breath odor since a time when, at the age of fourteen, classmates had commented on it.He had visited several breath clinics and consulted frequently with psychiatrists but without being able to allay his anxiety.
At our breath clinic, we first performed an initial medical interview.Using organoleptic measurement, a halimeter test and gas chromatography, we could detect a weak but measurable odor.An oral examination revealed no dental problem beyond a slight tongue coating but the gum test indicated a low saliva flow.We referred him to the departments of oral surgery and radiology, where no symptoms of Sjogren's syndrome were found but his parotid gland was revealed to be in an atrophic condition. We explained to him about the low saliva flow and told him that the dryness of his mouth may be the cause of the oral odor.He appeared relieved to know the possible cause of his halitosis and commenced tongue exercises to stimulate the saliva flow.
On his first visit to our breath clinic, he also asked to visit our hospital's clinic of psychosomatic medicine.As his anxiety seems to have been reduced, however, we have still not referred him to that clinic.We conclude from this experience that it is important to perform a proper medical interview and breath odor measurements prior to judging that a problem may have a psychological origin.

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A 37-year-old male visited a branch clinic complaining of inlays falling out from the right lower first molar and second premolar. The inlays were replaced but he next complained of dental pain in the first molar due to pulpal stimulation by the inlay. This soon subsided but only to revert to a masticatory pain that had been recurring for four years. The dentist categorized this as an “unidentified complaint.”
The author noticed that the symptoms had commenced just after the patient had taken perfenazine. The author suspected that it could, therefore, be a case of traumatic periodontal pain due to abnormal contraction of the masticatory muscles, induced by an extrapyramidal syndrome. It may then have been sustained by the patient's own bruxism after the drug was stopped. The author regarded the symptom as an example of qualia involving not only the sensation of pain but also the patient's negative feelings toward the dentist and traumatic experience at the dentist's hands.
The explanation to the patient of the mechanism of these symptoms and careful listening to his own account of how he felt that the dentist had insulted him had the effect of relieving his symptoms perfectly soon after.

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Dental psychosomatic diseases are those in which the main complaint is located in the oral cavity. Some patients who suffer from glossodynia, temporomandibular arthrosis or halitosis experience remission with the help of psychosomatic therapy. This paper reports case studies that demonstrate the efficacy of Outpatient Morita therapy for neurotic and psychosomatic diseases of the head and neck.

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We report two cases of temporomandibular disorder (TMD) associated with a tongue habit caused by dental treatment.
Case 1: A 75 year old woman was given a fixed partial denture (FPD) with hygienic pontic in her lower right molar region by a general dental practitioner in May 2001. She developed the habit of touching beneath the pontic with her tongue and this generated sharp pain in the right temporomandibular joint and masseter muscle during mastication. All pain disappeared whenthe interdental space was modified by means of a new spheroid pontic.
Case 2: A 72 year old woman had her upper left molar extracted by a general dental practitioner in November 2001. She then developed the involuntary habit of touching the space where the tooth had been with her tongue. The habit stopped when the space was closed by an FPD.
Reversible treatments were implemented prior to the use of FPD in both cases. Thetwo cases showed that changes in the oral cavity can lead to oral habits that result in TMD symptoms.
It is suggested that reversible bridge treatment in such cases is important not only from the direct treatment point of view but also to confirm the diagnosis prior to the final treatment procedure.

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We report a case of restricted mouth opening as somatization of a major depressive disorder. The patient was a 59 year old female who had her lower right third molar extracted at a dental clinic in March of the year in question and began to experience restricted mouth opening one month later. The clinic introduced her to the oral surgery department of a hospital but, despite many tests there, no physical disease was found. Her symptoms became worse in the October but a second dental clinic also found no abnormality in her mouth. She then visited the Nippon Dental University Hospital in December of the same year. Rather than performing X-rays and other physical examinations, we commenced with a medical interview. Her complaint was that she could no longer open her mouth properly since her dental treatment. She had, however, also been experiencing domestic problems that corresponded chronologically to the onset of her mouth opening problem and a number of factors satisfied the diagnostic criteria of a major depressive episode (DSM-IV-TR). Suspecting the somatization of a major depressive disorder, we introduced her to a psychiatrist who confirmed that diagnosis and undertook psychotherapy. Her mouth opening performance has improved as a result. We suggest that it is important to bear in mind that dental symptoms may be due to a mental disease and arrange for early referral to a psychiatrist when this is suspected.

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