This is a study of substances in the student apathy at our dental school.
In the investigation of the student apathy, we used a printed form “A questionnaire of an apathy”, which was made in the Hirosima University. This questionnaire was composed with 77 items, 46 items were subjective factors, 13 items were university factors and 18 items were social factors.
The subjects were 821 students in the all grade from 1st to 6 th of dental school, Aichi Gakuin University.
The results were as follows.:
1. The total score of student apathy was the lowest in 1st grade and tended to increased gradually. This tendency got to peak in 4 th grades, but decreased again from 5 th to 6 th grades.
2. The score of apathy about subjective factors was the same tendency, the peak was 4 th grades, as showed in the total score.
3. The score of apathy about university factors was not evident than the total score or the subjective score
4. In the score of social factors, there was a little change among each grade.
5. In the professional education, there was the most items which increasing the ratio of apathy.

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We established criteria for the diagnosis of glossodynia in a narrow sense, which consists of four items, and studied it in a retrospective manner. Of a total of 84 patients (11 males and 73 females), 51 patients (60.7%) fell under all of the four items.
However, 81 patients (96.4%) fell under the item concerning psychic symptoms. This suggests that patients with glossodynia in a narrow sense have a psychological element, as the base, which is common to patients with any other type of glossodynia.

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Meige syndrome (MS), which was described first by Henry Meige in 1910, is one of the rare nerve disease in the oral and maxillofacial area. Clinical characteristics are chiefly the distribution of abnormal involuntary movements (AIM) which are revealed as blepharospasm and oromandibular dystonia. They are aggravated by stress and disappear during sleep. But prognosis is comparatively wrong. We experienced a case of the MS and reported its outline.
The patient, a 60-year-old female, visited our hospital complaining of occlusal pain and disorder of ingestion due to AIM. Intraorally upper jaw was edentulous and teeth of lower jaw bited the alveola. Dental treatment of denture adjustment and osteoplasty in order to reduce the complaints induced stress and made her symptoms worse. Therefore she was introduced to the department of neuropsychiatry of Okayama University Medical School and diagnosed MS. Main treatment of MS is pharmacotherapy. Medicines are chosen conservatively based on empirical knowledge. A combination of oxypertin (60 mg/day) and clonazepam (1. 5mg/day) worked well.
Oral dyskinesia and Tardive dystonia off en indicate analogous symptoms, but they are quite different diseases and it is difficult to distinguish MS from them. It should be grasped neurologically and consulted by a specialist as soon as possible.

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Despite the absence of remarkable organic disease of the teeth, muscles of mastication or temporomandibular joints, some patients limit their chewing due to early muscle fatigue upon mastication of food. There are few studies on the clinical picture and pathogenesis of such fatigue upon mastication. In this study, the authors 1. surveyed the frequency of fatigue upon mastication; 2. compared two groups of senior high school students, one with and the other without fatigue upon mastication, through the questionnaire on food intake and mastication habits, and 3. examined the reliability of the method of survey through the questionnaire on food intake and mastication habits.
This study surveyed 701 junior high school students, 5997 senior high school students and 168 working men. The questionnaire used for the survey included questions on 1. dental status, 2. mastication habits; and 3. eating habits; 4. growth history; 5. living habits; and 6. general health.
The following results were obtained:
1. Early fatigue upon mastication was seen in 14-24% of the subjects.
2. The group experiencing early fatigue upon mastication was found to differ from the unaffected group in the following areas:
a. Disturbance of mastication due to childhood or current dental disease.
b. Habits of incomplete mastication with decreased desire for chewing.
c. Dietary habits such as preference for soft foods, preference for certain types of food, rapid eating, and eating between meales.
d. Decrease in personal health care, such as treatment for carious teeth
e. Presence of psychosomatic complaints suggestive of a syndrome of unidentified complaints.
3. The questionnaire on food ingestion and mastication employed in this study was judged to be reliable by review of answers on the dental status, attitudes of test subjects, sample size, and discrimination of the test subjects.

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In the liaison service atTsurumi University dental hospital, the author managed the 204 psychological and mental problem patients who complained dental and oral symptoms. They were classified according to their mental states. Thirtynine (19%) cases were normal, 80 (39%) cases depressive state, 69 (34%) cases neurotic state and 16 (8%) cases delusional. The cases of psychosomatic disease in strict meaning, were only 9. It was to be stressed that the therapy to consider the phenomenon of mental overlay was valuable in all most cases. By means of psychosomatic approach, the author gained therapeutic result that 47% was good, 33% fairly good.
This clinical experience suggests the nessesity of more fundamental and serious discussion about neurotic and depressive state cases rather than psychosomatic disease in strict meaning. And it seems to be necessary that psychosomatic dentistry includes various other mental disorder cases so far excepted from the subjects, for example severe neurosis or schizophrenia and so on, who complained dental and oral surgical symptoms.
The author find out the significance of psychosomatic medicine in dentistry in the extension of the ability of diagnosis and therapy in dental and oral surgical practice. But it seems to be more important significance that psychosomatic practice leads us to understand the contact relationship between dentistry and human being, and shows us the universal aspect of dentistry as medicine.

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This paper descrived the study on the care of patient of self halitosis. Firstly, we asked to make halitosis patient answer our questionnaires which included psychological factor.
We ref ered the results of them to check the oral psychosomatic disorders of the patients when they were interviewed in our clinic. We would like to propose the utility of the questionnaires check list with regard to the psychosomatic approach and detailed our psychotherapy, which was based on the relationship of the doctor-patient.

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Physiologic examinations, candida culture test and psychosomatic approach were carried out on patients complaining glossal pain or abnormal taste sensation without no visible or pulpable findings. By the examination results and response to treatments, causes of glossal hyperesthesia and taste impairment were differentiated. Tongue pain was based on a psychosomatic condition, i. e. glossodynia in 39 cases (43.4% of the total), and on organic diseases such as candidosis (23.3%), Fe deficiency (18.9%) and mechanical irritation (4.4%). Both psychic and organic impairments were associated with tongue pain in 9 cases (10%). Abnormal taste sensation was defined as hypogeusia and dysgeusia in 17 and 4 cases, respectively. Impaired taste sensation was considered to be derived from Fe deficiency (28.6% of the total), candidosis (23.8%), xerostomia (14.3%) and complicated with glossodynia (19.0%) including unknown origin origin in 2 cases.
Salivary flow rate (SFR) lowered clearly in hypogeusia group, but slightly in glossodynia cases. Both stimulated and non-stimulated SFR increased with improvement of the disturbed sensation, however SFR in hypogeusia did not elevated sufficiently to healthy control level.
Tongue pain threshold exhibited clear difference among glossal hyperesthetic patients. In organic disease-associated cases, the threshold on the painful region was significantly lowered than that on the painless region, and the threshold difference disappeared with improvement of the symptom. On contrary, no threshold difference could be found in glossodynia between the “painful” and painless region, and also between before and after treatment.
Lowered taste threshold was detected in all of glossodynia, candidosis, Fe deficiency and of course most greatly in hypogeusia. In four fundamental tastes, threshold for sweet most clearly lowered. Elevation of mean thresholds for four tastes was seen in all groups corresponding with the clinical course. From these, it was clearified that unexpectively large number cases of glossal pain without manifesting any objective finding are caused by organic disorders such as Fe deficiency, candidosis or xerostomia. Besides, it was also clearified that abnormal taste sensation is associated with these organic factors. Therefore, it seems important for differential diagnosis of abnormal tongue sensation to examine patient's physical conditions regarding SFR, pain and taste threshold and candida culture test including psychosomatic approach.

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Stomatognathic dysfunction is paid attention as the third disease in dentistry. In this disease, psychological factors play an important role. Chewing movement reflects stomatognathic function and is very important in a concept of ‘Clinical physiological Occlusion’. From this standpoint, we have made many stuidies in chewing movement. In the previous study, we reported that there was a relationship between psychological factors in foods-taste and chewing movement.
In this study, we approached to study the stomatognathic condition through chewing movement by kinds of sound. Because we have experienced that music makes us relax and noise makes us stress the mind.
The results indicated that sound makes change the parameter of rhythm in chewing movement. This suggeste that sound can change chewing movement and possibility of existence of relationship between psychological factors and chewing movement.

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It is said that homeostasis is kept by autonomic nerve system and endcrine system. There are many reports on the relationship between these two functions and emotional stressor. But, in dental domain, there are few reports on the relationship between immunity and emotional stressor. Then, we investigated immune functions of psychogenic disorder patients (14) in dental domain as well as healthy men (13).
These Patients' diagnosis were psychogenic temporo-mandibular joints syndrome (5), idiopathic glossodinia (3), psychogenic teeth pain (2), chronic recidive aphthous stomatitis (2) and psychogenic xerostomia (2).
From this study, it is shown that:
1. T-cell level of patients' group (81. 2%) is significantly low compared with healthy group (87. 5 %).
2. B-cell level of patients' group (7. 7%) is significantly high compared with healthy group (4. 4%).
3. Helper T-cell level of patients' group (42. 3%) is significantly low compared with healthy group (47. 5%).
4. Patients' group suppressor T-cell, plasma adrenaline and noradrenaline levels have no significance compared with those of healthy group.
These results suggest that psychogenic disorder patients in dental domain suffer some changes in immunity system.

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It has so far been pointed out that the surgical correction of mandibular prognathism has not only functional and morphological but also psychological influences. We experienced a case who showed a favorable functional recovery following surgical correction and yet fell into social adjustment disorder from some esthetical suffering.
The case is a 27-year-old singleman.
CC: masticatory disturbance and mandibular prognathism. Up to age 10, dental correction led to an improvement in mandibular prognathism, but at age 16, prognathic tendency began to re-appear. At age 25, retrusive surgery led him to have a new hope in future. Howevere, some children happend to laugh at his countenance, and this made him complain of “I can't laugh. I'm something like a demon” and led to a drop in his working capacity at his post. Subsequently, he was diagnosed by a psychiatrist as obsessive-compulsive neurosis. Examination of his life history suggested the following:
1) The commencement of dental corretion from his infancy upon his parents' initiatives directed his introversive character to more and more enervated way of life. Years of gnatho-corrective treatment formed the basis of his obsessive-compulsive character.
2) Identity disorder with his stout and resolute father was persistent.
3) The patient found out the object of dental correction mainly in its esthetical aspect, while actual dental treatment put emphasis mainly on its functional aspect, i. e. improvement in occlusal disturbance.
4) Postoperative psychological interviews were performed in sympathetic correspondence to the patient with respect to his esthetic suffering, leading to abandonment of re-surgery.
Generally, stomatograthic affections sometimes may cause various emotional reactions because of a close relationship between the stomatognathic region and the esthetic. For the present case, appearance of its string predilection for the countenance and its adherence to the countenance of the past made postoperative obsessive idea persistent. Oral surgical correspondence to a patient having strong esthetic requirements makes it important to grasp his premorbid personality. The confirmation of the therapeutic object in the patient-therapeutist relationship was also regarded as necessary for the judgment of surgical prognosis.

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