A simple method to understand the psychosomatic state of patients could be a useful tool in treating their problems. With this concept in mind, we studied the pH curve of saliva, along with salivary bacteria and their effect on the pH curve.
Saliva was collected at rest from 36 subjects on a sampling sheet, and its pH was measured for 15 minutes using a covering plastic plate to block volatilization of CO₂ only for the first 1minute. Assayed items of the pH curve were categorized as follows, 1) pH1, pH 5 and pH 15: pH value at 1, 5 and 15 minutes after sampling, 2) DpHI: difference between pH 5 and pH1, 3) DpHL: difference between pH 15 and pH5. The saliva sample from the sampling sheet was serially diluted, inoculated into agar by a standard method, and aerobically incubated at 37°C for 48 hours. The number of salivary bacteria per unit weight was then calculated.
By analyzing the correlation between the number of salivary bacteria and the items of the pH curve, a moderate negative correlation was estimated between the number of salivary bacteria and DpHI, as well as the number of salivary bacteria and DpHL. This result suggests that careful investigation is needed in the significant changes in the salivary bacteria during clinical application of the salivary pH curve.

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To obtain a consistent picture of the tendency towards apathy in dental students, one study was conducted when the students entered dental school and a follow-up study was conducted five years later. Students who had been promoted each year were studied separately from those who did not.
We used the questionnaire “A Diagnosis of Interest Decline” prepared by the Health Center of the University of Hiroshima to make our assessment. This form contains 77 items: 46 as the main factors in the decline of interest, 13 to do with the university environment and 18 concerned with the social environment.
The subjects used for this study were 84 students out of a group of 111 who were interviewed when they entered the dental school in 1985. In the follow-up study made five years later, 59 of these had advanced satisfactorily to the sixth year while 25 had only progressed to the third, forth or fifth grades.
In both groups of students the tendency to lose interest was stronger after five years than at the beginning of the course.
However, the follow-up study indicated a great loss of interest among those students who had not moved up satisfactorily.
Considering each item separately, increase in the reaction ratio toward the interest-loss tendency was more remarkable after five years in those students who had progressed satisfactorily each year.
Loss of interest as the years passed by was similar in both groups, but the students who did not move up satisfactorily had a marked lack of interest from the beginning of the course and this did not change much with the passage of time.
The results of this study show that the students who did not move up satisfactorily had a strong tendency toward a loss of interest right from the beginning of the course, suggesting the possibility that this information could be of use in helping students in the future.

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The purpose of this study was to clarify, from an epidemiologic standpoint, the actual relationship between mastication habits and overall health of senior highschool students in the city of Kyoto.
Questionnaires were given to 720 male and 1, 573 female senior high school students. These questionnaires asked questions about eating and chewing habits and were used to investigate the relationship between habits of mastication and overall health. Complete and incomplete masticatory habits were recorded using a classification system based on information obtained from an examination chart of mastication habits and an evaluation chart of masticatory patterns. The examination chart and evaluation chart were prepared by one of theauthors (H. M.). Analysis of the epidemiological data from the survey was performed at the Electronic Computer Center of Fukuoka University.
Complete mastication was observed in 25% of male and 30% of female senior high school students surveyed. Incomplete mastication was observed in 75% of male and 70% offemale students. Hence, a majority of students of both sexes exhibited patterns of incomplete mastication.
Regional differences in masticatory habits were found throughout Japan. Students from Kyoto city had the highest incidence of incomplete mastication whereas students from Okinawa exhibited the lowest incidence of incomplete mastication.
Factors which were found to predispose to masticatory habits included presence of teeth, desire for mastication, fatigue from mastication, attitudes concerning importance of mastication, mastication frequency, time of meals, amount of seasoning of food, and volume of saliva.
The relationship between masticatory habits and systemic health revealed that studentswho exhibited complete mastication tended to have better overall health while those who exhibited incomplete mastication tended to have poorer overall health.

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Systematic desensitization, a technique of behavior therapy, is known to be effective in the therapy of odontophobic patients. However, as there are differences between images on the one hand, and real situations on the other hand, this study presented a video of actual therapy situations in order to narrow the gap. The effectiveness of video systematic desensitization was evaluated by observing the changes in electrophysiological responses, the results of which are given below.
The subjects consisted of 16 odontophobic patients (8 males, 8 females) with ages ranging from 16 to 68 years old.
The content of videos which were presented were as follows:
1. Situations focused on from the patient's angle of view:
1-1 Dental therapy scene of a third person
1-2 Surgical instruments being placed one by one
1-3 Surgical instruments approaching the viewer
2. Situations focused on from the dentist's angle of view:
2-1 Scene of injecting anesthesia
2-2 Scene of tooth excision
2-3 Scene of tooth extracion
Almost all physiological responses during presentation of fear-eliciting situations showed significant differences as compared with the rest period. The heart rate, respiration rate, skin potential reflex frequency, and percentage of plethysmogram baseline oscilation showed a significant increase, and the plethysmogram pulse wave amount of power showed a significant decrease. Moreover the subjective unit of disturbance reports from patients showed that video presentations had the effect of stressors.
Along with the progress of therapy, physiological responses concomittant to the systematic desensitization by video showed significant differences in almost all situations. Heart rate, skin potential reflex frequency, and the plethysmogram pulse wave power showed a significant increase, thus confirming therapeutic results. In particular situations focused from the patient's angle of view were most effective therapeutically, so that no difference from the rest period was observed in the heart rate, the skin potential reflex frequency and the plethysmogram pulse wave percentage.
Anticipatory anxiety to oral anesthesia in-vivo slightly decreased by systematic desensitization through the video, as seen from physiological responses. Moreover, although anticipatory anxiety to anesthesia during actual therapy once the patient asks for it is more stressful than video situations as seen from physiological responses, it could be predicted that patients would be able to cope with the actual treatment without excessive influence from their individual reports.
In all processes of the treatment, modification of erroneous cognition within the relationship of doctor-patient was thought to be one factor for a successful therapy.

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The Jenkins Activity Survey (JAS) was invented in America in 1964 to understand how Type A behavior and related psychological traits contribute to health problems. Identifying the basic psychological traits that increase risk of coronary heart disease and other major illness of Type A patients should contribute to the improvement of the health.
However, due to differences of cultural and social environmental condition, to find out the Type A behavior of the Japanese, a different type of the survey was needed. Many Japanese researchers and clinicians therefore made a Type A behavior survey for the Japanese.
In this study, we used one of the Japanese editions of the JAS for 25 psychosomatic patients with disease of the oral region in our department. We found that 23 patients were type B and only 2 patients were type A. We presume that psychosomatic patients with disease of the oral region are quiet, calm and do not so much pay attention to the behavior of the other people, but on the other hand, they control their own emotion, act in moderation and are bad at reducing stress.

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The effects of carbachol and (-)-nicotine on extracellular levels of dopamine (DA), 3, 4-dihydroxyphenylacetic acid (DOPAC) and homovanillic acid (HVA) were studied using in vivo brain dialysis in freely moving rats. The drugs were injected directly into the dorsal striatum through a microinjection tube attached to a microdialysis probe. Carbachol (7.5, 15μg) induced a gradual and long-lasting increase in striatal levels of DA, DOPAC and HVA, whereas (-)-nicotine (2.5, 5μg) produced a rapid-onset transient increase in striatal DA release and a gradual decrease in DOPAC and HVA levels, respectively. These results demonstrate that in the dorsal striatum of rat, carbachol and (-)-nicotine exert different effects on the striatal DA release and its metabolism.

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To determine the inhibitory effect of autogenic training (AT) to control accelerated smpathetic nerve activity at the time of dental therapies, a comparative review was made studying the effects of beta-blocker by measuring the serum level of glucose and free fatty acids (FFA) as indices. As a dental therapeutic model, physiological saline solution was injected into the oral cavity.
The subjects were 35 volunteer male students in Nihon University School of Dentistry.
These volunteers were divided into the following groups; Group 1: 15 subjects trained for AT up to the second formula. Group 2: 8 subjects pre-treated with 10mg of a beta-blocker indenolol hydrochloride. Group 3: 12 control group subjects.
Method
AT was performed once a week, and training was continued until the subject became conscious of the heavy warm feeling of a hand or foot. Training was carried out 4 to 6 times. Group 2 was orally administered of 10mg indenolol hydrochloride, a first generation betablocker, one hour before injection into the oral cavity. Blood was collected before and after injection.
Result
Before and after injection, the glucose level showed a lower value in Group 1 compared with that of Groups 2 and 3. The FFA level showed a low level before and after injection in Group 1, followed by Group 2 and 3. Significantly low value was observed in Group 1 compared to Group 3.
As mentioned above, for the accelerated sympathetic nerve activity at the time of dental treatment, training up to the second formula has been suggested to be as effective as the administration of 10mg indenolol hydrochloride.

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There are many recent reports on emotional stress and the immunological system, but fewer reports have been published in the dental domain. We have recently performed immunological tests on diseases related to psychological causes in the oral cavity field, and reviewed the immunological function of these patients.
There were 28 subjects (3 males and 25 females). Their age ranged from 16 to 76 with an average of 48.4 years. Diseases were idiopathic glossodynia in 13 cases, psychogenic tooth pain in 5 cases, psychogenic jaw arthrosis in 5 cases, chronic regenerative aphtha stomatitis in 2 cases, and psychogenic dry mouth in 3 cases.
Immunological tests have been made on such items as lymphocytic T-cell, B-cell, T-cell subsets (T 4, T 8) and their ratios, and serum-catecholamines. For measurement, lymphocytes and subsets were measured by laser-flowcytometry, and serum-catecholamines were measured by the HPLC method.
Overall results showed 82.4% T-cells, 5.9% B-cells, 44.2% T 4, 25.2% T 8, and the T 4 /T 8 ratio was 1.85. In these patients, severe/depressive patients showed 81% T-cells, 7.1% B-cells, 41.7% T 4, 27.6% T8, and a 1.6 ratio of T4 /T 8.
Compared with other patients, remarkable decrease was observed in T-cells, T4, and the ratio of T4 /T8. By these results, the severely depressed patients with oral cavity disease might have been affected to some extent by their immunological system.

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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, 1993
Chief 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.

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We have introduced the therapeutic key word “bad myself” into the treatment of ahalitosis patient (olfactory bromidrosiphobia).
A 23-year-old female claimed to have suffered from halitosis for ten years. She was convinced that she bothered others with her halitosis, because she was avoided by them in conversation. However we could not recognize halitosis or any likely organic cause.
So we asked her, “Is there bad your threatening you that your halitosis is offending others?”. She affirmed it, and agreed to write a “description of impressions”. Then we had interviews once a week, and made brief comments on her reports pointing out that she could adjust herself to personal relations if only she never listen to her “bad myself”. Step by step, she became able to conquer her “bad myself” and enlarged her radius of action.
It can be concluded that this therapeutic key word “bad myself” helped her take an objective view of her conditions, and the confirmation of her experience through her “description of impressions” may also have been effective in treatment.

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In order to deal with juvenile patients properly, pedodontists are required to have a better knowledge about them in terms of personality, mother-child relationships and home environment. To this end, we selected pertinent factors from the personal and social, in addition to medical, histories taken when they visited our clinic for the first time, and performed a multivariate analysis by means of the quantification theory group III to examine similarities and differences between factors and the meanings of each factor.
1. The psychological factors were quite distinct in every category in light of the Takagi-Sakamoto juvenile personality test. This fact suggests that the test is highly dependable for assessing the personality of child subjects.
2. Bases on the analysis of psychological factors, the correlation axis representing emotional stability (or instability) and the correlation axis for introvert (or extravert) personality could be set.
3. The factors associated with mother-child relationships could be categorized clearly in accordance with the Yatabe-Guilford personality inventory. Thus, these factors were proved to be reliable for assessing the weight of mother-related factors in the child's personality.
4. Using the analysis of mother-related factors, a correlogram could be plotted with one axis representing positivism and the other axis for stabillity.
5. Among the factors associated with the environment in which the children were brought up, such factors as age, the number of brothers and sisters and the order of birth were clearly distinguishable.
6. Based on the analysis of the above-mentioned siblings and age, correlation curve was plotted.

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In order to improve the effect of the chewing gum on plaque removal, we mixed various calcium phosphates in the chewing gum, and evaluated their effect in vitro using a new method we developed. The calcium phosphates mixed in the chewing gum were secondary calcium phosphate and tertiary calcium phosphate, and we provided the small (diameter: 5μm) and the large (diameter: 30μm) respectively, and the amounts of the calcium phosphate in the chewing gum were 2.0 or 5.0 per cent respectively. The new method was that we rubbed the paraffin (used as artificial plaque) which coated the slide glass with the chewing gum utilizing a water bath shaker, then we measured their decreased weight.
From this study, it was suggested that mixing the secondary calcium phosphate having a large diameter in the chewing gum was good to improve the effect of the chewing gum on plaque removal.

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