Communication between the patient, mother and dental staff is very important in dental treatment for children. Whether or not the mother should be present beside the dental chair during the treatment of her child must be decided on a case by case basis. This study considers the reasons for having the mother beside the dental chair.
The subjects were a total of 300 persons consisting of 100 children (aged 3 to 8 years), 100 pediatric dentists and 100 mothers. Fifty mothers were positioned beside the dental chair and the other 50 waited outside the treatment room. Twenty-four factors were examined, consisting of 8 which were child-related, 4 which were mother-related, 4 which were family-related and 8 which were dentist-related. The factors were examined on the basis of dental charts and three types of psychological tests, namely a psychological test on the distance between the mother and child, dental anxiety test for the mother and a personality test for the pediatric dentist. Discriminant analysis was carried out according to the second class of Hayashi's quantifying theory, with entrance or non-entrance into the treatment room or chosen as an external criterion.
The results are summarized as follows.
The ratio of the discriminant efficiency of external criteria to entrance or non-entrance was found to have a high correlation of 0.84. When the factors mentioned above were ranked according to the external criteria, their order was: “the desire of the child”, “the clinical experience of the pediatric dentist”, “ the treatment experience of the child”, “the number of brothers or sisters”, “the mother's way of thinking concerning presence in the treatment room” and “the adult personality on the egogram”.

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We observed 240 patients with temporomandibular disorders (TDM) who had completed Cornel Medical Index (CMI) and Y-G questionares in order to investigate the relationship between TMD and psychological factors. The 240 patients were classified into 5 (IIV and others) types according to the criteria proposed by the Japanese Society for the Temporomandibular Joint. In addition, all 240 patients were classified into 4 (I-IV) categories by CMI and 5 (A-E) categories by Y-G.
Acupuncture to the meridian point “Gekan” has been used to treat the inferior articulator. Instead of using a needle, the author has irradiated the inferior articulator several times with a low power laser (Nd: YAG at 350mW) for the Type I and Type II patients. This relieved the pain somewhat, but since the results were determine only by the subjective judgement of the patient, the author also used thermography to evaluate the symptomatic change objectively. For Type III, with the closed lock, and Type IV patients, we used the low power laser from the first examination. We manipulated the mandible after the pain of the temporomandibular region had been relieved. The symptoms ceased after several months, but no change in the disk position was observed in the MRI.
We have now used the same treatment for psychosomatic patients with TMD. Counselling and medical therapy were also effective depending on the patient. The results was that, after several months, the symptoms of temporomandibular dysfunctions were cured. This suggests that low power laser treatment for TMD is effective not only for Types I, II, DI with closed lock and IV patients, but also for psychosomatic patients with TMD.

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This paper reports the results of the treatment of 100 patients with temporomandibular joint arthrosis, (30 males and 70 females), under our department's guidelines for masticatory patterns during the period from April 1992 to September 1996. The subjects under observation consisted of 78 cases (24 males, 54 females) from their first examination until prognostic observation 2 weeks later, and 22 non-examinees. The guidelines for masticatory patterns were applied as described in the manual prepared by our department. The essential requirements were as follows: for a morsel of boiled rice, patients were told to masticate twenty times slowly and to savor its taste before swallowing it. Symptomatic improvement was observed in 60% of patients 2 weeks later, increasing to 72, 80 and 100% 1, 2 and 3 months later, respectively. The improvement was also obtained even in cases of malocclusion or long suffering. By symptoms, masticatory muscle group pain was relieved and the combination of trismus and masticatory muscle group pain declined sooner than the combination of trismus (and/or masticatory muscle group pain) with temporomandibular murmur. These results suggest that masticatory organic dysfunction due to current rough masticatory habits, and especially disuse lesion (atrophy) of the masticatory muscle group, seems to be implicated in the pathogenesis of temporomandibular joint arthrosis.

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The effects of the traditional Chinese (Kampo) medicines, Hochu-ekki-to, Yoku-kansan and Saiko-ka-ryukotsu-borei-to, were compared to those of imipramine, a tricyclic antidepressant, in a mouse model of despair. Mice were placed in a water tank, from which there was no escape, for 15 min. The tank contained a water-wheel and the number of wheel rotations counted as escape attempts and, in accord with previous reports, imipramine (10 mg/kg i.p.), given either acutely or daily for 3 days 10 min before testing, markedly increased the number of wheel rotations. The Kampo medicines were administered for 14 consecutive days in the drinking water prior to testing. Hochu-ekki-to (60, 150 and 300 mg/kg/day) also increased wheel rotations but the effect was not dose-dependent. Yoku-kan-san markedly increased the number of wheel rotations at lower doses (60, 150 mg/kg/day), but decreased the number at the highest dose (300 mg/kg/day). Saiko-ka-ryukotsu-borei-to also increased the number of wheel rotations at the lowest dose (60 mg/kg/day), but decreased the number of rotations at higher doses (150, 300 mg/kg/day). These results suggest that these Kampo medicines, like imipramine, may ameliorate despair in mice.

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Antinociceptive effects of the traditional Chinese (Kampo) medicines, Hochu-ekki-to, Yoku-kan-san and Saiko-ka-ryukotsu-borei-to, were studied on acetic acid-induced writhing in mice. The number of writhings observed was counted in consecutive 5 min periods for 60 min after intraperitoneal injection of 0.6% acetic acid. Kampo medicines were administered for 14 consecutive days, prior to testing, in the drinking water. Oral administration of Hochu-ekki-to (60, 150 and 300 mg/kg/day) dose-dependently reduced the number of acetic acid-induced writhings. Yoku-kan-san (60, 150 and 300mg/kg/day) tended to inhibit the writhing response to acetic acid in a dose-related manner. Saiko-ka-ryukotsu-borei-to (60, 150 and 300 mg/kg/day) markedly reduced the number of acetic acid-induced writhings but its effects were not dose-dependent. These results suggest that these Kampo medicines may have antinociceptive properties.

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The study describes a case of ill-fitting dentures caused by long-term polypharmacy.
Patient: 55 year old female office worker.
First examination: March 26, 1996.
Chief symptoms: Difficulty fitting lower denture.
Therapeutic history: The patient gradually lost her lower teeth, except for a single canine, after breaking her leg in a fall. Several sets of dentures were made but the patient was unable to keep them correctly positioned.
Present status: The patient walks with difficulty and has the characteristic moon-face induced by chronic steroid administration. The alveolar membrane was frail and inelastic. The remaining canine was very mobile and was removed with minimal damage. However, bleeding continued for longer than was expected and healing was delayed. She was advised to stop taking steroids, non-steroidal anti-inflammatory drugs, anti-allergic drugs (anti-histamines?) and anxiolytics which had been prescribed by different clinics over a period of several years. She also received counselling and was informed that the problems with ill-fitting dentures would be resolved. This was indeed the case. Her alveolar membrane and psychological well-being also improved.

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Self-halitosis has been defined as psychosomatic halitosis. We have been caring for patients who are extraordinarily conscious of their own oral malodor by brief psychotherapy and periodontal therapy in our department. These therapies are effective for psychosomatic disorders, but not for psychiatric diseases like depression. Recently, we have emphasized that self-halitosis patients with such severe diseases should consult with and receive psychotherapy from a psychiatrist, not a dentist. However, many patients are resistant to seeing a psychiatrist for this problem. They sincerely believe that bad breath is not directly related to any psychiatric problem.
In this report, we describe the cases of two psychosomatic halitosis patients who were diagnosed with depression and hypochondriasis by psychiatric techniques.

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This paper reports the case of a 23-year old female halitosis patient treated by the description of impressions, and also discusses the therapeutic significance of this method.
It is generally difficult to treat halitosis patients because of their poor verbalization. Repeated interviews often end in drawing out only minimal and perfunctory replies.
We have often experienced, however that use of the description of impressions makes it easier for halitosis patients to express their emotions.
In this case, the therapist placed the emphasis on changing the patient's subjective view of the context of her halitosis, which is influenced by the awareness that a problem exists.
The therapeutic approach was adjusted according to the changing of strength of the patient's belief in the halitosis. At first, it was important to reduce her anxiety. Then we focused her on the problem in mind, which sought to deny the halitosis.
In this process, the therapeutic key word “bad myself” helped her to overcome her mental sickness.
In the end, she obtained some release from her mistaken conviction and was able to behave more freely.
In conclusion, the description of impressions has some therapeutic significance as follows;
First, it allows the doctor to grasp what is actually happening in the patient's mind, and so to give more effective assistance. Also, by using this method, we can correct the patient's mistaken cognition about their halitosis in a shorter time.

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Chronic oro-maxillary pain may be influenced by psychological and social factors and therefore diagnosis and therapy are not always straightforward. The following case study illustrates symptomatic improvement of the psychological pain associated with trigeminal neuralgia by a psychosomatic approach.
Patient: 25 year old woman.
First examination: visited the Department of Dental Anesthesiology, Nihon University Dental Hospital in February 1992.
Chief symptoms: Pain attributed to the second branch of the right trigeminal nerve.
Therapeutic history: The patient was treated with carbamazepine (200-300 mg/day p.o.), steroids and stellate ganglion block for 3years with only partial success.
Present status: The patient had flattened affect suggesting a depressed state and a psychosomatic symptomatology. The symptoms decreased considerably after the patient was taught abdominal breathing exercise, received autogenic training and was given Wu-Zhu-Yu-Tang (Tsumura, 5g/day p.o.).
Conclusions: The trigeminai pain was assumed to have had a psychosomatic origin because the symptoms were closely associated with the autonomic nervous system, particularly the vasomotor nerve, and responded appropriately.

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We report on two cases of tongue pain patients with physical factors. In both cases, the chief complaint was tongue pain, but the results of organic and blood examinations were normal.
Case 1: The patient was a 41-year-old woman. At the first medical examination, we knew from hemodynamic measurements that she had hypotension and disdynamic state (hypotonic type). Hemodynamic treatment improved her hemodynamics and reduced her tongue pain simultaneously.
Case 2: The patient was a 71-year-old woman. Using brain MRI, we diagnosed that she had a silent cerebral infarction. Her tongue pain was reduced by drugs for improving cerebral bloodflow, major and minor tranquilizers.
These cases suggest the importance of attending to the physical factors of patients diagnosed with glossodynia.

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