We investigated the psychological tendencies of adult orthodontic patients using the MINI system. The subjects consisted of 110 patients: 38 males (average age 20.84) and 72 females (average age 22.80), classified in 3 groups:(1) all adult patients (2) male patients (3) female patients. The MINI data were analyzed accordingly.
Significant differences were found on the Hy and Pa scales, and the frequency of male problem patients was higher than that of females.
About 30% of all adult orthodontic patients were identified as problem patients.

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Dental care provision for the Japanese people has increased considerably since the national medical insurance system began in 1961.
In this study, we surveyed the insurance situation of patients with psychosomatic dental disorders. A questionnaire was distributed to 41 trustees of the Japanese Society of Psychosomatic Dentistry. Responses were received from 27, who all treat patients with psychosomatic disorders. Approximately three quarters of the respondents had experience of requesting insurance. It was confirmed that reimbursements and valuations are made in this field, too. We asked the dental practioners to participate in a continuing study. We seek to request more understanding and cooperation from related organizations, such as the Ministry of Health, Labour and Welfare, the Social Insurance Medical Fee Payment Fund, the All-Japan Federation of National Health Insurance Organization, dental associations of each area and the Japanese Society of Psychosomatic Dentistry.

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著者らは, ヒトの日常行動の中で, 毎日行われている刷掃に関しGibsonのアフォーダンス理論の「持続」と「変化」という性質について小学生と短大生について比較検討し, 2-3の知見を得たので報告する.
刷掃の最初に行う「ハブラシに歯磨剤をつける」という行動には, どのような流れで行為が行われているのか, 行為と行為を結ぶ微細な調整運動であるマイクロスリップに着目し行動を撮影したVTRより, 機器のスローモーション機能を用いてミクロの単位で分析検討し, 以下の結論を得た.
1.66msec-198msec (1Frame-33msec) の躊躇であるマイクロスリップは, 肉眼で見落とす可能性があった.
2.231msec-1858msec (1Frame-33msec) の躊躇であるマイクロスリップは, 肉眼で容易に知覚できることが示唆された.
3.マイクロスリップを観察したことで, 歯ブラシと歯磨剤に触れる前の「pre-shape」の存在が小学生と短大生両方に明らかになった.
4.歯ブラシと歯磨剤の数が1本つつから複数 (TYPE1→2, 3, 4) になることにより, 小学生と短大生ともにマイクロスリップ発現回数が増加した.
5.マイクロスリップの発現平均回数に小学生と短大生における年代的な差は認められなかった.

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Depressive neurosis is depression with a psychogenic cause. It is characterized by anorexia, polyphagia, dyssomnias, poor concentration, enervation and desperation.
Pericoronitis arises through discordant development of the teeth and jaw. It is thought that food residue more easily causes inflammation when the gingival trough is wider and deeper in the lower wisdom tooth.
A 28-year-old male complaining of toothache was referred to our out-patient clinic by his internist of psychosomatic medicine.
The patient had been under treatment for depressive neurosis at the department of internal psychosomatic medicine in our hospital since the age of 26. After receiving therapy for dental caries, he came to our out-patient clinic voluntarily for his pericoronitis. We first consulted with the psychiatrists, who assured us that he would be able to undergo the surgical procedure. We extracted the wisdom tooth under general anesthesia.

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Conversion disorder is a mental disorder, generally known as hysteria or conversion reaction. The psychological stressor causes various somatic symptoms to develop. The patient becomes unable to stand, walk or speak, and the arms and legs relax. In dentistry, previous reports have identified problems with mouth opening or trismus due to conversion disorder, and a case of worsened conversion disorder following tongue cancer surgery. We experienced a case of worsened conversion disorder following dental treatment.
The patient was a 29-year-old woman who came to our Ambulatory Anesthesia Service in October, 1999. Her chief compliment was dizziness following dental treatment. She had been receiving treatment for periodontal disease at our dental hospital since March, 1998. The dizziness first occurred after impacted tooth extraction treatment in August, 1998. Since then, she had continued to experience occasional dizziness and/or other psychosomatic symptoms, such as discomfort or weakness in her arms and legs following dental treatment. She felt anxious about continued swelling and slight fever after impacted tooth extraction, and complained that she was not receiving good care. These somatic symptoms turned up after psychogenic factors, such as anxiety or unbelief. Self-rating psychological tests revealed she was in an anxious state with a type of neurosis, but not depressive. Her personality was egoistic and dependent. She had also been helping her father with his kidney failure for a long time. We diagnosed her various somatic symptoms as a case of conversion disorder.
We started brief psychotherapy and tried giving her periodontal treatment under the management of dental anesthetists. She gradually came to undergo dental treatment without anxiety. We recommended that she keep a diary, and she became able to express her moods in words and recognize that her somatic symptoms were based on psychological factors. Her somatic symptoms following dental treatment decreased little by little. In June, 2000, however, she experienced severe aphonia following a social stressor in her office. She stabilized psychologically, after resigning from the office, and since then has not exhibited any symptoms of conversion disorder following dental treatment.
It was concluded that the use of brief psychotherapy with diary guidance was effective in relieving the worsening of the conversion disorder after dental treatment.

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A 53-year old woman complained of a diverse range of symptoms, including sharp pain at the side and root of the tongue, feelings of anxiety, parching, depression, and exhaustion, and early-morning awakening. She had a high score of D on the Minnesota Multiphasic Personality Inventory (MMPI), and was diagnosed as suffering from light depression. Treated with 50mg/day of fluvoxamin, the insomnia was relieved after two weeks, the feelings of depression after four, and all symptoms, including the glossal pain, after eight. The dose was gradually reduced and then stopped altogether after six months. Fluvoxamin is easy to use in the ordinary dental clinical environment because it has almost no anticholinergic effects or cardiovascular side effects. It is thought to show promise for use as a medication for treating a variety of complaints in the oral area.

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Insight into the disease condition of schizophrenia patients remains poor, and we have often experienced difficulty with abnormal behavior during dental treatment. In this study, we report the case of a schizophrenia patient who harbored extreme doubts about a treatment and its correspondence. The patient was a 44 year old woman whose main complaint consisted of a request for caries treatment. The treatment was started at the Department of Operative Dentistry in April, 1997, but the patient would not cooperate at all with it. Even after being treated three times, the patient continued to complain strongly of toothache and demand a change of doctor on the grounds that she was not being treated well. The doctor in charge requested our assistauce with the doctor-patient relationship and treatment in June of the same year. The rapport between the doctor and patient was dearly not good, although the patient changed her tone completely when interviewed. Despite our perseverance, however, she still would not cooperate and continued to display both dissatisfaction and anger. The patient would say that we were treating the wrong tooth during treatment, but refused when offered to be shown the tooth by mirror to prove it was not so. She also complained of imagined dirt on my face guard, etc., and other complaints of persecutory delusion. Following negotiation with the chiefs of the hospital and department, the patient was told that it would be very difficult to continue her treatment in this hospital. The patient did not come back to the hospital after that. A psychiatric disorder was suspected from the first, and most of the time was spent in talking with a the patient. The opportunity of a hospital transfer to a psychiatri department was lost. Dentists cannot perform treatment if the patient does not want it, and this case dearly showed the difficulty of treatment by dentistry alone.

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Dysgeusia can derive from various causes ranging from oral disease to general disorders. A lack of trace elements, such as zinc, is considered to be one of the major causes of the disease. Trace element supplement drinks that contain various kinds of minerals and the Vitamin B group are now available.
In this report, we discuss two cases, one in which the patient was diagnosed as having dysgeusia resulting from latent zinc deficiency, and the other due to zinc deficiency.
The former, a female aged 87, had suffered from tingling pain on her tongue for 2 months and over-sensitivity to salty and hot flavors.
The latter, a male aged 70, had suffered from tingling pain on his tongue for 6 months and become insensitive to salty and hot flavors.
Both patients took two 100ml packs of trace element supplement drinks per day for 3 months.
Some improvements in their symptoms and serum zinc concentrations were observed as a result. It is concluded that the administration of trace element supplement drinks may be an effective way to treat dysgeusia that appears to be caused by zinc deficiency.

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