Bio‐psycho‐social assessment of occlusal dysaesthesia patients

Abstract

Dentists occasionally experience occlusal dysaesthesia (OD) patients, who complain of bite discomfort without evident occlusal abnormalities. It is suggested that this condition is related to somatosensory abnormalities of the trigeminal system and/or psychological problems such as somatoform disorders. The aim of this study was to investigate the characteristics of OD with a bio-psycho-social approach. Twelve OD patients (10 women, two men; mean age 54.7 years) and twelve healthy volunteers (10 women, two men; mean age 54.8 years) were selected. They were assessed using (i) interdental thickness discrimination ability test using 2-, 5- and 10-mm-thick standard blocks and 12 test blocks that were thinner or thicker than the corresponding standard block and (ii) psychological tests: General Health Questionnaire (GHQ60) and Profile of Mood States (POMS) brief-form. There was no significant difference in the interdental thickness discrimination ability between OD patients and controls (mixed-model anova, P=1.000). Regarding psychological tests, there were no significant differences between OD patients and controls in the total scores for either GHQ60 (P=0.143) or POMS brief-form (P=0.319) (Wilcoxon's test). However, OD patients showed significant differences from controls in several subscales, that is, 'somatic symptoms' (P=0.039) and 'severe depression' (P=0.039) for GHQ60 and 'depression-dejection' (P=0.014) and 'vigour' (P=0.008) for POMS brief-form (Wilcoxon's test). These results suggest there is no difference in interdental thickness discrimination ability between OD patients and normal controls, but OD patients tend to score higher on psychosomatic distress.

Phantom bite: a case report and literature review

“…In a recent study, interdental discrimination ability was tested again in 12 OD patients and twelve healthy subjects with bite blocks. The results of this study were consistent with those of Tsukiyama et al 23 Reeves and Merill 5 suggested that occlusal dysesthesia patients meet the criteria for somatoform disorders listed in the DSM-IV of the American Psychiatric Association. 24 Patients with somatoform disorders report somatic complaints that suggest physical illness, but these complaints cannot be explained by any general medical condition, other mental disorders, or medication or substance usage.…”

Prefrontal modulation during chewing performance in occlusal dysesthesia patients: a functional near-infrared spectroscopy study

“…Bilateral maximal occlusal force and contact area were measured using 97-μm-thick pressure-sensitive sheets (Dental Prescale 50H R-type, Fuji Film Co., Tokyo, Japan) during maximal clenching performance in the intercuspal position, and occlusal data was calculated by a precalibrated scanning device (Occluzer FPD703, Fuji Film Co., Tokyo, Japan) in terms of occlusal force (N), asymmetrical index (AI) for occlusal force (%), moment (N cm), average pressure (MPa), and maximum pressure (MPa), as well as occlusal contact area (mm 2 ) and AI for occlusal contact area (%).…”

“…Persistent occlusal discomfort is a common complaint among occlusal dysesthesia (OD) patients [1][2][3][4] who, in the presence of depression, schizophrenia, panic, or somatoform disorders [5][6][7][8], present with numerous neuropsychological associations. From a clinical standpoint, Tsukiyama et al [2] recommended a psychosomatic evaluation for diagnosis, and Reeves JL and Merrill RL [5], and Toyofuku et al [7] also recommended cognitive behavioral therapy and antidepressants for the treatment of OD patients.…”

“…From a clinical standpoint, Tsukiyama et al [2] recommended a psychosomatic evaluation for diagnosis, and Reeves JL and Merrill RL [5], and Toyofuku et al [7] also recommended cognitive behavioral therapy and antidepressants for the treatment of OD patients.…”

Psychiatric comorbidities and psychopharmacological outcomes of phantom bite syndrome

“…They nomadically visit various dentists seeking "bite correction" because of their strong belief in dental treatment despite possible symptom exacerbation [1]. PBS has been regarded as a psychiatric disorder [1,[5][6][7][8][9][10][11]related to paranoia, personality disorder, or somatoform disorder, while some authors have suggested proprioceptive dysfunction, false peripheral feed-back [12], or phantom occlusal sensation in the central nervous system [13][14][15][16][17] as possible etiologies. However, little is known about its psychiatric comorbidities [10,18].…”