Personality traits in patients with oral malodor.

Many patients presenting at oral malodor clinics have psychological halitosis, which is characterized as being obsessive about having oral malodor or being distressed from a keen awareness of oral odor. We used the Tokyo University Egogram (TEG) to evaluate personality traits in patients presenting at the oral malodor clinic of this institute. The incidence of each TEG personality type was compared between a total of 600 patients presenting at the clinic and a cohort of healthy individuals. Differences were found between the malodor patient and healthy groups. Nurturing Parent (NP)-dominant, Adult (A)-dominant, inverse N (NP low, Free Child high), showed a significant decrease of 6.7, 11.3, and 3.6%, respectively; whereas N (A low) and N (NP high, Free Child low) showed a significant increase of 3.3 and 6.4%, respectively (p < 0.01).

Multidisciplinary treatment of peripheral osteoma arising from mandibular condyle in patient presenting with facial asymmetry.

While osteomas often occur in the orofacial area, it is relatively rare for one to occur in the temporomandibular joint area. Here, we report a patient who underwent multidisciplinary treatment including high condylectomy for peripheral osteoma arising in the left mandibular condyle. The patient was a 46-year-old woman with the chief complaint of facial asymmetry. Cephalometric analysis revealed skeletal anterior crossbite due to anterior deviation of the mandible, with chin deviation of 10 mm to the right. A computed tomography scan revealed bone hyperplasia in the mesiodistal and inner areas of the left mandibular condyle, which exhibited outward anterior displacement. Bone scintigraphy showed a circular area of strong radioisotope accumulation with indistinct boundaries, consistent with the lesion in the left mandibular condyle. The above findings led to a diagnosis of skeletal mandibular prognathism with facial asymmetry due to peripheral osteoma originating in the left mandibular condyle. After orthodontic treatment and surgical resection of the tumor and mandibular condyle, preservation and prosthetic treatment were undertaken. A well-balanced facial appearance and good occlusion were achieved.

Analysis of dental treatment performed by dental residents at General Dentistry Department of Tokyo Dental College Chiba Hospital over 6 years following introduction of mandatory dental clinical training system.

Six years have passed since the introduction of legislation mandating at least 1 year of clinical training for those who have passed the national dentist examination. To determine whether clinical training has been appropriately implemented at the General Dentistry Department of Tokyo Dental College Chiba Hospital, a managed-type clinical training facility, the number of patients treated and types of dental and dental technical work performed by dental residents trained by the department were summarized and analyzed. The number of patients treated per dental resident increased from 11 in 2006 to 15 in 2011. By treatment type, periodontic treatment was the most frequently performed throughout the study period, followed by endodontic treatment. Conservation treatment, prosthodontic treatment with crowns/bridges, and prosthodontic treatment with dentures were performed at a similar moderate frequency, while oral surgical treatment was performed least frequently throughout the study period. The frequency of periodontic treatment increased slightly, whereas that of endodontic treatment decreased slightly or remained almost unchanged after introduction of the mandatory clinical training system. When the distribution of dental treatment performed at our department was compared with that of dental treatment performed by general dentists across Japan in 2011, our department showed a slightly lower frequency of periodontic treatment and higher frequency of endodontic treatment than the national total, whereas the frequency of other types of treatment was similar between the two populations. These results demonstrated that appropriate clinical training has been provided by our department to meet the purpose of offering dentists the opportunity to acquire the basic diagnostic and treatment abilities that would enable them to provide appropriate treatment for injuries and diseases frequently encountered in daily practice. The study also revealed some problems, such as a decreasing number of residents engaging in dental technical work each year. For additional improvement in the quality of dental clinical training, more analyses are needed to further identify and address potential problems in the system.

Recent trends among dental residents at Tokyo Dental College.

Trends among dental residents at Tokyo Dental College between 2006, at which time clinical residency became mandatory, and 2011 were analyzed and the following results obtained. Almost all the eligible students from our school participated in the orientation seminar on dental residency programs. Although the number varied slightly by year, approximately 70 to 150 students from other schools also participated in these orientation seminars. Almost all the students from our school and 60 to 80% of those from other schools participating in the orientation seminar each year applied to sit the dental residency entrance examination. The number of candidates was highest in 2006 (318) and lowest in 2010 (205) (average: 248), and the applicant-to-seat ratio for residency was 1.59. The examination pass rate was 59.02%. Approximately 10% of the students from other schools were admitted as dental residents.

Character traits of malodor patients.

Many patients visit oral malodor clinics because of malodors which are brought to their attention by friends and family, or because they note the behavior of people around them, they suspect a problem and develop a fear of having an oral malodor. However, only around 30% of such patients actually have levels of malodor high enough to bother other people. Many patients exhibit halitophobia symptoms, which present as self-perception of malodor, and thus have a strong obsession about their smell which results in distress. Here, we carried out a study on 300 outpatients who visited the Tokyo Dental College Chiba Hospital Odor Clinic. We used the Tokyo University Egogram (TEG) to elucidate character traits of affected outpatients and compared the occurrence of TEG types in these patients with those of normal individuals. We discovered that 10.4% of patients were A-dominant type, which was 10.6% lower than the 21.0% of normal individuals. On the other hand, 18.4% of patients were N-type (NP high, FC low), which was 9.9% higher than the 8.5% of normal individuals. Results revealed that very few of the malodor outpatients exhibited the trait that shows intelligence, calm judgment, and self-affirmation, and as a result enjoy their life. Instead, many of these patients tended to show high levels of kindness and appeared to be holding themselves back and exercising patience.

Matching system within clinical training facilities group of clinical dental training in Tokyo Dental College Chiba Hospital.

Since clinical dental training became mandatory in April 2006, Tokyo Dental College Chiba Hospital has been offering the following two types of training system: 1. a single system, and 2. a clinical training facilities group system. The clinical training facilities group system consists of program B, in which residents are trained in a cooperation-type clinical training facility for 3-4 months, and program C, in which residents are trained in two cooperation-type clinical training facilities for 7-8 months. A matching system within the clinical training facilities group is applied to select and decide on the cooperation-type clinical training facility for residents. In this system, the ranking of resident candidates that a cooperation-type clinical training facility would like to accept, and the ranking of training facilities that candidates choose are matched. The present study investigated the matching system within the clinical training facilities group in 2006, 2007, and 2008. The rate of matching to their third choice was more than 90% in program B and about 80% in program C in each year, suggesting a high matching rate. The percentage of cooperation-type clinical training facilities accepting dental residents dropped due to a decrease in the number of such residents. The distribution of accepted cooperation-type clinical training facilities is concentrated in Chiba Prefecture where our hospital, the management-type clinical training facility, is located, and the neighboring prefectures.

Clinical care provided on post-graduate dental clinical training course at Tokyo Dental College Chiba Hospital, Department of General Dentistry.

Number of patients assigned to dental residents, course of treatment and number of various technical tasks performed as described in the Reports on Clinical Training of Dentists published by the Department of General Dentistry, Tokyo Dental College Chiba Hospital since its establishment in 2002 were compared between before (2003-2005) and after (2006-2007) clinical training was made mandatory, and the state of clinical residency evaluated. Number of patients assigned generally increased, and mean number of patients treated by each resident in 2007 (15.08) was approximately 2 times higher than that in 2003 (8.47). Total number of treatments was 1.38 times higher in 2007 than in 2003, and periodontal treatment accounted for approximately 40% of all treatment both before and after clinical training became mandatory. Number of technical tasks in 2004-2007 was less than half the peak in 2003. To further improve clinical training, evaluation and implementation of effective approaches is necessary to secure an adequate number of patients, widen the variety of cases and increase the number of technical tasks.

Clinical training in department of general dentistry at Tokyo Dental College Chiba Hospital.

A compulsory postgraduate clinical training program was established in April 2006 in Japan, and an applicants-only postgraduate training program 9 years ago at Tokyo Dental College. In addition, a training program was also established in the Department of General Dentistry at Tokyo Dental College Chiba Hospital in April 2002. The curriculum consists of training in the outpatient clinic and the following: 1) clinical training (preparation of written treatment plans, simulation practice, submission of evaluation sheets, and submission of training journals), 2) tutorials, and 3) case reports. In 1), trainees write treatment plans for new patients, discuss them with their instructor, perform simulation practice using dummies based on those discussions, submit evaluation sheets and training journals concerning treatment, and receive their instructor's assessment. In 2), trainees are divided into small groups, independently study themes they have chosen, and present the results. In 3), they orally report cases they have treated and receive evaluation by other trainees and instructors in general discussion meetings. In addition, a course was also established at the Department of General Dentistry, Tokyo Dental College Chiba Hospital in April 2002. We report the training curriculum of this course.