Citation

Mashu S, Suzuki N, Kawashima M, Motohashi K, Umino M. Journal of Japanese Dental Society of Anesthesiology 1998; 26(2): 254-257.

Copyright

(Copyright © 1998)

DOI

unavailable

PMID

unavailable

Abstract

A patient with severe dental pain recovered completely on the opportunity of marriage. The patient was a 24-year old female. She complained of pain in the anterior teeth and gingiva of the lower jaw. Root canal treatment, stellate ganglion block and psychotherapy had already been attempted for pain relief at other clinics, but the pain had not been relieved by these treatments. Her lower right lateral incisor had been extracted and restored with a bridge including the right canine and central incisor as the abutment teeth. The left central and lateral incisors had been restored with facing cast crowns; these teeth had already undergone root canal filling. There were no other abnormal findings except pain in this area, but she looked pale and was cold especially in her lower extremities. She lived with her father, and her parents had divorced. Her father was under treatment for epilepsy. Her mother had attempted suicide and was in hospital for mental disease. The State Trait Anxiety Inventory, the Self Depression Scale, and Toho Medical Index revealed that she was in a highly anxious state, a moderately depressive state, and was neurotic. We diagnosed her pain as atypical facial pain and treated her with brief psychotherapy, oral administration of maprotiline, amitriptyline, etizolam, and kanpo medicine such as shigyaku san and saiko keishi to, electroacupuncture therapy with low frequency stimulation, and warming of cold lower legs (Fig. 1). She gradually looked better and brighter and was relieved from coldness. Her pain also gradually weakened. We stopped electroacupuncture therapy when she requested it for her pregnancy, but we continued brief psychotherapy. After her engagement and marriage, she complained of neither pain nor discomfort in the anterior teeth of the lower jaw, so we terminated her treatment. This patient had fallen into a vicious circle between the depressive and anxious state and toothache. When she developed a relationship with a dependable man who would get married with her, her mental condition became stable. Pregnancy is associated with increases in estrogen levels and may decrease pain activity. Apparently, the change in her circumstances broke the vicious circle and relieved her from the pain.

Language: ja

Keywords

Acupuncture therapy; amitriptyline; analgesia; Anxiety; anxiety neurosis; article; Brief psychotherapy; case report; depression; electroacupuncture; estrogen activity; etizolam; female; human; intractable pain; maprotiline; Marriage; oral drug administration; pain threshold; pregnancy; psychotherapy; social aspect; tooth pain; Toothache; treatment failure