Watanabe Motoko, Hong Chaoli, Liu Zhenyan, Takao Chihiro, Suga Takayuki, Tu Trang Thi Huyen, Yoshikawa Tatsuya, Takenoshita Miho, Sato Yusuke, Higashihori Norihisa, Moriyama Keiji, Motomura Haruhiko, Toyofuku Akira
Department of Psychosomatic Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.
Department of Basic Dental Sciences, Faculty of Odonto-Stomatology, University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam.
Front Psychiatry. 2021 Jul 21;12:701232. doi: 10.3389/fpsyt.2021.701232. eCollection 2021.
Phantom bite syndrome (PBS) is considered as the preoccupation with dental occlusion and the continual inability to adapt to changed occlusion. These patients constantly demand occlusal corrections and undergo extensive and excessive dental treatments. We present three cases with PBS-suspected iatrogenic concerns and the attribution to underlying psychosis. A 70-year-old female demanded orthodontic retreatment and complained of tightness and cramped sensation of teeth in the oral cavity, uncomfortable occlusion, and pain in her neck and legs that she was convinced was induced by orthodontic treatment. However, even earlier than the orthodontic treatment, she had kept doctor shopping for over 35 years, not merely dentists but also psychiatrists, neurologists, and so on; she was diagnosed with bipolar disorder. A 48-year-old female complained of malaligned improper occlusion and demanded occlusal adjustment. These symptoms occurred in the absence of a dental trigger and were worsened by orthodontic treatment. She underwent psychiatric treatment for 15 years with a diagnosis of bipolar disorder. A 38-year-old female, who had a history of schizophrenia for over 20 years, complained of occlusal discomfort and revisited with a complaint of abnormal occlusion due to excessive dental procedures. In the last two cases, requests for dental procedures had reduced owing to the collaboration between the psychiatrists and dentists. All the cases first visited our clinic following a succession of dental visits. They were strongly convinced that occlusal correction was the only solution to their symptoms, including the symptoms of discomfort in other body parts. Their misleading perceptions were uncorrectable, and repeated dental treatments exacerbated their complaints. Moreover, the dentists overlooked the psychotic histories of the patients, while the comorbid psychosis resulted in a strict demand for dental treatment by the patients. The presented PBS cases with psychosis suggest that repeated dental treatments and comorbid psychosis exacerbate PBS. Moreover, their persistent demands reflecting comorbid psychosis led dentists to perform numerous procedures. Early detection of underlying psychosis and the prompt collaboration between psychiatrists and dentists are integral to help prevent complications in PBS cases with psychosis.
幻咬综合征（PBS）被认为是对牙合关系过度关注且持续无法适应改变后的牙合关系。这些患者不断要求进行牙合调整，并接受广泛且过度的牙科治疗。我们报告了3例疑似医源性因素导致的幻咬综合征病例，并将其归因于潜在的精神病。一名70岁女性要求进行正畸再治疗，主诉口腔内牙齿有紧绷和挤压感、咬合不适，以及她坚信是由正畸治疗引起的颈部和腿部疼痛。然而，甚至在正畸治疗之前，她就已经在35年多的时间里不断更换医生，不仅看牙医，还看精神科医生、神经科医生等；她被诊断为双相情感障碍。一名48岁女性主诉牙列不齐和咬合不当，并要求进行咬合调整。这些症状在没有牙科诱因的情况下出现，并因正畸治疗而加重。她接受了15年的精神科治疗，被诊断为双相情感障碍。一名38岁女性有20多年的精神分裂症病史，主诉咬合不适，并因过度的牙科治疗复诊，抱怨咬合异常。在最后两例病例中，由于精神科医生和牙医的合作，对牙科治疗的要求有所减少。所有病例在一系列牙科就诊后首次来到我们的诊所。他们坚信咬合调整是解决其症状的唯一办法，包括身体其他部位的不适症状。他们的错误认知无法纠正，反复的牙科治疗加剧了他们的抱怨。此外，牙医忽视了患者的精神病史，而共病的精神病导致患者对牙科治疗有严格要求。所呈现的伴有精神病的幻咬综合征病例表明，反复的牙科治疗和共病的精神病会加重幻咬综合征。此外，他们反映共病精神病的持续要求导致牙医进行了大量治疗。早期发现潜在的精神病以及精神科医生和牙医的及时合作对于帮助预防伴有精神病的幻咬综合征病例的并发症至关重要。
