Moris Kleinhauz

Antecedents of Burning Mouth Syndrome (Glossodynia)-Recent Life Events vs. Psychopathologic Aspects

Burning mouth syndrome-BMS (also known as glossodynia, glossalgia, glossopyrosis, or oral dysesthesia)-primarily affects middle-aged women. Many possible etiologies have been proposed to account for the syndrome; most are still unsubstantiated. One possible suggested etiology involves the presence of psychological components. In this study, 45 BMS patients and 45 age-, sex-, ethnic origin-, socio-economic status-, and education-matched control subjects were evaluated for their psychopathologic profile and existence of recent life events. All subjects were requested to complete the SCL-90 questionnaire and a Recent Life Changes questionnaire. The BMS patients scored significantly higher on all SCL-90 scales except one. A MANOVA test to evaluate the overall group effect was significant at the 0.0001 level. No differences between groups were found for recent life events. The data suggest that although BMS patients are subjected to elevated psychological stress, initiation of BMS symptoms is not necessarily correlated with stressful life events.

Correlates of Success and Failure in Behavior Therapy for Dental Fear

Extreme dental fear and avoidance are universal problems, with severe adverse effects on the patients oral health. Although behavior modification techniques were shown to be effective in the treatment of this problem, their success is by no means absolute. In the present article, the SCL-90 questionnaire was used for development of possible predictive measures for success and failure of behavior modification as a treatment for dental fear. Patients who failed in treatment through behavior modification were found to score significantly higher on the global score of Positive Symptom Distress Index (p < 0.01) and on individual subscales of somatization (p < 0.02) and psychoticism (p < 0.05) than patients who were treated successfully. The predictive value of chosen SCL-90 scales was 71%. The results suggest that use of SCL-90 may be valuable for the prediction of success and failure of behavior modification as a treatment for dental fear and avoidance.

Treatment of Dental and Dental-Related Behavioral Dysfunctions in a Consultative Outpatient Clinic: A Preliminary Report

Abstract Dental and dental-related behavioral dysfunctions, such as dental anxiety or phobia, extreme gagging reflex, orofacial pain, rejection of prosthesis, glossal symptoms, and others, often cause severe problems during routine dental treatment. The multidisciplinary team of the Consultatory Outpatient Clinic for Behavioral Dysfunctions of the School of Dental Medicine, Tel-Aviv University, works toward creating a proper environment for the treatment of such patients and developing adequate therapeutic modalities. The philosophical approach of the treatment is reviewed, and various case histories are discussed.

Potential Deleterious Effects of Hypnosis in the Clinical Setting

The use of hypnosis for coping with a patients distress, anxiety, and/or pain during the performance of any clinical intervention may carry deleterious effects. This is especially true when the operator has not received a sufficiently broad training in all ramifications implicit in the use of hypnosis. Improper utilization of suggestive procedures and/or wording of suggestions, improper handling of spontaneous reactions, faulty dehypnotization, and the lack of adequate psychopathological knowledge by the hypnotist are only some of the factors that may be at the root of some consequences. Although these complications can occur in any clinical situation, we have chosen the dental setting for this discussion. Proper safeguards are recommended.

Hypnosis: A Tool for an Integrative Approach in the Treatment of the Gagging Reflex

Abstract The extreme exaggerated gag reflex can be an enormous obstacle to routine dental treatment. In some patients, extreme gagging may be a learned avoidance reaction; in others, it may act as a defense mechanism which inadequately compensates for an internal psychodynamic conflict. The most frequent areas of conflict encountered are those concerning the symbolic meaning of the mouth, fear of loss of control, and problems in the dependence/independence vector. In the Consultative Outpatient Clinic for Behavioral Dysfunctions at the School of Dental Medicine of Tel Aviv University, a multidisciplinary team of dentists, psychiatrists, and psychologists has been working on treatment modalities for such patients including hypnorelaxation and other hypnotic techniques. Hypnosis is incorporated in the framework of psycho-dynamic, behavioral, relaxation, and suggestive approaches that are integrated in the shaping of the therapeutic strategy. Clinical cases are described and treatment philosophies discussed.

Treatment of Cervical Headache with Hypnosis, Suggestive Therapy, and Relaxation Techniques

Abstract The effectiveness of combined hypnotic suggestive therapy and relaxation techniques in the control of cervical headache unaccompanied by discopatia or damage to the spinal cord was tested in two groups of 12 and 14 patients each. Each of the nine treatment sessions was 45 minutes long and was divided into three stages: (1) group therapy with nonspecific suggestions; (2) individual treatment with specific suggestions; and (3) repeat group therapy. In addition, patients were instructed to perform relaxation exercises twice daily at home (Schultz program). Of the 23 patients who completed treatment, all except one (95.66%) reported significant improvement in their condition. Follow-up after three and ten months indicated the continued effectiveness of the treatment: 52.17% of the 23 patients remained symptom-free and 43.49% showed mild improvement.

Prolonged Hypnosis with Individualized Therapy

A therapeutic approach is presented which involves the use of prolonged hypnosis for the treatment of diverse medical and/or psychological conditions, including intractable pain. This approach may be indicated either as a complementary tool used in conjunction with other treatment approaches or as the only method of intervention. The technique is based on achieving a prolonged hypnotic response, during which hypno-relaxation serves as the foundation for the delivery of an individualized therapeutic plan which includes self-hypnosis, suggestive procedures, metaphors, and constructive imagery techniques. In debilitated patients, medical supervision and nursing care are essential, and hospitalization is recommended if necessary. Theoretical assumptions underlying this approach are presented, and clinical implications are discussed. The method is illustrated through case presentations.