Читать книгу Dental Neuroimaging - Chia-shu Lin - Страница 22

The first evidence of the alliance between dentistry and brain science exists in an article published 130 years ago entitled Reflex Neurosis in Relation to Dental Pathology. The author mentioned that ‘… pain in a tooth is not indicative of the source of trouble, … The cause may be remote or in another tooth’ (Hayes 1889), a phenomenon now we may consider as heterotopic pain. Subsequently, the author put forward some insightful speculation on orofacial pain:

Figure 1.1 The association between the brain and the stomatognathic system. The traditional perspective highlights the brain as a ‘systemic factor’ associated with oral health, just like the factors related to other body systems. The functional perspective highlights that the brain and mental functions guided by the brain play an essential role in stomatognathic functions.

Cerebral diseases, for example, insanity, softening of the brain, tumors and inflammation may produce odontalgia, but clinical reports reveal comparatively few, inasmuch owing to their obscurity positive diagnosis is often rendered difficult.

(Hayes 1889)

Though not scientifically accurate from the modern view, the statement points out the complex association between the brain and orofacial pain, which has confused dentists for more than one century. The alliance becomes cemented due to the challenge of treating orofacial pain, and new technologies, including neuroimaging, have provided new insights into this field (see Chapter 6). Our second evidence comes from the issues of infection control, especially the brain abscess secondary to dental infection. At present, dentists have been highly aware of infection control within the oral cavity. However, new challenges have emerged, such as the recent debates on the neuroinflammatory mechanisms that may underlie the link between neurodegenerative disorders and periodontal diseases (see Chapter 7). Finally, the third evidence of the old alliance has an even longer history. Back in 1790, when the terms ‘brain science’ and ‘dentistry’ have not yet popularized, in an article entitled ‘Pathological Observations on the Brain’, the author reported a potential association between epileptic signs and symptoms and irregular behaviour in eating and drinking (Anderson 1790). The finding echoes the link between the brain and oral sensorimotor functions, extensively studied in animal research (Lund 1991). New issues have emerged in modern days. For example, can older individuals be benefited from oral functional training to improve mastication and swallowing (Sessle 2019)? Can patients with neurodegenerative disorders, who have deficits in mental functions, also improve their oral functions? There are more challenges to meet for the old alliance between dentistry and brain science.