Instructions for using Kampo medicine in dental clinical practice

Current status of Kampo (Japanese herbal) medicines in Japanese clinical practice guidelines

AimCoronavirus disease 2019 (COVID‐19) being declared a global public health emergency has become a significant challenge for all healthcare workers, including dentistry, recognised as a high‐risk profession during these times. This consensus statement aims to highlight and provide guidelines necessary to be implemented for a clinical dental practice.Materials and MethodsA total of nine conservative Dentists and Endodontists and one Oral and Maxillofacial Surgeon; with four panelists from government dental colleges, one each from the North, South, East and West India and six resource persons from private colleges in South India, all of them being clinicians and administrators practicing dentistry since the inception of the pandemic, collaborated in this consensus statement. The consensus statement was developed through a symposium conducted on the topics; general dental practice during COVID‐19 times, the importance of aerosols in clinical dental practice in the spread of COVID‐19, effective standard operating protocols for clinical dental practice and Institutional settings with scientific evidence‐based justifications, followed by a panel discussion with to devise mandatory protocols to be followed in clinical and institutional settings. The symposium was attended by 46 practitioners who participated in the deliberation.ResultsThis consensus statement provides clinicians and researchers with protocols for the dental practice, agreed upon by experts in the field. The Consensus Statement has been formulated according to the AGREE Reporting checklist for the formulation of guidelines.ConclusionThe experts and panelists reached a Consensus on the protocols and guidelines for the safe clinical and institutional dental practice.

BackgroundJapanese traditional (Kampo) medicines are commonly prescribed in clinical practice, with increasing evidence supporting their use during pregnancy. The efficacy and safety of Kampo medicines during pregnancy have increasingly been studied; however, evidence in support of these medicines is inadequate. Thus, we conducted a temporal trend analysis of Kampo medicine prescriptions to determine the Kampo medicines for which further safety evidence is required.MethodsAdministrative data from pregnant Japanese women who visited acute-care diagnosis procedure combination hospitals between January 1, 2014, and December 31, 2023, were used in this study. Therapeutic categories related to the Kyoto Encyclopedia of Genes and Genomes D numbers 5100 and 5200 were defined as target Kampo medicines. Annual prescription trends were calculated as proportions. Temporal trends in the proportion of prescriptions for each Kampo medicine were assessed using the Cochran–Armitage trend test. Statistical significance was set at p < 0.05.ResultsBetween 2014 and 2023, the proportion of Kampo medicine prescriptions increased significantly from 12.0% to 13.6% (p < 0.001). As of 2023, tokishakuyakusan (2.9%) was the most prescribed medication, followed by kakkonto (2.4%) and daikenchuto (2.0%). From 2014 to 2023, the proportions of tokishakuyakusan (3.3% to 2.9%) and kakkonto (2.4% to 2.4%) prescriptions showed no significant temporal changes (p = 0.07 and 0.36, respectively). In contrast, the proportion of daikenchuto prescriptions increased significantly from 0.8% to 2.0% (p < 0.001).ConclusionThe primary prescribed Kampo medicines were those with established safety evidence for use in pregnant women. The proportion of Kampo medicine prescriptions for pregnant women in Japan has increased over time, with tokishakuyakusan being the most prescribed during the study period.Supplementary InformationThe online version contains supplementary material available at 10.1186/s40780-025-00515-5.

A serious problem currently plaguing the medical field is the widening gap between academic medicine, which studies the features and causes of illness, and the medical care that patients desire. An example of this gap can be observed in the practice of psychotherapy, which is effective only for certain patients. Kampo medicine that combines the advantages of Western medicine with those of traditional Japanese medicine is currently undergoing a revival in the healthcare sector. The therapeutic policies underlying Kampo medicine are based on the physical constitution and current symptoms of each patient. For this reason, Kampo medicine is referred to as “tailor-made medicine” and has properties similar to “mind and body” or psychosomatic medicine. Some women exhibit multiple undefined stress-related symptoms during the peri-menopausal period. In order to accurately diagnose and provide patient-specific treatment, physicians should not only investigate the various stress factors in patients’ lives but should also provide a Sho, or a Kampo diagnosis. The therapeutic approach in Kampo medicine is aimed at harmonizing the mind, body, and spirit; this practice involves the use of narrative and holistic medication that treats the entire being of the patient, resulting in an increased number of specialized treatment plans.There are many Kampo prescriptions tailored to treat women who exhibit various stress-related symptoms. Both Kampo and psychosomatic medicine are based on the principles of narrative-based medicine, and by integrating these two medical systems, an ideal system can be devised to better cope with the various needs of patients. This new medical system established by integrating and harmonizing Western and Eastern medicine can be used for the treatment of women with stress-related symptoms.

Background: The COVID-19 pandemic has had profound effects on oral healthcare services globally. Objective: The main objective of this study was to determine the impact of COVID -19 pandemic lockdown on clinical dental practice in Nigeria and discuss how adverse impact could be mitigated. Methods: A cross-sectional self-administered pre-tested questionnaire-based survey of consenting dental practitioners from different States and geopolitical zones in Nigeria was employed for the study. Study participants were recruited by non-random convenience sampling. Data were analyzed using Statistical Package for Social Sciences (SPSS) version 20. Results: A total of 105 out of 142 respondents completed and returned the survey questionnaire giving a response rate of 74%. While only about 47% of respondents in public sector practice had their clinics shut down, all the respondents in private sector practice (100%) had their clinics closed down during the pandemic lockdown and the difference was statistically significant (p=0.000). Majority of respondents in private sector practice (65.4%) experienced income loss compared to 24.1% of respondents in public sector practice and this difference was also statistically significant (p=0.000). Conclusion: The COVID-19 pandemic was associated with government instituted lockdown periods with attendant scaling down or outright closure of dental clinical practices in Nigeria. The private sector practice bore the brunt of the adverse impacts of the pandemic lockdown in terms practice shutdowns and attendant economic losses. The adverse impact of COVID-19 pandemic lockdown on clinical dental practice could be mitigated by the incorporation of teledentistry into routine dental practice.

Traditional Japanese Kampo medicine has been widely used in clinical practice in Japan. Though it is a compulsory subject in Japanese medical schools, a standard educational program in Kampo medicine does not exist. Tohoku University has incorporated Kampo medicine into clinical education via didactic lectures since 2003; however, student evaluations have been lower for Kampo than for all other clinical specialties. We administered a questionnaire about a Kampo medicine course for fifth-year students from 2009 to 2012 and developed an educational program based on feedback obtained. The questionnaire consisted of nine questions (a clear training plan; opportunities for learning, practice, and patient contact; acquisition of medical knowledge and physical examination; learning professionalism; understanding the specialty; overall assessment) that were rated on a 5-point Likert scale along with open-ended questions about the course's strengths and weaknesses. The students responded to the questionnaire after clinical practice in Kampo medicine and other clinical specialty courses. Scores for Kampo medicine and the average of other clinical specialties were compared. All 389 students who participated in Kampo clinical practice answered the questionnaire. In 2009, scores for Kampo medicine for nine questions were lower than for the average of the other clinical specialties. After curriculum reformation involving hands-on training in 2012, all scores except "opportunities to learn about clinical cases" and "opportunities to practice involvement" were higher than the average of all other clinical specialties. In conclusion, we have successfully developed a Kampo medicine educational program for our university through this survey study.

Some 20 years ago, there was much speculation about improving oral health and the subsequent emergence of a vastly different type of clinical dental practice and vis versa. Few of the predictions have come to pass in Australia. Caries in children has somewhat rebounded, new treatment philosophies have not gained widespread adoption, and work effort in clinical dental practice remains dominated by diagnostic services, restorations and removable prosthodontics. What was behind the wayward predictions was a failure to separate the potency of 'care' from ability to 'cure' and an overestimation of the improvement in child oral health attributable to clinical dental services. If progress is to be made in improving oral health, an understanding of the mid- and upstream determinants of oral health needs to guide new population oral health activities. The contribution of clinical dental services to oral health should also be enhanced, but this should not divert attention from necessary population oral health activities to improve oral health.

Introduction to Kampo medicine for dental treatment - Oral pharmacotherapy that utilizes the advantages of Western and Kampo medicines.

Japan has created a unique culture, based on the influence and acceptance of Chinese culture since long years ago. This can also be said of medicine.Traditional medicine of Japan, is called “Kampo” medicine, which had been rearranged from Chinese medicine years ago suitable for the topography, climate, and race of the Japanese islands.The rearrangement of Chinese medicine to Japanese medicine started at the latter half of the 16th century. This took place during the Ming era when medical treatment was that of the Chin-Yuan era. In Japan, Li-Chu medicine was accepted among schools in medicine, and resulted in establishing the socalled Gosei-Ho school later.During the 18th century, there arose a movement to search for the origin of its medicine and to follow the original medical treatment. They finally attained the “Chang Han Lun” (“Shokan-Ron” in Japanese), established in the Heu-Han era in China. Many doctors read and studied that textbook and wrote their interpretation in their own books at that time. The medical treatment based on “Shokan-Ron” is called Ko-Ho school. Also the name Kampo, traditional Japanese medicine, may be implicated by the original medical treatment of the Han (Kam in Japanese) era.The unique point of Ko-Ho school in medical treatment of Japanese kampo medicine may be the restoration of the old medical textbook “Shokan-Ron” to apply for clinical practice. The following books have left great influence up to the present time, “Ruiju-ho” written by Tohdo Yoshimasu, “Fukusho-Kiran” (1800) and “Fukusho-Kiran yoku” (1809-1853) which contain the method for abdominal examination by palpitation so-called Fukushin, written by Bunrei Inada and Shukuko Wakuda, respectively.On the contrary, Ko-Ho school established a therapeutic method based on the readjustment of disorders mentioned in “Shokan-Ron” (Shokan namely febrile acute illness), followed by the concepts of Hyo-Ri, Kan-Netsu, and Kyo-Jitsu. Also, the school recalled Fukushin (abdominal sho), the sign of the abdominal wall, written in “Shokan-Ron” following the objective restoration. Based on its original Fukusho, other Fukushos were found and extended its original Fukusho, other Fukushos were found and extended its category to apply for other diseases. This has been handed down to the present era.My presentation on this theme, review of Japanese traditional medicine: Kampo, will be given more concretely.

Chapter 13 - Kampo Medicine for Renal Inflammatory Conditions

OBJECTIVE: To investigate the perception of general dentists regarding the over-prescription of antibiotics leading to Antimicrobial drug resistance in their clinical practice. METHODOLOGY: A cross-sectional study encompassing a personalized Likert scale questionnaire on factors influencing anti-microbial resistance in dental general practices was conducted on 196 practitioners. The questionnaire inquired about different factors which tend to affect the over-prescription of antibiotics and influence anti-microbial resistance. It was piloted on 30 participants before dissemination. RESULTS: Factors showing the highest level of agreement were "lack of patient awareness regarding use of antibiotics" (96.9%), "over-the-counter availability" (95.4%), and self-medication" (95.4%). General dental practitioners were overprescribing in their clinical setup due to improper guidelines (24.4%), for their patient's satisfaction (21.2%), and lack of knowledge (19.2%).33.5% of them stated that patients reporting to them were self-medicating and 27.2% found that their patients had a lack of awareness. CONCLUSIONS: This study concluded that all the factors were responsible for the Antimicrobial Drug Resistance phenomenon in clinical dental practice. However, the majority of the dentists were over-prescribing antibiotics due to improper guidelines, lack of knowledge, and for the patient's satisfaction. KEYWORDS: Antimicrobial Drug Resistance; Awareness; Antibiotics; Dental General Practices; Over-the-Counter Drugs.

Advancements in three-dimensional (3D) surface imaging and artificial intelligence (AI) are transforming dental research and clinical practice by providing high-precision, non-invasive tools for diagnosis, treatment planning, and outcome prediction. Traditional imaging methods, while effective, often lack dimensional detail and involve radiation exposure, whereas 3D imaging and AI offer improved safety and accuracy. This systematic review aims to evaluate the efficacy, safety, and practical applications of 3D surface imaging and AI technologies in dentistry, with a focus on orthodontics, maxillofacial surgery, and diagnostic practices.Following PRISMA guidelines, a comprehensive literature search was conducted across databases including PubMed, Cochrane Library, and Google Scholar. Studies were selected based on criteria such as population, intervention type, and outcome relevance. Data extraction and quality assessment were performed using standardized tools, and bias was evaluated with the Cochrane Risk of Bias Tool for randomized controlled trials and ROBINS-I for non-randomized studies.The review included 50 studies encompassing various imaging technologies (e.g., structured light scanning, laser scanning) and AI applications (e.g., convolutional neural networks). Findings indicate significant improvements in diagnostic accuracy, patient-specific modeling, and clinical workflow efficiency. Benefits include reduced radiation exposure, enhanced diagnostic precision, and increased affordability, although challenges remain in terms of operational complexity, cost, and potential AI biases.3D surface imaging and AI represent substantial advancements in dental practice, enabling precise diagnostics, tailored treatment, and improved patient outcomes. Future research should focus on refining AI algorithms, standardizing protocols, and developing accessible, portable 3D imaging devices to expand these technologies’ reach in clinical settings.

Subjective physical symptoms, irrespective of whether they are psychosomatic or not, do not always show obvious or reasonable signs in examinations, which often makes the differential diagnosis between somatoform disorders and actual physical disease difficult for psychiatrists. In addition, psychiatrists have few clues as to how to treat diverse "medically unexplained" symptoms. This difficulty has highlighted the need for alternative treatments for somatoform disorders. A 16-year-old high school baseball player was suffering from coxalgia and was unable to walk without crutches over 6 months. No painkiller was effective, the orthopedist found no remarkable signs in any examinations, and the patient was psychiatrically diagnosed with undifferentiated somatoform disorder. However, conventional therapies such as psychotherapy and selective serotonin reuptake inhibitors were ineffective. The therapeutic strategy was reevaluated from the perspective of Kampo diagnostics and keishikajutsubuto, a traditional Japanese herbal (Kampo) medicine, was chosen to be prescribed, which had a remarkable effect. His leg function improved within 2 weeks, and his pain and need for crutches disappeared in 6 weeks. Keishikajutsubuto has a different pain-relieving effect from conventional therapies. Kampo medicine thus provides an alternative approach for treating medically unexplained symptoms without strictly distinguishing between physically existing illness and psychologically caused somatoform disorders. Although details regarding the therapeutic mechanisms of Kampo medicine remain unclear and further studies are needed to increase its usefulness in clinical practice, Kampo medicine should be considered as an alternative treatment, especially for somatoform disorders.

Recognition and management of medical emergencies in dental practice is an essential topic area in dental education. However, limited published research on the topic is available from dental institutions in lower-middle income countries (LMICs). Therefore, the aim of this study was to evaluate the teaching methodologies and self-reported confidence of dental undergraduate (predoctoral) students in the management of medical emergencies likely to be encountered in clinical dental practice. After obtaining ethical approval, undergraduate dental students from six dental institutions were invited to participate in an online survey. Data were collected using a purposefully designed questionnaire which was pretested. The survey inventory explored multiple facets of teaching, training, and assessment of recognized medical emergencies in clinical dental practice. In addition, the questionnaire evaluated the self-reported confidence of the participants in the management of medical emergencies. Responses were received from 12 institutions with a population of 1402 students. A total of 727 participants responded to the survey, yielding a response rate of 51.85%. Marked variations in didactic and practical training of medical emergencies were reported. Overall, the participants reported between low and moderate confidence in the management of medical emergencies (α = 0.96). Analysis of variance showed significant variations in confidence based on demographic variables with male students, students aged over 26 years, interns, and those at private institutions reporting higher confidence (p < 0.05). Responses to open-ended items highlighted significant gaps in practical training of dental students on the management of medical emergencies. The results of this study highlight significant gaps in practical training of dental students on the management of medical emergencies. The participants expressed low to moderate confidence in their knowledge and skills to manage medical emergencies. The findings underscore the need to improve the teaching, training, and assessment of undergraduate students to improve their knowledge, skills, and confidence for prevention and enable them to manage medical emergencies promptly and effectively.

The role of Kampo (Japanese traditional herbal) medicine in psychosomatic medicine practice in Japan