Psychosomatic problems in dentistry

Abstract

Many dental patients complain of oral symptoms after dental treatment, such as chronic pain or occlusal discomfort, for which the cause remains undetermined. These symptoms are often thought to be mental or emotional in origin, and patients are considered to have an "oral psychosomatic disorder". Representative medically unexplained oral symptoms/syndromes (MUOS) include burning mouth syndrome, atypical odontalgia, phantom bite syndrome, oral cenesthopathy, or halitophobia. With an increasing prevalence of these MUOS, dentists are being asked to develop new approaches to dental treatment, which include taking care of not only the patient's teeth but also the patient's suffering. Progress in the understanding of mind-body interactions will lead to investigations on the pathophysiology of MUOS and the development of new therapeutic approaches.

Keywords: Atypical odontalgia; Burning mouth syndrome; Halitophobia; Medically unexplained oral symptoms; Oral cenesthopathy; Phantom bite syndrome; Psychosomatic dentistry.

Fig. 1

Panoramic radiograph of a patient with phantom bite syndrome. Several dentists had treated a 40-year-old woman for her malocclusion over many years, performing not only prosthodontic procedures but also orthognathic surgery on her mandible. No one was able to treat her to her satisfaction

Fig. 2

Panoramic radiograph of a patient with phantom bite syndrome. This 70-year-old woman had been complaining of occlusal dyscomfort and had visited various dentists for “bite correction”, but had never finished the treatments