Abstract
Patients: A 27-year-old female complained of pain and paresthesia of upper and lower anterior teeth that began suddenly after dental treatment. After counseling and clinical examination, both somatic disorders (hyperesthesia and temporomandibular disorders) and psychosomatic disorders were suspected. Hyperesthesia and temporomandibular disorders were managed by conservative treatment and counseling, respectively. Regarding psychosomatic disorders, I referred her to a psychologist and we managed together. Our cooperative consultation, psychotherapy and pharmachological management (antidepressants, antianxiety drug) relieved her symptoms in the short term.
Discussion: If we could find no objective finding which explains the subjective symptoms, the patients’ clinical conditions are explained, followed by conservative treatment, rather than actively providing surgical treatment. If necessary, the patients are suggested to consult a psychiatrist for collaboration treatment.
Conclusion: Dentists need knowledge and skill of oral and psychosomatic medicine. The cooperative consultation and treatment with a psychiatrist called “liaison” is necessary for assessment, diagnosis and management of orofacial pain. Around the world, dentists became participants in multidisciplinary approaches to studying these complicated orofacial pains, and multiple evaluation and management are important for patients with complicated conditions as well. Since 2012, the Orofacial Pain Clinic in Nagasaki University Hospital has developed a liaison program pairing dentists with a psychiatrist to treat complicated conditions. (206)
