Abstract
We have recently observed an increase in the number of patients exhibiting oral psychosomatic disorders in the oro- maxillofacial area. The revision of dental fees by Japan's Ministry o Health, Labour and Welfare, in April, 2006, has caused dentists to refer such patients to a psychosomatic physician or psychiatrist when a fee is required for psychosomatic dental treatment. This revision appears to have denied dentists the discretion to treat oral psychosomatic disorders.
We report on patients of this type referred from dentistry to psychosomatic medicine since the 2006 revision of dental fees. The diagnoses and prognoses of 20 patients are reviewed in terms of both dental and psychosomatic medical aspects. This is followed by a discussion of salient points in the treatment of oral psychosomatic disorders. Ins conclusion, we assert, first, that dentists ought to have the independent discretionary power to treat oral psychosomatic disorders. Second, it is observed that broad and profound coverage of medical subjects, notably in the fields of internalmedicine, surgery, emergency medicine and psychosomatic medicine/psychiatry, needs to be provided during the undergraduate course of dental school. It is also noted, in this respect, that oral medicine is an important subject of study prior to the study of oral psychosomatic medicine. Third, dentists who have a broad grounding in both basic and oral medicine are the clinicians best placed to treat oral psychosomatic disorders. Regarding dentistry as a part of medicine, we propose drastic reform of the dental educational system in order to win back the independent discretionary power of dentists for the treatment of oral psychosomatic disorders.
We propose that departments of oral medicine and psychosomatic medicine should be established at dental schools. New systems are needed to assist the many patients who suffer from oral psychosomatic disorders.
