Objective: Glossodynia （burning mouth syndrome, BMS） has historically been regarded as a representative disorder within oral psychosomatic disorders. The “pain” associated with this condition is considerably diverse and complex, suggesting a multiplicity of neural circuitry required for its emergence and persistence, and a corresponding diversity and complexity of these circuits. When considering BMS from a neurofunctional perspective, it is crucial to recognize that different combinations of brain activation pathways can produce identical symptoms. The unambiguous causality of the cerebral basis on oral symptoms can be conceptualized as the “distance from the brain.” Based on this keyword, this study examined the extent to which the “pain” of BMS and its corresponding neural circuits are specifically linked.
Study Selection: We expanded our scope to encompass “mimicking non-painful oral symptoms” of BMS, such as dry mouth sensation and denture intolerance. We reconsidered the neurobiological basis of BMS and more practical approaches to understanding its pathophysiology by comparing neuroimaging studies and clinical psychopharmacological studies across various oral psychosomatic disorders.
Results: Results from functional neuroimaging studies suggested that, despite individual variations, oral cenesthopathy （OC） is considerably “closer to the brain” than phantom bite syndrome （PBS）, whereas BMS is considered to be unexpectedly “distant from the brain.” Furthermore, based on responsiveness to antidepressants, it is suggested that the “distance from the brain,” from a chemical perspective, may be closer in the following order: BMS < PBS < OC.
Conclusion: Even with significant heterogeneity in the underlying anatomical neural circuitry of BMS, further elucidation of its pathophysiology through the perspective of chemical neurotransmitter systems may advance our understanding and provide critical clues for establishing more effective treatment strategies.

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Recently, the importance of psychological well-being has been increasingly recognized in dentistry. The “Model Core Curriculum for Dental Education in Japan, AY 2022 Revision,” issued by the Ministry of Education, Culture, Sports, Science and Technology, highlights the necessity of understanding and treating mental and psychosomatic disorders in dental practice. In line with this, psychiatry and psychosomatic dentistry lectures have been introduced in dental school curricula. However, the awareness, knowledge and understanding of students in this field remain unclear. To assess this, pre- and post-lecture surveys were conducted among third-year dental students at Matsumoto Dental University to evaluate their awareness, knowledge and understanding of psychosomatic dentistry. The results indicated significant improvements in students’ knowledge acquisition and deepening of understanding following the lectures. In addition, increased interest in psychosomatic dentistry and greater motivation to treat patients with dental psychosomatic disorders were observed after the lectures. This study highlights the significance of lectures on psychosomatic dentistry in undergraduate dental education.

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Objective: To mark the 40th anniversary of the Japanese Society of Psychosomatic Dentistry （JSPD）, this study performed a bibliometric analysis of the Society’s scholarly output to clarify long-term trends, major contributors, thematic transitions, and future challenges.
Materials and Methods: We analyzed all articles published in the Society’s journal from Volume 1 to Volume 39, excluding non-scholarly content such as editorials, invited lectures, symposium records, and administrative reports. We also analyzed general presentations （oral and poster） from the 1st to the 40th annual meetings based on programs and abstract books. For each item, the first author/presenter and primary affiliation were extracted. To capture historical changes, the journal and meeting data were each summarized across four periods. Keywords assigned to journal articles were consolidated by meaning and their frequencies were examined over time.
Results: A total of 511 journal articles and 1,348 meeting presentations were included. Journal publications increased in the early years and peaked in the second period, followed by a marked decline thereafter, whereas the overall number of meeting presentations remained relatively stable across the 40-year span. Scholarly output was concentrated in several institutions; Tokyo Medical and Dental University （currently, Institute of Science Tokyo） contributed consistently high numbers of both journal articles and meeting presentations. Keyword analysis suggested a shift in major topics from early interests （e.g., halitosis and temporomandibular disorders） toward persistent and emerging themes such as burning mouth syndrome, psychosomatic dental/oral disorders, atypical odontalgia, occlusal discomfort/phantom bite syndrome, oral cenesthopathy, and evolving treatment approaches （e.g., cognitive-behavioral therapy and specific pharmacotherapies）.
Conclusions: Over four decades, the JSPD’s academic activities have been driven by a limited number of leading institutions and researchers. The recent decrease in journal publications represents a key challenge. Strengthening the pathway from conference presentations to peer-reviewed papers, fostering early-career investigators, and enhancing the dissemination of clinically grounded knowledge may support the sustainable growth of psychosomatic dentistry in Japan.

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Introduction: Hypersensitivity, which is one of the specific features in neuro­developmental disorders, besides restrictive persistence and impulsivity, occasionally causes daily distressing problems. This case report presents an adult patient with phantom bite syndrome （PBS）, involving these developmental traits, who experienced strong occlusal discomfort and struggled with dental procedures, but achieved the final prosthesis following improvement of PBS through cooperative treatment with his psychiatrist and general dentist managed by our department.
Case presentation: A 42-year-old man complained of unpleasant occlusion and squeezing sensations in his dental bridge over the left lower incisors induced by its reproduction in X－3 year. Several adjustments or reproductions never improved his sensation. The patient was referred to our department, reporting that “I cannot bear it any longer, it is beyond my patience,” “Please remove it as soon as possible,” and repeatedly demanded dental procedures in an irritated strong tone. His psychiatric treatment was not stable due to wandering psychiatrists; the latest psychiatrist considered his developmental traits. We diagnosed him with PBS. Following the additional prescription of Methylphenidate and Aripiprazole by his psychiatrist, his tone during consultations gradually became gentler, and he increasingly listened attentively to our medical explanations. His psychiatric assessment noted that his daily irritability had subsided, his speech was no longer verbose but relatively composed, and his behavior also became settled. In May X year, dental procedures restarted after prudent consultation, considering his neurodevelopmental traits, with his general dentist. Occlusal discomfort was observed with the temporary dental bridge, but irritability or strong demands for further dental procedures were not observed. In January X+1 year, the final prosthesis was set and was bearable. His occlusal discomfort was more ameliorated in April with contentious psychiatric treatment. No further occlusal complaint was found; consequently, both dental and psychiatric prognoses have been good in August X+1 year.
Conclusion: The present case suggests that hypersensitivity and persistence of occlusal sensations in PBS were related to developmental traits. Moreover, the prudent and precise collaboration with his psychiatrist and general dentist, connected by our department, might have contributed to completing the dental procedures with a better prognosis.

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Atypical odontalgia is a chronic orofacial pain condition frequently encountered in psychosomatic dental practice and is often difficult to distinguish from odontogenic pain. Although pharmacological treatments, particularly antidepressants, have been reported to be effective, clinical responses and optimal strategies vary among patients. In contrast to burning mouth syndrome, patients with atypical odontalgia are often perceived to exhibit distinctive personality traits, including strong dissatisfaction toward previous dental treatment, yet systematic evaluation of personality characteristics has rarely been addressed in the literature.
We report a case of a 52-year-old man with atypical odontalgia in whom symptom stabilization was achieved through a combination of pharmacological treatment with aripiprazole and personality-oriented intervention using the Picture-Frustration Study （P-F Study）. Despite relatively low pain intensity on the Visual Analogue Scale, the patient showed high scores on the Pain Catastrophizing Scale and the Injustice Experience Questionnaire, suggesting that cognitive and emotional factors, rather than pain severity itself, played a central role in his clinical suffering. Aripiprazole led to a marked reduction in ruminative thinking and stabilization of pain, although residual discomfort persisted.
The P-F Study was subsequently administered to explore the patient’s characteristic responses to frustrating situations. The results revealed low frequencies of impunitive and non-punitive responses, indicating a tendency to express dissatisfaction and disappointment toward others or oneself with limited tolerance for ambiguity. Sharing these findings with the patient facilitated objective self-reflection and promoted a deeper understanding of how his cognitive and behavioral tendencies might contribute to symptom persistence. Following this process, residual discomfort gradually subsided, and pharmacological treatment was successfully tapered without relapse.
To our knowledge, this is the first report describing the use of the P-F Study in a patient with atypical odontalgia. Although generalization from a single case should be approached with caution, this case suggests that evaluating personality traits and cognitive response patterns may provide meaningful therapeutic opportunities, particularly when pharmacological treatment alone is insufficient. Furthermore, the timing of psychological assessment appears to be critical, as such interventions may be most effective after initial symptom stabilization. This case highlights the importance of patient understanding and acceptance of the treatment model in the management of atypical odontalgia and underscores the potential role of personality-informed approaches in psychosomatic dental care.

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Halitophobia is characterized by the persistent preoccupation and belief of bad breath despite the absence of objectively perceptible halitosis. Initiating and maintaining treatment for halitophobia is often challenging and requires a long-term approach, in which establishing rapport is crucial. We report a case of halitophobia in which early social reintegration was achieved by “description of impressions.”
A 28-year-old woman presented with a chief complaint of halitosis. She had become concerned about halitosis since starting orthodontic treatment three years before. Despite consultations with a physician, a private dental clinic, and an oral surgeon, no abnormal findings were identified. She felt compelled to brush her teeth frequently, even while working as a nursing assistant, which eventually led her to resign from her job and withdraw socially. She was prescribed various psychotropic medications by a psychiatrist, but she experienced no subjective improvement. She discontinued them and visited our hospital.
Her oral hygiene was good, and no objective halitosis was detected, therefore she was diagnosed with halitophobia. During her initial consultation, we focused on her current symptoms associated with distress through acceptance and attentive listening. We explained the relationship between halitosis and anthropophobia and suggested psychotropic medication to alleviate interpersonal fear. At each follow-up visit, supportive psychotherapy was provided and we tried to pick up her experience based on “description of impressions,” and gave reassurance that her symptoms were getting better.
Amitriptyline was prescribed at 10mg/day and increased to 20mg/day. She began vocational rehabilitation in the fourth week, and obtained a medical administrative qualification and subsequently commenced job-hunting in the 16th week. By the 21st week, she was employed as a medical administrative assistant at a clinic.
In this case, halitophobia gradually diminished through supportive psychotherapy including accepting her symptoms and reassurance of her improvement during follow-up outpatient treatment from the first visit. “Description of impressions” allowed her to share and confirm her experience, and the accumulation of this supportive psychotherapy led to awareness and solidification of her own changes, which likely led to a recovery of her confidence and early social reintegration.

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