Basic & clinical knowledge of Psychosomatic medicine for the Dentist

Part of the dental outpatients require psychosomatic assessment and treatment. The main disorders are Glossodynia, Burning mouth syndrome, Atypicalodontalgia, Oral dysesthesia, Occlusal dysesthesia, Taste abnormality, Xerostomia, Halitophobia, Temporomandibular disorders (TMDs), etc.
These patients who we cannot find abnormal findings even if detail physical examinations (x-ray, saliva, blood examination etc.). On the other hand, if we can find abnormal findings but we cannot understand their severe pain and /or discomfort. We reported about 70% of these patients could diagnose Somatoform disorders by psychiatrist.
However, TMDs are slightly different. TMDs are disability of the TMJ and the masticatory muscles, and include pathologies in which obvious objective findings such as disc derangement and osteoarthritis.
Also there are many patients whose pain and mouth opening limited are closely related to psychosocial factors. For this reason, TMDs are considered to apply the Bio-psychosocial model, and both physical and mental correspondence are required.
Recently, these patients are being treated with psychotherapy such as Supportive psychotherapy (listening, acceptance, empathy, etc) and Cognitive behavioral therapy and psychotropic drugs.
We have proposed MW classification (by Miyaoka, Wake in 2001) as a guide for dentists to treat such patients. This classification is combines for dentists who do not have knowledge of psychiatric medicine.
In addition, we have advocated the importance of collaboration with a psychiatrist because some patients cannot be treated only by dentists.
This time, I will describe the basic and clinical knowledge of psychosomatic medicine necessary for the dentists.

Contents：
1. Psychosomatic diseases and Mental disorders
2. Diagnosis of Mental disorders
3. The most common TMDs
4. Complex cases of TMDs
5. Medical interview for dental patient with psychological problems
6. Psychosomatic classification & approach