Editorial
Volume 6 Issue 3 - 2016
Strategy of Psychosomatic Therapy. Considerations for Dentists
Tibor Karoly Fabian*
Private Dental Practitioner, Tandklinik Fabian (Tandlaege Tibor Karoly Fabian Aps), Odense, Denmark
*Corresponding Author: Tibor Karoly Fabian, Private Dental Practitioner, Tandklinik Fabian (Tandlaege Tibor Karoly Fabian Aps), Odense, Denmark.
Received: December 12, 2016; Published: December 13, 2016
Citation: Tibor Karoly Fabian. “Strategy of Psychosomatic Therapy. Considerations for Dentists”. EC Dental Science 6.3 (2016): 1336-1337.
Although dentistry is a profession dedicated to treat somatic disorders of the oral- and orofacial region primarily, there are certain oral/orofacial psychosomatic manifestations dentists should also deal with. This is because majority of psychosomatic dental patients refuse to accept psychological background of their symptoms, and instead of psychiatrists or psychotherapists, first they visit dentist and insist on the somatic origin of their symptoms. Therefore, a simple referral to psychiatrist and/or psychotherapist would not solve the problem in most cases, majority of patient would continue doing “dentist shopping” (i.e. frequent and useless change of dentist) with futile attempts at somatic therapies and/or surgical interventions. Consequently, an initial psychosomatic intervention is needed prior to definitive therapy, which is a scope of dental profession’s duty. The most important goals of this initial psychosomatic intervention are avoidance of further useless invasive dental treatment and motivation of patients to participate in a definitive psychosomatic therapy, which is the highest-level care of psychosomatic dental patients.
In contrast to the initial dental intervention the definitive psychosomatic therapy is clearly not a scope of every dentist’s duties. The definitive psychosomatic therapy should be carried out by specialized dental professionals as members of a specialized psychosomatic team including experienced dentists and other medical and psychological/psychotherapeutical professionals. This is because in most cases close collaboration with medical professionals (especially with psychiatrists and neurologists) and with psychologists/psychotherapists is clearly needed.
Gradual escalation of the psychosomatic treatment modalities and avoidance of irreversible forms of somatic treatment are “cornerstones” of both the initial psychosomatic intervention and the definitive psychosomatic therapy. Besides proper communication with the patient, several placebo and/or palliative methods (i.e. physiotherapies, medication, medicinal herb therapy, diet therapy, complementary/alternative medicine etc.) are frequently used for both the initial psychosomatic intervention and the definitive psychosomatic therapy. Use of certain psychotherapeutic approaches and administration of various mind-body therapies (i.e. relaxation, hypnosis, self-hypnosis, meditation, photo-acoustic stimulation, biofeedback etc.) are also frequently used especially for the definitive psychosomatic therapy.
The most frequent oral/orofacial psychosomatic symptoms are atypical facial pain, burning mouth syndrome, myofascial pain, temporomandibular dysfunction, bruxism and other parafunctions, gagging, psychogenic denture intolerance, psychogenic taste disorders, certain recurrent oral ulcerations or inflammations, some oral allergic reactions, psychogenic occlusal problems, tic, psychogenic salivation problems, and oral discomfort, but any other symptoms mimicking somatic symptoms of jaws, mouth and teeth may appear. The symptoms may appear singly or in combination. Since the appearing psychogenic symptoms may mimic a great variety of (most of) somatic symptoms of jaws, mouth and teeth, a clear-cut diagnosis and proper differential diagnosis could be rather difficult; even if a history of symptoms that are inconsistent with the physical findings and a history of a precipitating life event after which the symptom first appeared are hallmarks of such psychosomatic manifestations.
In early recognized cases the most important goal is the avoidance of further useless invasive dental treatment, especially because aggravation or spread of symptoms following invasive dental interventions may occur frequently. The prevention of symptom chronification is also crucial, because chronification (especially with prolonged unsuccessful somatic/operative dental therapy in the history) frequently render pain and other symptoms intractable. Prevention of symptom chronification can be carried out efficiently with the simple avoidance of repeating unsuccessful dental treatments in many cases, in other cases symptom-centered palliative methods, certain psychotherapeutic approaches and mind-body therapies should also be used.
In lately recognized cases the prognosis is rather poor primarily because of chronification processes leading to a relatively large amount of patients without any success or with suffering from several residual symptoms. Therefore, these patients should be made aware that it may not be possible to provide a permanent cure for their problem, but that they can learn to manage in a satisfactory manner. Home practice of most mind-body therapies, diet- and medicinal herb therapy as well as complementary and alternative medicine therapies regularly supervised by the specialized dentist (and/or other professionals) are good tools to manage such residual symptoms as well as to maintain clinical results and to prevent relapse (and/or exacerbation of symptoms).
The oral/orofacial psychosomatic manifestations are caused by either acute psychological stress conditions (i.e. existential trauma, workplace problems, relationship problems with the sexual partner etc.) or by chronic conditions like depression, neuroses, chronic anxiety, death anxiety, schizophrenic or paranoid reactions (etc.). The patients usually display a lower level of psychopathology comparing to psychiatric patients; but in some cases, severe psychopathologies including psychoses may also appear as a background of these manifestations. In such cases referral to psychiatrist and definitive psychiatric therapy (instead of psychosomatic therapy) is crucial; although a supportive type psychosomatic dental care may also be needed for stabilizing oral functions and oral health.
Acknowledgements
There are no acknowledgements.
Conflict of Interest
There is no financial interest or any conflict of interest to declare.
Copyright: © 2016 Tibor Karoly Fabian. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

PubMed Indexed Article


EC Pharmacology and Toxicology
LC-UV-MS and MS/MS Characterize Glutathione Reactivity with Different Isomers (2,2' and 2,4' vs. 4,4') of Methylene Diphenyl-Diisocyanate.

PMID: 31143884 [PubMed]

PMCID: PMC6536005


EC Pharmacology and Toxicology
Alzheimer's Pathogenesis, Metal-Mediated Redox Stress, and Potential Nanotheranostics.

PMID: 31565701 [PubMed]

PMCID: PMC6764777


EC Neurology
Differences in Rate of Cognitive Decline and Caregiver Burden between Alzheimer's Disease and Vascular Dementia: a Retrospective Study.

PMID: 27747317 [PubMed]

PMCID: PMC5065347


EC Pharmacology and Toxicology
Will Blockchain Technology Transform Healthcare and Biomedical Sciences?

PMID: 31460519 [PubMed]

PMCID: PMC6711478


EC Pharmacology and Toxicology
Is it a Prime Time for AI-powered Virtual Drug Screening?

PMID: 30215059 [PubMed]

PMCID: PMC6133253


EC Psychology and Psychiatry
Analysis of Evidence for the Combination of Pro-dopamine Regulator (KB220PAM) and Naltrexone to Prevent Opioid Use Disorder Relapse.

PMID: 30417173 [PubMed]

PMCID: PMC6226033


EC Anaesthesia
Arrest Under Anesthesia - What was the Culprit? A Case Report.

PMID: 30264037 [PubMed]

PMCID: PMC6155992


EC Orthopaedics
Distraction Implantation. A New Technique in Total Joint Arthroplasty and Direct Skeletal Attachment.

PMID: 30198026 [PubMed]

PMCID: PMC6124505


EC Pulmonology and Respiratory Medicine
Prevalence and factors associated with self-reported chronic obstructive pulmonary disease among adults aged 40-79: the National Health and Nutrition Examination Survey (NHANES) 2007-2012.

PMID: 30294723 [PubMed]

PMCID: PMC6169793


EC Dental Science
Important Dental Fiber-Reinforced Composite Molding Compound Breakthroughs

PMID: 29285526 [PubMed]

PMCID: PMC5743211


EC Microbiology
Prevalence of Intestinal Parasites Among HIV Infected and HIV Uninfected Patients Treated at the 1o De Maio Health Centre in Maputo, Mozambique

PMID: 29911204 [PubMed]

PMCID: PMC5999047


EC Microbiology
Macrophages and the Viral Dissemination Super Highway

PMID: 26949751 [PubMed]

PMCID: PMC4774560


EC Microbiology
The Microbiome, Antibiotics, and Health of the Pediatric Population.

PMID: 27390782 [PubMed]

PMCID: PMC4933318


EC Microbiology
Reactive Oxygen Species in HIV Infection

PMID: 28580453 [PubMed]

PMCID: PMC5450819


EC Microbiology
A Review of the CD4 T Cell Contribution to Lung Infection, Inflammation and Repair with a Focus on Wheeze and Asthma in the Pediatric Population

PMID: 26280024 [PubMed]

PMCID: PMC4533840


EC Neurology
Identifying Key Symptoms Differentiating Myalgic Encephalomyelitis and Chronic Fatigue Syndrome from Multiple Sclerosis

PMID: 28066845 [PubMed]

PMCID: PMC5214344


EC Pharmacology and Toxicology
Paradigm Shift is the Normal State of Pharmacology

PMID: 28936490 [PubMed]

PMCID: PMC5604476


EC Neurology
Examining those Meeting IOM Criteria Versus IOM Plus Fibromyalgia

PMID: 28713879 [PubMed]

PMCID: PMC5510658


EC Neurology
Unilateral Frontosphenoid Craniosynostosis: Case Report and a Review of the Literature

PMID: 28133641 [PubMed]

PMCID: PMC5267489


EC Ophthalmology
OCT-Angiography for Non-Invasive Monitoring of Neuronal and Vascular Structure in Mouse Retina: Implication for Characterization of Retinal Neurovascular Coupling

PMID: 29333536 [PubMed]

PMCID: PMC5766278


EC Neurology
Longer Duration of Downslope Treadmill Walking Induces Depression of H-Reflexes Measured during Standing and Walking.

PMID: 31032493 [PubMed]

PMCID: PMC6483108


EC Microbiology
Onchocerciasis in Mozambique: An Unknown Condition for Health Professionals.

PMID: 30957099 [PubMed]

PMCID: PMC6448571


EC Nutrition
Food Insecurity among Households with and without Podoconiosis in East and West Gojjam, Ethiopia.

PMID: 30101228 [PubMed]

PMCID: PMC6086333


EC Ophthalmology
REVIEW. +2 to +3 D. Reading Glasses to Prevent Myopia.

PMID: 31080964 [PubMed]

PMCID: PMC6508883


EC Gynaecology
Biomechanical Mapping of the Female Pelvic Floor: Uterine Prolapse Versus Normal Conditions.

PMID: 31093608 [PubMed]

PMCID: PMC6513001


EC Dental Science
Fiber-Reinforced Composites: A Breakthrough in Practical Clinical Applications with Advanced Wear Resistance for Dental Materials.

PMID: 31552397 [PubMed]

PMCID: PMC6758937


EC Microbiology
Neurocysticercosis in Child Bearing Women: An Overlooked Condition in Mozambique and a Potentially Missed Diagnosis in Women Presenting with Eclampsia.

PMID: 31681909 [PubMed]

PMCID: PMC6824723


EC Microbiology
Molecular Detection of Leptospira spp. in Rodents Trapped in the Mozambique Island City, Nampula Province, Mozambique.

PMID: 31681910 [PubMed]

PMCID: PMC6824726


EC Neurology
Endoplasmic Reticulum-Mitochondrial Cross-Talk in Neurodegenerative and Eye Diseases.

PMID: 31528859 [PubMed]

PMCID: PMC6746603


EC Psychology and Psychiatry
Can Chronic Consumption of Caffeine by Increasing D2/D3 Receptors Offer Benefit to Carriers of the DRD2 A1 Allele in Cocaine Abuse?

PMID: 31276119 [PubMed]

PMCID: PMC6604646


EC Anaesthesia
Real Time Locating Systems and sustainability of Perioperative Efficiency of Anesthesiologists.

PMID: 31406965 [PubMed]

PMCID: PMC6690616


EC Pharmacology and Toxicology
A Pilot STEM Curriculum Designed to Teach High School Students Concepts in Biochemical Engineering and Pharmacology.

PMID: 31517314 [PubMed]

PMCID: PMC6741290


EC Pharmacology and Toxicology
Toxic Mechanisms Underlying Motor Activity Changes Induced by a Mixture of Lead, Arsenic and Manganese.

PMID: 31633124 [PubMed]

PMCID: PMC6800226


EC Neurology
Research Volunteers' Attitudes Toward Chronic Fatigue Syndrome and Myalgic Encephalomyelitis.

PMID: 29662969 [PubMed]

PMCID: PMC5898812


EC Pharmacology and Toxicology
Hyperbaric Oxygen Therapy for Alzheimer's Disease.

PMID: 30215058 [PubMed]

PMCID: PMC6133268


News and Events


August Issue Release

We always feel pleasure to share our updates with you all. Here, notifying you that we have successfully released the August issue of respective journals and can be viewed in the current issue pages.

Submission Deadline for September Issue

Ecronicon delightfully welcomes all the authors around the globe for effective collaboration with an article submission for the September issue of respective journals. Submissions are accepted on/before August 15, 2020.

Certificate of Publication

Ecronicon honors with a "Publication Certificate" to the corresponding author by including the names of co-authors as a token of appreciation for publishing the work with our respective journals.

Best Article of the Issue

Editors of respective journals will always be very much interested in electing one Best Article after each issue release. The authors of the selected article will be honored with a "Best Article of the Issue" certificate.

Certifying for Review

Ecronicon certifies the Editors for their first review done towards the assigned article of the respective journals.

Latest Articles

The latest articles will be updated immediately on the articles in press page of the respective journals.

Immediate Assistance

The prime motto of this team is to clarify all the queries without any delay or hesitation to avoid the inconvenience. For immediate assistance on your queries please don't hesitate to drop an email to editor@ecronicon.uk