Die Psychosomatik des Orofacialsystems – Eine fachliche und ethische Herausforderung

摘要

The oral region is very specifically predestined – in terms of depth psychology as well as neuroanatomy – to serve as a field of projection for mental conflicts or psychological diseases. Although psychosomatic manifestations in the orofacial system have been very precisely described at various points in medical as well as philosophical literature from ancient to present times, it took nearly two and a half millennia for psychosomatic medicine to be recognized and accepted as a discipline within the body of knowledge known as scientific medicine. The focus of interest has been the so-called "somatization" of psychological problems via a somatic orofacial pathway. This includes anxieties which may be partly manifested in a masked form, as well as a series of diverse symptoms such as functional disorders or somatization by way of the psychosomatics of dentulous persons, psychosomatics of edentulous persons, and psychosomatics of tooth loss. Deficiencies in preliminary diagnostic procedures as well as deficiencies in primary care frequently lead to several years of painful lives as patients, involving numerous unsuccessful somatic or "alternative" therapy attempts and/or surgical procedures. The medical and ethical challenge for the practicing dentist include the following aspects: re-creating the doctor-patient relationship in such a way that the patient's psychological needs are given due attention to an appropriate and reasonable extent, recognizing one's own limitations as a dentist, and being receptive to any remarkable features in terms of one's own psychopathology.