Multidisciplinary management of chronic atypical facial pain of psychogenic origin: A unique case report

Abstract

Aim: The following case report discusses the diagnostic dilemma presented by and the multidisciplinary management of a patient with chronic atypical facial pain of psychogenic origin. Background: Though oral health care professionals are primarily concerned with the treatment of somatic disorders of the orofacial region, there remains a particularly challenging need to identify, diagnose and treat various psychological and psychosomatic symptoms. Case description: This case report describes the management of a 13-year-old male patient with the chief complaint of pain and discoloration of the skin over the right side of the face for the last 5 months, who also demonstrated symptoms of chronic anxiety and social withdrawal. As no associated soft or hard tissue abnormalities could be identified, a diagnosis of atypical/psychogenic facial pain was established. The skin discoloration was diagnosed as pityriasis versicolor and treatment for the same commenced. Following the complete resolution of the skin lesion the patient was asymptomatic, and no longer anxious. Conclusion: Our role as dentists is to mitigate the suffering of patients and to improve their quality of life in collaboration with specialists in psychosomatic medicine. Clinical significance: This case highlights that dentists must be trained to treat not only teeth, but also attend to patient’s psychosomatic symptoms.