[Psychosomatic and psychopathological aspects in dental-orofacial medicine with special reference to old age]

The mouth is frequently affected by psychosomatic manifestations and communicative intimacy. Together with the age-related changes to central nervous system and organic changes in the chewing mechanism and oropharynx, these changes represent a failure of psychodynamic coping. With advanced age a "tempora minoris resistentiae" associates with a "locus minoris resistentiae". This etiopathogenetic constellation triggers psychosomatic conversion phenomena and "circumscribed" hypochondrias, as well as dysmorphobobic delusional developments, and hypochondric cyclothymic depressions. When there is an organic, nerval accentuation of these changes the symptoms often became chronic. It must be pointed out that a mimic disease often resembles a monosymptomatic masked depression, frequently resulting in false diagnosis. Contextual to anthropologic-psychologic dimensions of pain sensation, this work finally deals with the psychophysiologic complementary model of orofacial pain-dysfunction syndrome.