The Inconspicuous Link: Psychosomatic Disorders and Oral Health – A Review

@ 2025 | PUBLISHED BY GJR PUBLICATION, INDIA 15 Global Journal of Research in Dental Sciences ISSN: 2583-2840 (Online) Volume 05 | Issue 06 | Nov. – Dec. | 2025 Journal homepage: https://gjrpublication.com/gjrds/ Review Article The Inconspicuous Link: Psychosomatic Disorders and Oral Health – A Review 1 Sandhyadurai, 2 Ashwinnathan, 3 Divya Vinayachandran* 1,2 Undergraduate Student, Department of Oral Medicine and Radiology, SRM Kattankulathur Dental College and Hospital, Faculty of Medicine and Health Sciences, SRM Institute of Science and Technology, Kattankulathur, Chengalpattu, Tamilnadu, India. 3 Associate Professor and HOD, Department of Oral Medicine and Radiology, SRM Kattankulathur Dental College and Hospital, Faculty of Medicine and Health Sciences, SRM Institute of Science and Technology, Kattankulathur, Chengalpattu, Tamilnadu, India. *Corresponding author: Divya Vinayachandran Associate Professor and HOD, Department of Oral Medicine and Radiology, SRM Kattankulathur Dental College and Hospital, Faculty of Medicine and Health Sciences, SRM Institute of Science and Technology, Kattankulathur, Chengalpattu, Tamilnadu, India. ORCID ID: 0000-0001-7042-6435 INTRODUCTION "Somatic" refers to the observed biological or physical symptoms and indications, whereas "psycho" or "psyche" refers to emotional or intellectual components. The mind and body are closely related to and impact each other. Abnormal stimulation of the immune system, endocrine system, and autonomic nervous system results in extreme emotional overload and physiological disruption1. Disruption of typically occurring key physiological mechanisms and unique interactions between many biological systems distinguish psychosomatic disorders. Unpleasant responses to psychological causes result in psychosomatic diseases. There is a connection between potential physical signs of psychological origin and the oral cavity. mouth symptoms, including severe palatal erosion, facial pain, mouth dysaesthesia, and self-harm, might be the initial or only indications of mental health disorders. Psychopathologic symptoms appear in an estimated 30% of dental patients, and they frequently go unnoticed and neglected. In a similar vein, oral health issues can affect an individual's mental and social health1. Managing psychosomatic oral conditions effectively requires a comprehensive strategy that integrates medication, behavioural therapy, stress reduction methods, and access to psychosocial support systems.2 Abstract Among the various prominent conditions of the mind in regular practice are psychosomatic or somatoform disorders. The adverse consequences of certain psychological stimuli on the organic regulation of tissues can result in psychosomatic conditions. Psychosomatic disorders are bodily imbalances that are profoundly affected by emotional factors. Multiple mental disorders can affect the orofacial region, but because of the limited extent of their highlighting symptoms, they are very often bypassed. We did our best to emphasize the linked nature between orofacial conditions and psychosomatic factors which include stress, anxiety, and depression. This article explores the intricate relationship between psychosomatic disorders and oral health, emphasizing how psychological stressors manifest in oral pathologies and influence overall well-being. It delves into the biopsychosocial model, highlighting the interplay of psychological, social, and biological factors in shaping an individual's vulnerability to both oral and systemic diseases. Keywords: Psychosomatic disorders, Oral health, Mind-body connection, Dental psychology, Stress, Anxiety, Depression. Global J Res Dent Sci. 2025; 5(6), 15-23 @ 2025 | PUBLISHED BY GJR PUBLICATION, INDIA 16 CLASSIFICATION OF PSYCHOSOMATIC DISORDERS 2 (Table 1) CATEGORY DISORDERS Disorders Related to Pain ✓ Myofascial pain dysfunction syndrome (MPDS) ✓ Atypical facial pain ✓ Atypical odontogenic pain ✓ Phantom pain Disorders Related to Altered Oral Sensation ✓ Burning mouth syndrome ✓ Idiopathic Xerostomia ✓ Idiopathic Dysgeusia ✓ Glossodynia ✓ Glossopyrosis Disorders Induced by Neurotic Habits ✓ Diseases caused by bruxism ✓ Biting of oral mucosa Autoimmune Disorders ✓ Oral lichen planus ✓ Recurrent aphthous stomatitis ✓ Psoriasis ✓ Mucous membrane pemphigoid ✓ Erythema multiforme Disorders Caused by Altered Perception of Dentofacial Form and Function ✓ Body dysmorphic disorder Miscellaneous ✓ Recurrent herpes labialis ✓ Necrotising ulcerative gingivostomatitis ✓ Chronic periodontal diseases ✓ Cancerophobia ✓ Delusional halitosis DISORDERS RELATED TO PAIN 1)Myofascial pain dysfunction syndrome (MPDS) Also referred to as masticatory myalgia syndrome or temporomandibular joint pain dysfunction syndrome3. The primary reasons are psychological problems. According to Schwartz, clenching and grinding behaviours that resulted in masticatory muscle spasms may have their origins in stress. The symptoms of MPDS include soreness in one or more mastication muscles following palpation, limitation or deviation of the mandible upon opening, and one-sided dull discomfort in the ear and pre-auricular areas that gets worse upon waking up. A supplementary function is played by occlusal abnormalities2.Because attrition of all teeth diminishes the vertical dimension, occlusal splints were created to maintain the vertical dimension and reinstate jaw function3. 2) Atypical facial pain Atypical facial pain was initially documented in 1924. Facial discomfort is commonly described as burning, aching, or cramping. It usually starts on one side of the face, close to the trigeminal nerve, and moves to the back of the head or upper neck. There is ineffective localization of the pain. The regions supplied by the second and third cranial nerves, as well as the fifth and ninth cranial nerves, may be impacted. Bilateral soreness and discomfort are possible at times.2Overfilling and apical fenestration may cause facial pain.4 3) Atypical Odontalgia McElin and Horton originally documented atypical odontalgia in 1947. It develops as pain where the tooth has been extracted5. Atypical odontalgia impacts 10% individuals and 50% of the elderly population. It is more prevalent in females. Trauma and psychological conditions are major implicated factors. Etiology: Psychological, Deafferentation,Vascular or neurovascular2 4) Phantom pain The phrase "phantom tooth pain" was coined by Marbach in 1978. Phantom bite syndrome, intraoral stump pain, and phantom tooth pain are common terms used to explain the causes and symptoms of orofacial phantom pain in the mouth. (4) According to Marbach, phantom tooth pain is a condition that can arise during pulp extraction, apicoectomy, or tooth extraction and is distinguished by persistent discomfort or paraesthesia in teeth and other oral tissues. Physical damage, Global J Res Dent Sci. 2025; 5(6), 15-23 @ 2025 | PUBLISHED BY GJR PUBLICATION, INDIA 17 even typical inferior alveolar nerve blocks, might induce nerve injury if the needle punctures the nerve sheath6. Phantom tooth pain (PTP) is classified as a deafferentation syndrome characterized by persistent odontogenic pain localized to teeth that have undergone neural denervation, such as following endodontic treatment, or to regions previously occupied by extracted teeth. This pain frequently radiates to adjacent facial structures contiguous with the deafferented tissues7. ALTERED ORAL SENSATION BASED DISORDERS 1) Burning Mouth Syndrome (BMS) A significant proportion of Burning Mouth Syndrome (BMS) cases are attributed to psychogenic origins, with emotional conflicts, sexual maladjustment, and cherophobia being among the most frequently implicated psychological factor8. Burning mouth syndrome, the International Headache Society first recognized the syndrome as a condition in 20046. It is a condition marked by a persistent intraoral burning sensation that has no apparent medical or dental etiology. Somatization, anxiety, sadness, and poor life quality are all commonly linked with the condition4. Burning is typically bilateral and symmetrical, and it doesn’t correspond to the anatomical parts of a peripheral sensory nerve. Patients with burning mouth syndrome frequently report subjective symptoms such as xerostomia, dysgeusia, sialorrhea, and glossopharyngeal hystericus. halitosis or dysphagia. Pain happens spontaneously, bilaterally, and without any identifiable causes. Pain can be indicated firmly within the mucosa for at least a period of 4-6 months, with a varying degree that changes throughout the day2. 2) Idiopathic xerostomia Xerostomia is a condition defined by defects in the quality and quantity of saliva, together known as salivary hypofunction4. Xerostomia is common in postmenopausal women. According to Manson and Glen, as saliva secretion is regulated by the neurological system and are subjected to reflex activation from various sources which are physical and psychological, xerostomia can be a result from four fundamental causes, of which factors impacting the salivary centre are major causes, which includes: Various emotions, organic diseases (like brain tumour, Parkinson’s disease) and medications. 3) Idiopathic dysgeusia Defined as distorted gustatory perception, the absence of stimulation. These are often distinguished by a bitter, sour, or metallic flavor. The link between stress and taste may have a same mechanism, as increased activation of many neural pathways influences stress and appetite regulation2. Dysgeusia is a common side effect that can negatively affect quality of life, resulting from cancer treatment like chemotherapy, radiation, or combination therapy4.The stress hormones may also influence one's sense of taste5. 4) Glossodynia A form of psychosomatic illness that causes the patient to endure persistent discomfort on the tongue's surface. The conditions burning mouth syndrome (BMS), Candida-associated lesions (CAL), or a combination of both are typically linked to it4. Glossodynia is a neuropathic pain disorder predominantly observed in women of middle age and older, particularly within a demographic considered at elevated risk for hormone-related malignancies. The condition is frequently exacerbated by hormonal fluctuations associated with menopause and postmenopausal states, as well as by psychological factors such as stress, anxiety, and emotional distress, which contribute to the persistence and intensification of symptoms9. 5) Glossopyrosis The burning feeling on the tongue is known as glossopyrosis. Usually, burning mouth syndrome is linked to it. Diseases affecting the GI tract, immune system, nervous system, psychiatry, and skin might cause this syndrome. Extended depressive episodes typically occur before the entire clinical picture of glossopyrosis10.Lingual burning is indicative of hyperalgesia. Neurogenic inflammation is majorly reported in individuals with low magnesium levels4. DISORDERS RELATED TO NEUROTIC HABITS 1) Diseases caused by bruxism Bruxism - a diurnal or nocturnal parafunctional behavior that includes clenching, bracing, and grinding of the teeth, which can occur with or without consciousness and is regarded as one of the most damaging habits. 11.This action allows for the application of exceptionally powerful forces for longer periods of time than functional mastication does. These biomechanical pressures cause numerous dental issues, including hypersensitivity, temporomandibular dysfunction and periodontal distraction, and abfraction. The physiology and pathophysiology of bruxism remain quite unclear, while stress and anxiety are thought to be aggravating factors. Behavioural issues have been identified as potent risk factors for bruxism in kids4. Sleep issues, behavioural or psychiatric disorders, are thought to be the leading causes of bruxism12. Global J Res Dent Sci. 2025; 5(6), 15-23 @ 2025 | PUBLISHED BY GJR PUBLICATION, INDIA 18 2) Biting of oral mucosa (self–mutilation) Morsicatio mucosae oris, or the constant chewing of the oral mucous membrane, is a self-induced lesion and is often noticed in neurodevelopmental & psychiatrically impaired children13.Then the occurrence of oral mucosa biting leads to self-mutilation, and when clients consistently bite their cheek, lip, and/or tongue. Neurotic individuals are also likely to cause more harm to the mouth and oral cavity using instruments such as a pencil, toothpick, or nails. Differentiation of the various lesions is probably not quite as straightforward when the patient has local abrasions, for instance, on a fingernail or a sharp object, and they develop linear palatal or facial ulcer or gingival ulcers. Factitious ulcers or stomatitis artefacta: Relative to the type of the lesion, its morphological characteristics can be variable. Some of the sources are very common, and they do not cause so much discomfort, for instance, cheek injuries that are caused by biting them. In general, young neurotic people will tend to bite the buccal mucus membranes and thus form areas of sloughing, macerated, and hyper-keratinized skin. In a similar way, lip biting leads to crack formation. Hyperkeratosis is presented visibly, and a white mucosa extravasation cyst, which looks like a round, bluish, fluctuant swelling in the lower labial vermilion border, will swell and reduce its size. Therefore, lip chewing leads to varices in the old anxious patients, where the vermillion border of the lip has a rather painted cyanotic look13. CLASSIFICATION OF SELFINFLICTED INJURIES 13 I - Stewart and Kernmohan: • A: Injuries superimposed on already existing lesion. • B: Injuries secondary to a known habit. • C: Injuries of unknown or complex etiology. II - Sneddon (1977): • True malingerers: Hurt that is done in an abusive relationship as planned for a gain in the instance of time or to escape accountability. • Munchausen’s syndrome: They act sick, maimed, or injured simply to gain the attention they never got in their childhood or console themselves with after a rebuff. • A clearly defined characteristic of the individual as regards the mental disorder, for instance, a personality disorder if it is the disturbed relationship that is underlying. AUTOIMMUNE DISORDERS 1) Oral lichen planus OLP is an idiopathic immunologically induced condition and has a particular predilection for the production of lesions of the oral cavity in the form of a condition that is revealed by interlacing white keratotic lines, referred to as Wickham's striae. Chronic ITP is of an autoimmune nature and causes psychological stress among its symptoms12. Traditionally, skin lesions may be characterized as papulosquamous or, in some cases, purple, itchy, polygonal, and found most frequently in the flexor aspect of the limbs. Oral lesions that are defined by certain characteristics include the reticular, erosive, atrophic, plaque-like or keratotic, and papular and bullous types. Subsieve lichen planus involves the buccal mucosa and internally, the dorsum of the tongue, the lateral border of the tongue, the hard palate, and the vermillion border. Upon the posterior third of the buccal mucosa, primary radiating white striation, and red atrophic pattern may be detected around the circumscribed ulcers. At present, it cannot be said that it is at an early stage, while its relation to an autoimmune disease is modern14.Interestingly, it is diagnosed today as an ailment that manifests itself as a compulsive mental condition that comes with stress, concern, and dejection15. 2) Recurrent aphthous stomatitis One of the most prevalent oral mucosal ulcerative disorders2. Three varieties—minor, major, and herpetiform—are identified5.RAS is characterized by a self-limiting, recurrent ulcer that mostly affects the non-keratinized oral mucosa. About 20% of people are impacted by it. Anxiety and stress are two psychological issues that may play a crucial role in the onset and recurrence2.Psychological stress triggers immunoregulatory activity by increasing leucocytes at the site of inflammation in an immunological complex vasculitis. Psychological stress may not be the cause of the illness, but rather one of its triggers or moderators6. 3) Psoriasis It is a widespread chronic inflammatory skin condition associated with confined, reddish, dry, scaly plaques of different sizes. It can occur at all ages, but commonly first emerges during early adulthood5.Significant correlations have been observed between oral diseases, including fissured and geographic tongue, and pustular psoriasis. Psoriasis can result in mucosal and gingival lesions, as well as temporomandibular joint inflammation4. The specific cause is uncertain; however, it appears to be a complex disease on including the hereditary and psychological aspects5.Psychological stress redistributes leucocytes and increases the transportation of inflammatory cells into the skin, potentially aggravating it. Langerhans cells are involved in the normal skin's stress response, but their significance in psoriasis is unknown. Second, in psoriasis, stress sensitivity may limit the HPA axis response. Furthermore, psychological disturbances may aggravate neurogenic inflammation in patients with psoriasis. While stress can worsen the illness, psoriasis itself can have serious Global J Res Dent Sci. 2025; 5(6), 15-23 @ 2025 | PUBLISHED BY GJR PUBLICATION, INDIA 19 psychological implications. And, stress reduction by psychotherapy and medication may be useful in treating individuals with psoriasis who are stress responders6. 4) Mucous membrane pemphigoid Heterogeneous category of autoimmune conditions with blistering that mostly affect mucous membranes, including the ocular and oral mucosa. This spectrum of diseases has been linked to stress and emotional disturbance as risk factors4. 5) Erythema multiforme Oral erythema multiforme develops ulceration while concealing target lesions on the skin. A herpes infection may cause this disease. Herpes-associated erythema multiforme is most likely caused by HSV DNA fragments in the mucous membranes and skin. Stress plays an important role in this setting, as demonstrated by T-lymphocyte activity deregulation4. MISCELLANEOUS DISORDERS 1) Recurrent herpes labialis Mucocutaneous infection caused by herpes simplex virus type I (HSV-1), which causes discomfort and blistering on the lips and areas around the mouth. Stress is a key triggering factor in those who have recurrent herpes labialis, influencing T-lymphocyte function4. After producing a first acute infection, HSV stays persistent in nerve ganglia and skin epithelium, causing lip/intraoral ulcers by reactivation. Immune suppression, sun exposure, tissue injury, and psychological stress are known to be triggers for reactivation5. 2) Necrotising ulcerative gingivostomatitis Necrotising ulcerative gingivostomatitis is a condition categorized by gingival necrosis, pain, ulceration, and bleeding. Also called “Trench mouth” and Vincent's angina. It is an endogenous oral infection characterised by necrotic punchedout ulcers of interdental papilla and marginal gingiva caused by Spirochetes, Fusiform, and Bacteroides species6.Emotional stress is one of the risk components of necrotising ulcerative gingivostomatitis, known to have an effect by elevating cortisol and catecholamine levels4. 3) Chronic periodontal disease Abnormal periodontal conditions are inflammatory diseases, largely associated with subgingival pathogenic bacteria. Nevertheless, the presence of microorganisms does not, in and of itself, lead to progressive tissue injury in all individuals. Local and systemic variables, known as risk factors, influence the initiation and course of periodontal infection. Diabetes, smoking, age, and genetics are all considered systemic risk factors16.A psychosomatic disease affects the periodontium in two ways: i. These patients have self-inflicted injuries. ii. The autoimmune nervous system disrupts tissue response13. 4) Cancerophobia It describes an extraordinary, persistent fear, phobia, or concern that is unfounded in reality and above the normal range. This illness falls under the category of hypochondriasis. The patient's constant fear is that they are cancerous. These are also usually intelligent, well-read patients who use a range of mouthwashes and replace their toothpaste on a regular basis. They visit many dentists in an attempt to get reassurance that everything is well. Depression and cancerophobia have been connected; however, the exact explanation is yet unclear. Burning mouth syndrome is commonly seen in conjunction with cancerophobia5. “PSYCHE” AND “SOMA” Two hypotheses were proposed to discuss the link between psyche and soma. Specific theorycertain conflicts, stimuli, or stressors are what lead to the emergence of a predefined sickness or illness. This is because of the body's hypervigilant reaction, which persists long after the altering stimulus has subsided and ultimately results in illness. Unspecific theory - wide range of disorders that are not always predictable are made possible by generalized stress. The theory states four kinds of reactions that stress can cause: neurotic, psychotic, psychosomatic, and healthy normal13. ASSOCIATION BETWEEN PSYCHOSOMATIC DISEASE AND ORAL CAVITY5 (Table 2). Association between stress and Myofascial Pain Dysfunction Syndrome (MPDS) Step Physiological Response 1 Stress 2 Release of neurotransmitters: norepinephrine, serotonin, epinephrine, dopamine 3 Excitation of muscular nerve cells 4 Aggravated muscle tension 5 Decrease in focal blood flow 6 Reduced oxygen (O₂) and ATP reserves 7 Decreased calcium pump activity 8 Formation of myofascial trigger points Association between stress and orofacial pain Global J Res Dent Sci. 2025; 5(6), 15-23 @ 2025 | PUBLISHED BY GJR PUBLICATION, INDIA 20 Step Physiological Response 1 Stress 2 Modulation of excitatory/inhibitory descending control 3 Sensitisation of the central nervous system 4 Release of centrally triggered analgesics or activation of the sympathetic nervous system 5 Manifestation of orofacial pain Association between stress and Atypical Odontalgia (AO): Step Physiological Response 1 Non-nociceptive neurons (1st order neurons) 2 Release of Substance P and Calcitonin 3 Activation of second-order neurons 4 Redistribution of sodium channels 5 Ectopic activity in afferent nerve fibres 6 Manifestations of Atypical Odontalgia (AO) Association between stress and taste perception: Step Physiological Response 1 Stress 2 Activation of β-adrenergic receptors 3 Release of exogenous noradrenaline 4 Taste cells respond to α and β adrenoreceptor agonists 5 Modulation of gustatory information Association between stress and Lichen Planus: Step Physiological Response 1 Stress 2 Increase in nitric oxide (NO) levels 3 Counteraction of norepinephrine (NE) activity and sympathetic responsivity 4 Increased oxidant generation 5 Decreased antioxidant levels 6 Failure to produce oxidative repair 7 Development of oxidative stress 8 Production of reactive nitrogen species (RNS) 9 Formation of S-nitroguanine 10 Higher epithelial-subepithelial damage 11 Manifestation of Lichen Planus Association between stress and oral ulcers: Step Physiological Response 1 Stress 2 Increase in the number of leucocytes in the epithelium 3 Degeneration of supra-basal epithelial cells 4 Lymphocyte infiltration in the lamina propria 5 Extensive edema 6 Epithelial degeneration 7 Frank ulceration Association between stress and Psoriasis: Step Physiological Response 1 Stressful events 2 Elevated levels of Substance P (SP) 3 Activation of SP-expressing neurons near mast cells 4 Release of vasovagal intestinal polypeptide 5 Autonomic pathways stimulate neuropeptide release via SP 6 Increased release of adrenocorticotropic hormone (ACTH) 7 Local neurogenic inflammation 8 Manifestation of Psoriasis Association between stress and periodontal diseases Pathway Physiological Response Global J Res Dent Sci. 2025; 5(6), 15-23 @ 2025 | PUBLISHED BY GJR PUBLICATION, INDIA 21 Psychosocial stress Triggers multiple biological systems Autonomic nervous system Acute stress → Adrenal medulla activation Central nervous system (CNS) Activates adrenal cortex → Cortisol release Hypothalamus Chronic stress → Depressed immunity (↓ IgA, IgG, PMS) Immune and inflammatory response Prostaglandins and proteases Increased susceptibility to infection Elevated IL-1 and MMP levels Final outcome Development and progression of periodontal disease MANAGEMENT Various treatment modalities are: Stress relaxation training15.Various approaches are: • Cognitivebehavioural therapy • Selfobservation • Relaxation training • Hypnotherapy • Biofeedback • Positive thinking • Distraction techniques • Habit reversal8. Pharmacologic management10. Antianxiety drugs: Benzodiazepines - Diazepam (5 to 10mg), Alprazolam (0.25 to 0.5mg) • Antidepressants: Monoamine oxidase inhibitors: Phenelzine (15 to 90mg/day), Isocarboxazid (10 to 40mg) • Tricyclic Antidepressants: Amitriptyline (10 to 100mg), Nortriptyline (25mg) • Sedatives/Hypnotics: Barbiturate (15 mg) • Antipsychotic drugs • Serotonin-Norepinephrine Inhibitors (SNRIs): Venlafaxine (37.5-75 mg)2. (new). DISCUSSION The intricate interplay between the mind and body illustrates how psychological states can profoundly influence physical health, with the oral cavity emerging as one of the most sensitive regions to such effects. The oral mucosa, owing to its dense neural network and rich vascular supply, often mirrors psychological stress—either through direct manifestations as visible lesions or indirectly by increasing susceptibility to pathological changes. Emotional distress may initially appear as subtle changes, such as gingival irritation or “nervous” sores, and can progressively contribute to a psychosomatic profile in which physical disease manifests even in the absence of traditional risk factors. Psychosomatic disorders of the oral cavity have been extensively described in terms of their pathophysiological mechanisms and clinical presentations. The medical and dental literature has long recognized psychological or emotional disturbances as significant predisposing factors influencing both the onset and progression of oral mucosal lesions5,22. To minimize potential confounding from psychogenic associations, this study excluded individuals with systemic illnesses, tobacco use, or psychoactive drug consumption. Participants were stratified into three age categories—young adults (18–49 years), middle-aged adults (also 18–49 years, as per study design), and older adults (50–77 years). Comprehensive oral examinations were conducted for all participants under artificial illumination on dental chairs, adhering to World Health Organization (WHO) guidelines and utilizing standard diagnostic instruments for the detection of oral mucosal diseases (OMD)14. To more accurately evaluate the role of psychological stress, several biological stress markers were assessed. These encompassed neuroendocrine and immune indicators, including dopamine and adrenaline (representing the nervous system); adrenocorticotropic hormone (ACTH) and corticosteroids measured in blood, urine, and saliva (representing the endocrine system); and immune-related parameters such as lymphocyte subsets, immunoglobulins, and cytokines like IL1, IL-2, IL-6, interferon, and tumor necrosis factor (TNF)5. Clinically, participants diagnosed with oral lichen planus (OLP), aphthous stomatitis (AS), burning mouth syndrome (BMS), or myofascial pain dysfunction syndrome (MPDS) were categorized based on their specific clinical features. Global J Res Dent Sci. 2025; 5(6), 15-23 @ 2025 | PUBLISHED BY GJR PUBLICATION, INDIA 22 OLP was identified by its characteristic bilaterally symmetrical, reticular, gray-white lace-like lesions. Recurrent AS was diagnosed through a combination of patient history and the presence of persistent round or oval ulcers with erythematous halos. BMS was diagnosed in patients who experienced persistent oral burning or pain despite the absence of visible mucosal alterations 14and was further subtyped as follows: Type 1: Symptoms intensify progressively throughout the day and are often linked to systemic conditions such as nutritional deficiencies or diabetes. Type 2: Continuous symptoms persist throughout the day and night, frequently associated with disrupted sleep patterns or antidepressant-induced xerostomia. Type 3: Intermittent symptoms occur with symptom-free intervals and are commonly associated with anxiety or food allergies. MPDS was diagnosed based on the presence of masticatory muscle trigger points, unilateral preauricular pain, facial tenderness, restricted mandibular movement, joint sounds, tooth wear due to bruxism, and concurrent headaches5. Collectively, these observations underscore the strong bidirectional relationship between psychological stress and oral health, highlighting the critical need to integrate psychosocial assessments into the routine evaluation and management of chronic oral mucosal disorders. RESULTS The study attempts to identify stress as a causative agent in a few oral lesions, which include four groups: (I) OLP, (II) Aphthous ulcer, (III) burning mouth syndrome, and (IV) MPDS 18. The review will explore the efficacy of various psychological and dental interventions in managing complex interrelationships and improving patient outcomes. It also seeks to critically evaluate current diagnostic frameworks and treatment approaches, highlighting existing knowledge gaps and proposing directions for future research within this multidisciplinary domain. This comprehensive review aims to bridge the existing divide between psychology and dentistry by methodically categorizing various psychosomatic manifestations in the oral cavity and proposing a unified approach for their effective management. CONCLUSION Psychosomatic illnesses are physical conditions complicated by psychological factors. Psychological variables, whether direct or indirect, can have an impact on one’s general and dental health. Also, various studies conclude, dental professionals were severely impacted by stress and anxiety. While the psychosocial reasons varied, dental practitioners experienced a considerable amount of anxiety related to their career20.When treating oral psychosomatic diseases, comprehension of the interplay between psychological components and the oral cavity is essential. It is imperative to act quickly to put in place an interdisciplinary plan that includes long-term follow-up, including a dentist, psychiatrist, and oral physician. Finally, there should be a greater emphasis on the dental health of people suffering from serious mental illnesses because it contributes to their overall physical well-being1.Let's hang onto the old saying, "Sound mind, sound body." ACKOWNLODGEMENT Nil. REFERENCE 1. Priyadharshini, G., Ramalingam, K., & Ramani, P. (2024). Unveiling the unspoken: exploring oral manifestations of psychological disorders. Cureus, 16(1). 2. Kumar, N. N., Panchaksharappa, M. G., & Annigeri, R. G. (2016). Psychosomatic disorders: An overview for oral physician. 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