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Medically unexplained symptoms (MUS) are common in all areas of healthcare, and when the term is applied to oral symptoms, it can be appropriately focused as medically unexplained oral symptoms (MUOS). This article reviews the causes/associations and presentations of MUOS in dentistry, and describes confusable or possible comorbid psychiatric conditions. Management of patients with MUOS in primary dental care often requires close working with the patient's GP and other professionals. Strategies for the assessment and management of such patients are described.
CPD/Clinical Relevance: Dentists in primary care are likely to see patients with medically unexplained oral symptoms. A good knowledge of the correct identification and management of these symptoms is crucial for a satisfactory outcome. A proficiency in assessing and managing MUOS patients is an important skill for all primary care dentists.
Article
Medically unexplained symptoms (MUS) occur commonly in patients attending all areas of healthcare. In simplest terms, they are symptoms that cannot be ascribed to a known disorder, or an explanatory physical disorder cannot be found. The range of such possible symptoms is large and examples include fatigue, chest, muscle and back pain, palpitations, breathlessness, cough, dyspepsia, feeling faint, diarrhoea, weakness, sensory disturbance, dysuria and urinary frequency. All of these symptoms are commonly caused by recognized disease, also there are links between general health and MUS as discussed later. Those symptoms pertaining to the mouth can be described as medically unexplained oral symptoms (MUOS). The terminology in this paper reflects that MUOS is used to refer specifically to MUS in the mouth, whereas the term MUS refers to non-oral problems or the broad concept. Some entities, for example chronic fatigue and irritable bowel syndromes, fibromyalgia and non-epileptic attack disorder, have long been, and still are by many authors, considered to be MUS. However, pathophysiological mechanisms are now being elucidated for these disorders. Irritable bowel syndrome has been deemed to be explainable, and thus should not be considered to be MUS.1
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