Doc. MUDr. Roman Šmucler, CSc.
MUOS- Medically Unexplained Oral Syndromes- threat and opportunity
Increasing psychological burden, sharing symptoms on social networks, and ageing of the polymorbid population – all contribute to a significant increase in patients with multiple symptoms of pain and other pathological feelings in the orofacial area, which dentists and other specialists can not explain by pathological-anatomical findings. There are a considerable number of such patients (approximately 5-10% of all patients in dentistry), but their treatment seems to be almost at point zero (Mignogna et al., 2005). The embarrassment around them led to unclear classification, the absence of recommended treatments, and the „switching“ of these patients among specialists. They form a dreaded group of patients that many are trying to avoid and who have been harmed „in good faith“ by some doctors to „help“ with unindicated invasive procedures (Lipsitt et al., 2015). Interest in working with such patients is desperately insufficient. Care is underfunded because health insurance companies nowhere in the world can appreciate „talking to the sick“ – they agree to be charged for significant diagnostic or therapeutic services. The effort to reverse this is the creation of the concept of MUOS-medically unexplained oral symptoms associated with the education of a new type of specialists and calls for the creation of the necessary network of outpatient clinics or inpatient facilities. Great attention is paid to the overall medical view of the patient and the manifestations of somatization of central nervous system problems (Schwartz et al., 2015). In some countries, typically Japan, there are already specialized clinics with outpatient and inpatient sections and dedicated specialists.
Identifying and capturing patients with MUOS in the primary care network (mainly dentistry) is essential. Prevent not-so-critical and sometimes mutilating invasive procedures. The treatment of many patients requires repeated and long-term visits, so they shouldn’t have to travel long and are ideally treated at the district level. There is also an excellent way to create an informal group of collaborating multidisciplinary specialists (at least dentistry, ENT, neurology, algesiology and psychiatry) who can diagnose and treat most patients. However, many patients require even more detailed multidisciplinary cooperation and extensive clinical experience, given the number of complicated cases treated. This is possible at the level of a large medical facility (typically a teaching hospital) for a population of at least one million. Such a concentration will allow sufficient quality diagnosis and treatment, education of new specialists and scientific development of a new field – psychosomatic dentistry.
Private health service provider – Stomatology. ČSK expert; forensic expert; former chairman of the review committee of OSK Prague 2, in the term of office 2017-2021 and 2021-2025 president of Czech Dental Chamber. National Dental Officer. Chairman of the Scientific Council of the Czech Dental Council. Member of the Scientific Council of the Ministry of Health. Member of the Council of Providers of the Ministry of Health. Manages an NHS with 400 employees. Deputy Head of the Dental Clinic of the 1st Faculty of Dentistry, Charles University in Prague. Associate professor in dentistry (Prague, Košice). President of the Society of Aesthetic and Laser Medicine of the Czech Academy of Dentistry (2013). Contributor to 7 monographs, 84 original and review scientific publications. Author of over 200 lectures, 69 abroad. Member of 7 international organizations. Minister of Health Award for Medical Research 2008. Dedicated to the popularization of science, wrote 135 articles, contributed to 4 monographs, TV and radio professional programs. Hobby – radio and television programs.