The Mouth, the Face, and the Mind Edited By Charlotte Feinmann. Oxford: Oxford University Press, 1999. 172 pp. £55.00 (hb). ISBN 0-19-263062-8

The relationship between the mind and disorders of the mouth and face is not merely a matter for philosophical analysis. The lack of a common clinical language shared by all concerned in patient management remains a significant barrier to the development of liaison psychiatric services. The implicit ‘category error’ in the title of this book thus provides an important reminder of one of the significant blocking factors which continue to hinder improvement in the psychiatric care of patients who present their psychological and emotional distress through physical symptoms. A further category problem arises from the nature of chronic idiopathic facial pain, which has many similarities and overlaps with other somatoform disorders, in that patients may present to different medical or surgical specialities and receive diverse treatments, from antidepressants to surgery.

The main focus of this excellent book is the multi-disciplinary assessment and management of patients with chronic orofacial pain, together with the presentation of psychosocial morbidity in dental practice and disorders of facial appearance. Although the authors are writing primarily for non-psychiatrists (the book is aimed at dental practitioners and clinicians in related specialities), the text provides a useful synopsis of current opinion about causation and treatment of functional somatic disorders, here with emphasis on presentations with chronic facial pain. The authors take substantial steps towards creating a common vision of management, demystifying the psychiatric approach to this difficult-to-manage group of patients.

Dental practitioners reading this text will, one hopes, recognise their particular opportunity to improve the mental health of their patients. With this in mind, I would have liked to have seen greater discussion of the dental health needs of patients with severe mental illness and conversely of coping with the stresses involved in dental practice. Each chapter is well referenced and there are useful appendices on information for patients and practitioners involved in the treatment of facial pain.

This is a relatively expensive book, but it is recommended for anyone involved in the management of patients with somatic symptoms, whether or not facial pain.