Working-age patients with medically unexplained oral symptoms who receive public assistance in Japan.

Medically unexplained oral symptoms (MUOS) are frequently associated with psychosocial factors. Although most affected individuals can maintain their usual daily activities, a small subset experience pronounced socioeconomic hardship, and the prevalence and characteristics remain unclear in working-age Japanese public assistance recipients. This retrospective chart review examined 3685 first-visit patients at a tertiary psychosomatic dentistry clinic between April 2016 and March 2023. Of these, 98 (2.7%) received public assistance, and 55 (1.5% of the total sample) were aged 18-64 years. Demographic, clinical, and social determinants of health-including psychiatric diagnoses, living arrangement, and employment status-were analyzed. Results showed that 90.9% of the 55 participants had current or past psychiatric diagnoses, most commonly depression, anxiety, schizophrenia-spectrum, or bipolar disorders; 74.5% experienced polypharmacy. Unemployment and living alone were prevalent, underscoring persistent social isolation and limited support networks. These findings highlight the importance of integrating psychosomatic care with psychiatric support and broader social resources-such as community-based NPO services, and informal family or peer support-to address the complex needs of this underserved population. By situating MUOS within a broader context of social determinants of health, this study offers insights for more holistic, multidisciplinary interventions.