In the examination of psychosomatic dentistry, confirmation of organic findings requires particular attention. Once a diagnosis of oral psychosomatic symptoms is made, various complaints tend to be treated as mentally related, and the discovery of organic diseases could be delayed. We actively accept patients with oral psychosomatic symptoms, but there are cases of burning mouth syndrome comorbid with malignant tumors and other oral mucosal diseases, and in some cases, it is difficult to distinguish between atypical odontalgia and root fracture. This article reports our experience of four cases related to oral psychosomatic symptoms and organic oral disease for whom a favorable course was obtained. <br>Oral candidiasis developed during the treatment of burning mouth syndrome in case 1 and 2. Case 3 showed burning mouth syndrome comorbid with oral lichen planus. Case 4 was a patient with suspected atypical odontalgia, who was diagnosed with trigeminal neuralgia after magnetic resonance imaging. <br>As presented in the above cases, even after a diagnosis of psychosomatic oral symptoms has been made, there are some cases in whom mucosal diseases appear during treatment, so regular oral examinations are important. In particular, when psychosomatic treatment is successful but pain recurs amid favorable progress, careful evaluation is required as to whether it is due to an exacerbation of psychosomatic oral symptoms or an organic disease. <br>On the other hand, it is also necessary to consider that patients with organic abnormal findings in the orofacial area may have comorbid symptoms of psychosomatic oral symptoms. By focusing on whether or not the entire complaint can be explained by the intraoral findings, appropriate diagnosis becomes possible.