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Body dysmorphic disorder in prosthodontics - A practice based study

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01 February 2017

Body Dysmorphic Disorder (BDD) is a psychiatric condition characterised by an excessive preoccupation with a slight or imagined defect with some aspect of physical appearance.

Patients think about their real or perceived flaws for hours each day. They can’t control their negative thoughts and don’t believe people who tell them that they look fine. Their thoughts may cause severe emotional distress and interfere with their daily functioning. They engage in lengthy rituals of camouflage or avoid social contact. Current co-morbidities include depression, anxiety, social withdrawal or social isolation and even suicidal thoughts.

The disorder is part of the Obsessive Compulsive spectrum (Diagnostic and Statistical Manual of Mental Disorders–V) and constitutes a different entity to Anorexia Nervosa. Far from being an uncommon disorder, body dysmorphia affects 1-2% of the general population but the number rises to around 15% of patients presenting for cosmetic treatments (including dental).

Patients with BDD are not only more likely to undergo cosmetic procedures, but will often be dissatisfied with the outcome and pursue further treatment or complain.

Whilst broadly recognised in the dermatologic and plastic surgery fields, BDD is widely under-reported and under-recognised in dentistry with only a handful of studies, mostly in orthodontics and maxillofacial surgery. However, with the current increase in patients seeking cosmetic dental procedures, it seems prudent to be able to identify patients with increased cosmetic concerns and expectations.

The University of Melbourne, in collaboration with eviDent, is conducting a study aiming to identify patients with increased symptoms of BDD before irreversible prosthodontic or cosmetic treatment is carried out. The study involves a questionnaire that has been validated in other medical specialties like dermatology, ophthalmologic and plastic surgery.

eviDent Associate Investigator, Dr Carolina Perez Rodriguez said, “Research in this field is important because the number of patients seeking cosmetic treatments is increasing and these treatments may be irreversible, expensive and need long term maintenance. Effective management of expectations will lead to more successful outcomes, happier patients and less future litigation”.

eviDent Chief Investigator, A/Prof Roy Judge said, “One of the longer term aims of the project is to increase the understanding and delivery of coordinated care for patients. This approach will more readily take into account the needs of our aging population with diverse backgrounds and increasingly complex medical needs”.