Body Dysmorphic Disorder in Orthodontic Patients: A Review of Prevalence, Diagnosis, and Management Approaches
DOI:
https://doi.org/10.63682/jns.v14i2S.8956Keywords:
Body Dysmorphic Disorder, Orthodontics, Aesthetic Dentistry, Psychiatric Rehabilitation, Patient ManagementAbstract
Background: Body Dysmorphic Disorder (BDD) is a psychiatric condition marked by excessive concern about perceived flaws in physical appearance, often resulting in emotional distress and functional impairment. Given that orthodontic treatment primarily addresses facial esthetics, orthodontic patients may have a higher prevalence of BDD than the general population.
Objective: To review the literature on BDD in orthodontic patients, focusing on prevalence, diagnostic challenges, clinical implications, and management strategies.
Methods: A narrative review of PubMed, Scopus, and Web of Science databases was performed using the keywords “Body Dysmorphic Disorder,” “Orthodontics,” “Malocclusion perception,” and “Psychiatric rehabilitation.” Articles from 2000 to 2025 were analyzed.
Results: BDD prevalence is 1.7%–2.4% in the general population but 7%–12% in orthodontic patients. Risk factors include perfectionism, history of bullying, and comorbid psychiatric disorders. Diagnostic challenges arise because appearance-related dissatisfaction is common in orthodontics. Undiagnosed BDD can result in unrealistic expectations, dissatisfaction, treatment dropout, and litigation risk. Early screening and interdisciplinary management involving mental health professionals are recommended.
Conclusion: BDD screening should be part of orthodontic evaluation, and interdisciplinary management is crucial for preventing treatment failure and psychological harm.
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Phillips KA, Menard W, Fay C, Weisberg RB. Demographic characteristics, phenomenology, comorbidity, and family history in 200 individuals with body dysmorphic disorder. Psychosomatics. 2005;46(4):317–25.
Sarwer DB, Crerand CE, Gibbons LM. Body dysmorphic disorder in cosmetic surgery patients. Facial Plast Surg. 2007;23(3):184–9.
Marques L, et al. Prevalence of body dysmorphic disorder in a community sample of adolescents. J Nerv Ment Dis. 2011;199(6):470–474.
Veale D, Gledhill LJ, Christodoulou P, Hodsoll J. Body dysmorphic disorder in different settings: a systematic review and estimated weighted prevalence. Body Image. 2016;18:168–86.
De Jongh A, Aartman IHA, Parvaneh H, Ilgner A. Prevalence of body dysmorphic disorder among orthodontic patients. Am J Orthod Dentofacial Orthop. 2009;135(4):496–501.
Phillips KA. Body dysmorphic disorder: recognizing and treating imagined ugliness. World Psychiatry. 2004;3(1):12–7.
Crerand CE, Franklin ME, Sarwer DB. Body dysmorphic disorder and cosmetic surgery. Plast Reconstr Surg. 2006;118(7):167e–80e.
Buhlmann U, Glaesmer H, Mewes R, Fama JM, Wilhelm S, Brähler E, et al. Updates on prevalence and risk factors of BDD. J Psychiatr Res. 2010;44(8):571–5.
Neziroglu F, Khemlani-Patel S. A review of cognitive-behavioral therapy for body dysmorphic disorder. Body Image. 2002;9(1):13–20.
Ruffolo JS, Phillips KA, Menard W, Fay C, Weisberg RB. Comorbidity of body dysmorphic disorder and social phobia. Depress Anxiety. 2006;23(1):26–33.
The Body Dysmorphic Disorder Questionnaire (BDDQ). J Nerv Ment Dis. 1995;183(9):563–71. Phillips KA.
First MB, Spitzer RL, Gibbon M, Williams JB. Structured Clinical Interview for DSM-IV Axis I Disorders. Washington, DC: American Psychiatric Press; 1997.
. Body dysmorphic disorder. BMJ. 2015;350:h2278. Veale D, Bewley A
Williams J, Hadjistavropoulos T, Sharpe D. A meta-analysis of psychological and pharmacological treatments for body dysmorphic disorder. Behav Res Ther. 2006;44(1):99–111.
Ipser JC, Sander C, Stein DJ. Pharmacotherapy and psychotherapy for body dysmorphic disorder. Cochrane Database Syst Rev. 2009;(1):CD005332.
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