ABSTRACT
The aim of this study was to determine evidence of Body Dysmorphic Disorder [BDD] amongst patients attending for orthodontic assessment, in particular to identify those individuals who expressed high facial dissatisfaction, anxiety and depression but who have low levels of orthodontic need as assessed by the clinician. A further aim was to examine discrepancies between the perceptions of clinician and patient in the severity of malocclusion. Prospective, observational, single centre study. Orthodontic department of a district hospital. A total of 69 patients were recruited for the study over a period of four months. Informed consent was obtained from all participants. All the participants were assessed by questionnaire and clinical examination. The data collected included: demographic details, weight, height, expressed reasons for attendance, expectations of treatment, body image and satisfaction with facial appearance [Body Satisfaction Scale], anxiety and depression [Hospital Anxiety and Depression Scale]. The average age of the sample was 12.7 years [SD=-3.33], with a range from 8 to 29 years. On average the participants had a low Body Mass Index [Mean=19.4, SD=4.06: range 13.6 to 33.2]. There was little evidence of Body Dysmorphic Disorder. Clinicians rated the patients' appearance on the IOTN Aesthetic component as higher on average. In 41 cases [59.4%] the clinician's rating was more severe than that of the patient, in 8 cases [11.6%] the ratings coincided, and in 20 cases [29.0%] the respondent rated themselves as more severe than the clinician's rating. The findings suggest that Body Dysmorphic Disorder is uncommon amongst patients presenting for orthodontic treatment. There is evidence that clinicians' judgements of the severity of malocclusions are influenced by crowding and the presence of overjet to a greater extent than patients' judgements