Links Between Body Dysmorphic Disorder (BDD) With Aesthetic Components of Orthodontic Treatment Need Assessed by Orthodontic Patients or Orthodontists (IOTN-AC, IOTN-ACE) and Also With Its Risk Factors: An Epidemiological Cross-Sectional Study.

BACKGROUND AND AIMS: Body dysmorphic disorder (BDD) is a type of obsessive-compulsive disorder that can adversely impact an individual's self-perception. It may influence both the demand for and results of orthodontic treatment, making it a significant concern. Research on BDD among orthodontic patients is scarce, controversial, and methodologically limited. Associations between BDD with IOTN-AC and IOTN-ACE have not been studied at all. Moreover, IOTN-ACE itself (even regardless of BDD) is not studied except in a very few articles.

METHODS

The Yale-Brown Obsessive-Compulsive Scale modified for Body Dysmorphic Disorder (BDD-YBOCS) was administered to 529 orthodontic patients aged ≥ 12 (112 males, 417 females) in five clinics of xxxx city, 2023-2024. The diagnosis and severity of BDD were determined using both the first three items (BDD-3) and all twelve items of the questionnaire (BDD-All). Orthodontists and also patients evaluated the esthetic aspect of the Index of Orthodontic Treatment Need (IOTN-AC and IOTN-ACE). Multiple linear/binary logistic regressions and bivariable analyses were used to determine correlations and risk factors (among age/sex/marital status/education level/rhinoplasty/esthetic treatments/time passed since treatment began) (α = 0.05).

RESULTS

Mean BBD-3 and BDD-All were 3.28 ± 2.35 and 13.15 ± 6.97, respectively. BDD prevalence was 39.3% (BDD-3) or 15.1% (BDD-All). IOTN-AC/ACE were significantly but weakly correlated with all four measures of BDD. Mean IOTN-AC and IOTN-ACE scores were 3.19 ± 2.30 and 3.46 ± 2.30, respectively. IOTN-AC and IOTN-ACE were moderately correlated with each other (p < 0.05). Age was not correlated with BDD, but it was negatively correlated with IOTN-AC and IOTN-ACE (p < 0.05). Female sex and lower IOTN-AC/ACE scores were associated with BDD (regression p < 0.05).

CONCLUSION

BDD was significantly yet weakly associated with IOTN-AC/IOTN-ACE. BDD may be more prevalent in women. Rhinoplasty needs further research. Other factors might not be risk factors.