Body dysmorphic disorder: a guide to identification and management for the orthodontic team

Rosten, Adina; Cunningham, Susan; Newton, Tim

doi:10.1080/14653125.2018.1490874

Cited by 7 publications

(3 citation statements)

References 24 publications

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“…As some patients might have unrealistic expectations regarding physical and non-physical changes, professionals must be alert during patients’ first consultations [ 9 ]. Mental disorders like the body dysmorphic disorder, where a minor or even imagined defect causes significantly distress [ 40 ], have to be thought of when patients report about high expectations, especially regarding non-physical changes [ 41 ]. The prevalence of such mental disorders among orthognathic patients has not extensively been described so far, but researchers like Veale et al estimated it to be 11.2% in the field of orthognathic surgery and 5.2% in orthodontics and cosmetic dentistry [ 42 ].…”

Section: Discussionmentioning

confidence: 99%

Does one size fit all? A qualitative study about the need for individualized information transfer for orthognathic patients

et al. 2022

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Aims For any orthodontic-orthognathic treatment, it is crucial that patients are provided with enough and proper information in order to make evidence-based decisions- not only prior to treatment start, but also throughout the course of therapy. Thus, the objectives of this qualitative study were to identify information needs of patients undergoing combined orthodontic-orthognathic treatment. Additionally, professionals’ perspectives were evaluated. Methods A qualitative research approach was chosen in order to determine crucial aspects of information needs before and throughout treatment. With respect to a purposive sampling strategy and thematic saturation, we conducted ten semi-structured interviews with patients who had finished their orthodontic-orthognathic surgery treatments (five women, five men; being 21 to 34 years old). The indications for the combination treatment were severe skeletal Class IIs to Class IIIs with various vertical and transverse discrepancies. In addition, a multidisciplinary focus-group with six professionals from the maxillofacial surgery and orthodontic department (three women, three men; being 30 to 38 years old) helped to reflect about the experts’ point of views. After transcription, data was categorized and analyzed by Mayring’s content analysis. Results We identified three key themes. During this analysis, we focused on theme (1) ‘information transfer’ with its corresponding categories ‘information needs’ – depending on different treatment stages –, ‘source of information’ and ‘doctor-patient-communication’. The affected patients ranked individualized patient information and empathetic doctor-patient-communication high. This was mostly in line with the professionals’ point of view. Verbal communication was seen as being the best way to communicate throughout treatment. The role of the internet as a source of information was seen diversely. Conclusion This qualitative study highlights the need for individualized patient information and reveals both met and unmet information needs by patients. Although evidence-based written information is highly necessary for orthognathic patients and their families alike, it cannot replace an empathetic way of direct verbal doctor-patient-communication. It seems crucial to give specific individualized information at different treatment stages, starting at a thoroughly interdisciplinary screening at the very beginning.

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Section: Discussionmentioning

confidence: 99%

Does one size fit all? A qualitative study about the need for individualized information transfer for orthognathic patients

et al. 2022

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“…One of the most complex patient group are those presenting with the red flag of Body Dysmorphic Disorder (BDD). BDD is a psychiatric disorder in which 'the individual has a disproportionate concern about a particular body part' (Rosten et al, 2018). There are diagnostic criteria such as a 'preoccupation with one or more perceived defects or flaws in physical appearance that are not observable or appear slight to others' (American Psychiatric Association, 2013).…”

Section: Inclusion Criteriamentioning

confidence: 99%

Establishing a clinical psychology team within the orthognathic service: A triad model of orthodontic, maxillofacial and psychological care

et al. 2021

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The importance of psychological support for orthognathic patients has taken an increasing precedence over recent years and is embedded in orthognathic commissioning guidelines. Furthermore, attention towards mental health-related conditions and their management is of prime importance and continues to be a key area of focus within healthcare settings. With this in mind, this paper aims to outline our experience of establishing a need for and subsequently securing funding to establish a clinical psychology service within an existing orthognathic service in the NHS. The information outlined may be of benefit to orthognathic teams seeking to secure such psychological support within their respective units.

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“…Secondly, patients with unrealistically high expectations of the outcome of treatment may need additional support or be living with a psychological disturbance such as body dysmorphic disorder (Rosten et al, 2018). Clinicians often become concerned when patients' expectations of treatment process or outcome are deemed too 'high', that is they are beyond what might reasonably be expected.…”

Section: Introductionmentioning

confidence: 99%

How do you identify the patient with ‘high expectations’ of orthodontic treatment: An empirical approach

2020

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Objectives: To identify an empirical method for identifying patients with ‘high expectations’ of orthodontic treatment with fixed appliances using a questionnaire-based approach. Design: Secondary analysis of data from four studies which collected data on patients’ expectations of orthodontic treatment using the same questionnaire. Setting: Secondary care orthodontic services. Participants: All four datasets comprised new patients aged 12–15 years, with no history of orthodontic treatment, who fulfilled the criteria for NHS treatment using the Index of Orthodontic Treatment Need (IOTN). Unpublished dataset 1 comprised 100 participants, while dataset 2 had 70 participants, dataset 3 had 67 participants and dataset 4 comprised 40 participants. Methods: The questionnaire utilised in all studies had a question which asked respondents to rate seven different expectations of outcome relating to straight teeth, better smile, ease of eating, speaking, cleaning teeth, improved career prospects and social confidence. Dataset 1 was analysed to determine the proportion of patients who had rated all seven outcome expectation items at a maximum score. Similar analyses were performed for the other three datasets to explore the trend in the proportion of patients with high expectations over time. Results: For dataset 1, 2.0% of participants had high expectations, as defined by their scores on the questionnaire. The proportions for the datasets 2, 3 and 4 were 4.0%, 4.5% and 2.5%, respectively. Conclusion: The method outlined provides an empirical basis for identifying patients with statistically infrequent high expectations. This can potentially help clinicians in the management of such patients.

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Body dysmorphic disorder: a guide to identification and management for the orthodontic team

Cited by 7 publications

References 24 publications

Does one size fit all? A qualitative study about the need for individualized information transfer for orthognathic patients

Does one size fit all? A qualitative study about the need for individualized information transfer for orthognathic patients

Establishing a clinical psychology team within the orthognathic service: A triad model of orthodontic, maxillofacial and psychological care

How do you identify the patient with ‘high expectations’ of orthodontic treatment: An empirical approach

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