Body dysmorphic disorder (BDD) in the orthodontic and orthognathic setting: A systematic review

Evidence‐based review: Screening body dysmorphic disorder in aesthetic clinical settings

“…Clinical interview‐based described as reliable, reproductible, and valid severity measure tool 68 . (also reportedly being used to screen BDD) 3 …”

“…From the 12 relevant articles produced using aforementioned research strategy, five were systematic reviews related to aesthetic interventions, 2,3,18–20 which referenced a total of 27 prospective non‐randomized follow‐up studies, 10,27,29,31–33,36–40,44,47,48,62,63,69,71,74,76,77,80,82,83,85,88,89 with only two having a control‐group 33,85 . Of these systematic reviews, one included both surgical and non‐surgical procedures, 19 while others evaluated BDD exclusively in cosmetic surgery, 2,18 among orthodontic and orthognathic surgery setting, 3 or in dermatology population 20 . The systematic reviews from 2011 to 2017 had 13 overlapping studies, 2,19 the latter had two additional studies which in turn were repetitive in the most updated systematic review on the topic from 2021 18,19 .…”

“…In this context, the aim of this evidence‐based review was to identify validated BDD screening tools and appraise available data regarding its implementation and efficacy in daily practice, by preventing post‐treatment complications for both aesthetic patients and practitioners. Previous reviews on this topic have not sought to clearly distinguish the validated screening tools for BDD from non‐validated instruments or other measures for BDD that have been misused for screening purposes in the aesthetic population 2,3,18–20 . Therefore, the present study attempted to address this gap in the available literature, and to assess the impact of current discrepant interpretations of screening measures for BDD on reported validation processes of screening instruments, and aesthetic treatment outcome among positive screening patients.…”

“…1 The estimated prevalence in general population ranges from 0.7% to 2.9%. [2][3][4] The BDD prevalence varies, depending on the population and criteria adopted, but it is thought to be higher among patients seeking for aesthetic treatments and predominantly in the face. 5,6 Gender ratio is reportedly equal, although some studies found a slight preponderance in women, highlighting the need for larger epidemiological studies in BDD prevalence.…”

“…13,17 It may be particularly difficult for aesthetic practitioners without training or experience in mental health to determine if the appearance-preoccupation is disproportionate when the defect is only mild, fueling the debate on whether BDD incidence in aesthetic population may be underrated. 3,5 Indeed, the survey provided by Joseph et al, 10 demonstrated that from a sample of 402 participants, 42 patients screened positive on a BDD questionnaire, 16 were clinically suspected of having BDD, while only two were appropriately identified by aesthetic surgeons. Another recent observational cross-sectional study by Kattan et al, 16 exploring 155 aesthetic practitioner's awareness of BDD concluded that more familiarity with BDD diagnostic criteria resulted in an increased number of appropriate identification of cases.…”