Abstract

Background: Body dysmorphic disorder (BDD) is defined in psychiatry as a mental health condition in which there is a strong preoccupation with an imagined or minor defect in appearance that is often not visible to others. In a dental practice, patients who have BDD but have not been diagnosed may display an exaggerated worry about dental esthetics, which may lead to unreasonable expectations about therapy, seeking treatment from multiple providers, seeking ongoing treatment with the same provider, and dissatisfaction despite clinically acceptable outcomes. Recognizing BDD in dental settings is critical for appropriate patient management, and to avoid unnecessary or inappropriate treatments. Objectives: This study aimed to assess the prevalence of BDD among patients seeking dental treatment in a tertiary care hospital and to examine its association with unrealistic treatment expectations. Material and Methods: A cross-sectional observational study was performed over a period of 12 months in the outpatient department of a tertiary care teaching hospital. Two hundred consecutive adult patients seeking dental aesthetic treatments were enrolled. Sociodemographic information was collected, and participants were assessed with the Body Dysmorphic Disorder Questionnaire (BDDQ), a validated screening tool. The unrealistic treatment expectations were evaluated with a structured questionnaire designed specifically for this study, which focused on expectations of esthetic perfection, immediate outcome, and reversibility of treatment. Data were analyzed using descriptive statistics, chi-square tests, and logistic regression in order to examine the relationship between BDD and unrealistic expectations. Results: The mean age of participants was 29.6 ± 8.4 years, with 58% female and 42% male. The prevalence of BDD was found to be 12.5% (n = 25). Patients who screened positive for BDD were much more likely to report unrealistic expectations of treatment (68% vs. 24%, p < 0.001). Multivariate analysis showed that BDD was independently associated with unrealistic expectations (adjusted odds ratio 4.2, 95% CI 2.0-8.9, p < 0.001). There were no significant differences concerning sex or socioeconomic status. Conclusions: BDD was relatively common among dental patients seeking aesthetic procedures in tertiary care settings, and is strongly associated with unrealistic expectations of treatment. Routine screening for BDD in dental practice may assist in identifying high-risk individuals, allowing for prompt psychiatric referral and improved patient care overall.

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