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

ABSTRACT 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.