Psychological Aspects in Periodontal Aesthetics: Managing Gingival Recession in Body Dysmorphic Disorder

Patients with body dysmorphic disorder have a pathological preoccupation with a perceived physical imperfection, which is often imagined or negligible, and seek medical or cosmetic management for the same. At times, they may engage in altering their illusory imperfections to correct their appearance, which in turn can result in injuries. Besides affecting multiple organ systems, dentists often encounter oral manifestations of self-caused injuries, which pose a diagnostic dilemma as they may resemble common periodontal conditions. The success of the intervention is also significantly influenced by whether the patient continues to practice self-harming behaviors while the cosmetic treatment is ongoing. This case demonstrates a unique connection between perio-aesthetics and psychiatric factors, which is characterized by the patient's exaggerated distress over a minor self-inflicted gingival recession defect, due to a distorted perception of self. The results of this report also indicate that psychological stabilization is necessary before the initiation of any cosmetic procedure to obtain optimal therapeutic outcomes and realistic long-term expectations, emphasizing the importance of an interdisciplinary approach.