Correlation Study of Anxiety, Body Dysmorphic Disorder, and Quality of Life in Preoperative Patients for Orthognathic Surgery: A Cross‐Sectional Study

BACKGROUND: Orthognathic surgery effectively corrects dentofacial deformities, but patients often present with considerable preoperative psychological distress which may compromise postoperative satisfaction. The incidence of anxiety and body dysmorphic disorder (BDD) in preoperative dentofacial deformity patients, and their impact on patients' quality of life, remain insufficiently defined. OBJECTIVE: To investigate the prevalence of anxiety level, BDD and quality of life in preoperative patients for orthognathic surgery, and evaluate the associations between psychological factors and quality of life. METHODS: In a cross-sectional study of 392 patients scheduled for orthognathic surgery, we assessed preoperative state-trait anxiety, BDD severity, and orthognathic quality of life. Sociodemographic and clinical variables were recorded. Spearman correlations and hierarchical regression examined associations and predictors. RESULTS: High anxiety was reported by 25.8%-32.7% of participants, while clinically significant BDD symptoms were present in 22.9%. The median score of orthognathic quality of life was 34.5, with facial aesthetics and oral function most impaired. Anxiety level and BDD severity jointly explained 49.6% of the variance in orthognathic quality of life, exceeding demographic and clinical factors. Class III malocclusion predicted poorer quality of life, whereas being married and higher income were protective. CONCLUSIONS: Preoperative patients for orthognathic surgery experience high rates of anxiety levels and BDD, which are the primary determinants of preoperative quality of life. Integrating psychological screening and support into preoperative care may optimize outcomes.