The psychological and social aspects of orthognathic treatment

Cooperative management of dentofacial abnormalities by orthodontists and oral and maxillofacial surgeons has experienced tremendous growth in recent years. Frequently these patients have suffered considerable emotional trauma from ridicule of their deformity. This history of emotional abuse may influence the patient's attitude and expectations regarding corrective treatment and even lead to dissatisfaction in spite of technical success. Review of the literature and interviews with patients previously treated for dentofacial abnormalities revealed a very high rate of satisfaction. This high degree of satisfaction is in contrast to several studies involving patients undergoing cosmetic plastic surgery. However, in spite of over-all satisfaction, retrospective interviews identified a number of concerns which deserve additional attention. These concerns would be best approached with a preoperative interview to delineate the patient's motivation and expectations. Such an interview, including a cursory psychological evaluation, could provide increased insight and communication among orthodontist, surgeon, and patient. The results would help identify and prevent some of the pitfalls leading to patient dissatisfaction after treatment.