Correct diagnosis can depend on specialized questioning and correlation with emotional distress or social dysfunction. Estimates place the Body Dysmorphic Disorder Questionnaires sensitivity at 100% (0% false negatives) and specificity at 92.5% (7.5% false positives). BDD is also comorbid with eating disorders, up to 12% comorbidity in one study. Both eating and body dysmorphic disorders are concerned with physical appearance, but eating disorders tend to focus more on weight rather than ones general appearance.BDD is classified as an obsessive-compulsive disorder in DSM-5. It is important to treat people with BDD as soon as possible because the person may have already been suffering for an extended period of time and as BDD has a high suicide rate, at 2-12 times higher than the national average. Treatment
Medication and psychotherapy
Anti-depressant medication, such as selective serotonin reuptake inhibitors (SSRIs), and cognitive-behavioral therapy (CBT) are considered effective. SSRIs can help relieve obsessive-compulsive and delusional traits, while cognitive-behavioral therapy can help patients recognize faulty thought patterns. Before treatment, it can help to provide psychoeducation, as with self-help books and support websites. Self-improvement
For many people with BDD cosmetic surgery does not work to alleviate the symptoms of BDD as their opinion of their appearance is not grounded in reality. It is recommended that cosmetic surgeons and psychiatrists work together in order to screen surgery patients to see if they have BDD, as the results of the surgery could be harmful for them. References


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amalgam particles can contaminate dental floss and lead to linear amalgam tattoos in between the teeth, especially if flossing is carried out immediately after placement of an amalgam filling with a mesial or distal aspect
Polishing of an amalgam filling
The pressure from high speed turbine dental drills can be enough to force amalgam particles into soft tissue, as may occur when an old amalgam filling is being removed
When a tooth with an amalgam filling is extracted,: 183  e.g. broken bits of amalgam filling falling into an extraction socket unnoticed
When an amalgam filling is placed in the same appointment as a tooth extracted, as may occur in "quadrant dentistry"
Apicectomies are common causes of amalgam tattoo, since the amalgam is being placed inside the alveolus and the soft tissues are replaced on topOver time, the amalgam particles embedded in the soft tissues corrode. : 183  Macrophages take up the exogenous particles, and the silver in amalgam leads to staining of collagen fibers. : 183 A similar appearance can be caused by implantation of graphite (e.g. from pencil leads), and is sometimes termed a graphite tattoo, although this is less common than tattooing with amalgam. : 138

Diagnosis
The diagnosis is clinical. : 138  Amalgam tattoo can be distinguished from other causes of localized oral pigmentation because it does not change significantly in size or color,: 138  although it may appear to slowly enlarge for several months after the initial implantation of the metal particles. : 183  Some amalgam tattoos appear radio-opaque on radiographs (i.e.