Self-harm, defined as deliberately hurting oneself, is a growing public health concern. Self-harm includes cutting, biting, scratching, hitting, pulling out hair, burning, swallowing pills, and banging the head against a wall. It represents a maladaptive expression of distress related to stressful life problems. Self-harm is a primary risk factor for repeated self-harm, substance abuse, and suicide.
The age of onset for self-harm is reported to occur between 12-14 years, peaking at 15-17 years, then declining in adulthood. The global prevalence of self-harm in adolescents ranges between 7.5%-46.5%, with a lifetime prevalence rate of at least one self-injuring event seen in 18% of community samples.
Several factors may be involved in the etiology of self-harm, including depression, anxiety, stress, being bullied, body image, low self-esteem, abuse, neglect, and cigarette, alcohol, and drug abuse. Oral health and dentofacial esthetics contribute to self-esteem and self-perception of body image. Research has found an attractive dentofacial appearance is important to adolescents and is an essential factor for self-esteem. Prevalence of bullying because of dentofacial features is reported between 7% to 73%.
Researchers investigated the prevalence of self-harm and the contribution of dentofacial appearance on self-harm and bullying among 699 grade eight students (339 females, 360 males, aged 13-14 years).
The prevalence of self-harm was 27% (188), with no statistically significant gender differences. Among students who reported self-harm, 90 (48%) reported self-harm because of dentofacial features. A total of 41 students reported self-harm because of bullying targeting dentofacial features, representing about one fifth of students who reported self-harm. The most common dentofacial features contributing to self-harm and self-harm as a result of bullying were tooth colour and shape, spaces between the teeth or missing teeth, and prominent maxillary anterior teeth.
The study provides data to better understand the relationship between self-harm and dentofacial features. Addressing adolescents’ discomfort over dentofacial esthetics may be a way to reduce the prevalence of self-harming behaviours and may contribute to lower rates of bullying.