Abstract
It was the best of times, it was the worst of times, it was the age of wisdom, it was the age of foolishness, it was the epoch of belief, it was the epoch of incredulity, it was the season of Light, it was the season of Darkness. —A Tale of Two Cities- Charles Dickens
Respected readers, my fellow seniors, colleagues, and juniors, I sincerely hope all of you are safe and healthy. As we bid goodbye to a most definitely torrid and forgettable year, the promising results of several vaccine trials bring a required glimmer of hope for the new year. “Work from home” and “Zoom calls” have become a part of the “new normal”; these trends are very likely to be continued,1 and while technology has made our lives and our work front more convenient, it has also brought forward its own set of unique problems, especially related to one’s own appearance over these digital platforms.
God has given you a face, and now you make yourself another. —William Shakespeare
It has been reported that viewing idealized images in both traditional media (e.g., magazines and billboards) and social media (e.g., Facebook, Instagram, etc.) has a negative influence on individuals’ body image.2-5 Several of these applications have the option to edit and enhance portraits before posting them online; these “idealized” images also tend to negatively impact the average viewer’s body image as well.
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The same is known to cause oneself to develop unnecessary and unrealistic facial-image expectations, including the desire to seek compulsively dento-facial corrective procedures, which include surgical modalities as well.
If we were living in ancient Rome or Greece, I would be considered sickly and unattractive. The times dictate that thin is better for some strange reason, which I think is foolish. —Gwyneth Paltrow
The time spent on social media viewing and browsing has increased dramatically over this pandemic period, and this has only compounded this unfortunate aspect in an average person’s mind. Moreover, Zoom and other video-conferencing applications display an unedited version of oneself in motion, a notion very few people are used to, that too on a daily basis. This ends up compounding the dissatisfaction of oneself and one’s associated body image.
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So what is the reason that so many people are unsettled by this phenomenon? Conventionally, in real-life scenarios, we seldom see our emoting faces and hardly ever do see our faces stacked side by side as seen in video chats. What is also important to understand is that the mobile-phone and computer web cameras often distort video quality and create a less-than-accurate true appearance of oneself. Several studies have noted that varying the distance increases the perceived size of nasal and facial appearance, overall producing an image of a more rounded face, wider set eyes, and a broader nose.8,9
May I never be complete. May I never be content. May I never be perfect. ―Chuck Palahniuk
Thus, given how this pandemic and the associated lockdown have either caused or aggravated existing anxiety and depression issues, it is very prudent for us clinicians to make not only ourselves but also patients understand and recognize the limitations of such digitized self- images and thus, by extension, to this flawed representation of the body image. There is already a surge in patients seeking aesthetic correction due to dissatisfaction of their facial appearance in Zoom and analogous apps. 7 A similar correlation between body dysmorphic disorder and self-perceived smile aesthetics has been noted. 10 Furthermore, self-confidence and perfectionism are also negatively associated with altered/poor dentofacial aesthetics, 11 a facet of our face which is being constantly projected in these video-conferencing platforms—for work, leisure, or otherwise. Thus, a similar surge in patients seeking orthodontic correction may be expected due to this ‘video-conferencing’-induced perception of poor dentofacial aesthetics, which in good probability may not correlate so well with actual clinical findings.
As ethical care providers, we must resist the financial temptation to cash in on such a frivolous opportunity, and instead of straight away placing appliances, it is my humble opinion that we should counsel the patient first before resorting to any other mode of interventional therapy. Unrealistic patient expectations are usually hard to fulfill and in turn cause a vicious cycle of treatment dissatisfaction and subsequent disaster management in practice (private or otherwise). As this phenomenon is unique and thought-provoking, here I would also invite communications and studies in this regard from our esteemed readers to further deconstruct the motivations behind this influx of patients in the era of Zoom.
Stay safe, and stay well.