**4. Psychological impact of maxillofacial defect**

Maxillofacial defects may be congenital, developmental or acquired. **Acquired defects produce a deeper impact as the individual is not born with the same and is affected later in life, resulting in drastic change in appearance, post-surgical or after Prosthodontic intervention.** They alter the integrity of craniofacial region leading to disruption in normal functioning, maintenance of form and esthetic appearance of an individual affecting overall psychological status of the patient. **The condition might also alter the individual's financial, spiritual and social status due to irreversible loss. Impaired social status due to physical disfigurement and mental impact. Individuals are also affected spiritually as they question 'Why Me'**. Surgical or Prosthodontic modalities help in rehabilitation of the patient to bridge the gap and help to restore his individuality in the society. The whole process may manifest itself into various kinds of psychological impairment including psychoneurotic, psychotic or personality disorders and the treating clinician must observe for clinical signs hinting towards these [6]. These may include:

**Anxiety disorders** including panic disorder, obsessive-compulsive disorder (OCD), posttraumatic stress disorder (PTSD), social phobia, and generalized anxiety disorder.

**Mood disorders** or **affective disorders**, create disturbances in a person's emotional life. Depression, mania, and bipolar disorder are examples of mood disorders.

People with schizophrenia and other psychotic disorders lose contact with reality. Symptoms may include delusions and hallucinations, disorganized thinking and speech, bizarre behavior, a diminished range of emotional responsiveness and social withdrawal.

**Personality Disorders** are mental illnesses in which one's personality results in personal distress or a significant impairment in social or work functioning.

**Cognitive disorders**, such as delirium and dementia, involve a significant loss of mental functioning. **Dissociative disorders** involve disturbances in a person's consciousness, memories, identity and perception of the environment [7].

**A patient suffering from any mental or behavioral disorder sustains a deeper impact of the disease or the residual maxillofacial defect produced as a result of surgical correction due to altered or reduced tolerance.**
