Psychometric properties of the Croatian version of the Orofacial Esthetic Scale and suggestions for modification

PURPOSE

The aims of this study were to develop a Croatian version of the Orofacial Esthetic Scale (OES) and to test its psychometric properties.

MATERIALS AND METHODS

The English version of the OES was translated into Croatian (forward-backward method). The original 11-point scale as well as a 5-point scale (1 = unsatisfactory, 5 = excellent) were used. Convergent validity was tested on 126 subjects, and discriminative validity was tested on the same subjects divided into four groups: esthetically normal patients (n = 25), esthetically impaired patients (n = 42), esthetically normal controls (n = 37), and esthetically impaired controls (n = 22). Test-retest reliability was tested on 43 subjects. Responsiveness was tested on 32 esthetically impaired patients who received prosthodontic treatment.

RESULTS

An additional explanation was added to the first two items of the OES. Convergent validity was confirmed by the association between OES scores and self-reported oral esthetics and three questions from the Oral Health Impact Profile related to esthetics (correlation coefficients ranged from 0.734 to 0.811, P < .001). Discriminative validity showed the results as predicted. Test-retest reliability showed high intraclass correlation (0.79 to 0.95) and no significant differences between the two administrations of the 5-point OES scale (P > .05). The 11-point OES scale showed significant differences for questions 3 and 8 (P < .01). Internal consistency showed high Cronbach alpha values (0.802 to 0.962). Responsiveness was confirmed by a significant difference between baseline and follow-up (P < .001) and a high effect size.

CONCLUSION

Psychometric properties of the Croatian version of the OES render the instrument suitable for the assessment of esthetics in Croatia. The authors recommend changing the first two items by adding the explanation that the questions are related to the lower third of the face and using the 5-point scale for rating.

[Cosmetic dental treatment. Its impact on happiness and quality of life]

This study assessed the impact on happiness and quality of life of the cosmetic treatment of frontal teeth. This was compared with the impact of a restorative, not primarily cosmetic, treatment in the (pre)molar region on happiness and quality of life. The hypothesis that a cosmetic dental treatment makes a person happier or improves the quality of one's life was not supported by the results of the present study. In fact, oral health-related quality of life appeared to decline after the dental cosmetic treatment. Further research is needed to assess whether the results of the present study can be replicated in a larger sample and how the findings can be explained.

[Quality of life and oral health in children]

In recent years, research on the influence of oral health on quality of life among children has become increasingly popular Half of the children and adolescents will have had moments of diminished oral health and that can lead to functional problems, pain and decreased quality of life. While measuring oral health-related quality of life of children, reports of parents are frequently used as a proxy. Diminished oral health not only has an impact on the child's quality of life, but also on that of his family members. Results from studies on oral health-related quality of life in children may be used as the basis for useful guidance for parents and children on improving oral health and quality of life.

Dental aesthetic self-perception and desire for orthodontic treatment among school children in Benin City, Nigeria

BACKGROUND

The availability of information on the individual perception of own's dental appearance and desire to uptake orthodontic treatment is of importance in the planning of orthodontic care within a population.

OBJECTIVE

The subjective assessment of personal dental appearance and desire for orthodontic treatment was appraised among Nigerian children.

METHODS

The study was conducted among 91 school children (33 boys, 58 girls) aged 12 years old in Benin City, south-southern region of Nigeria. The satisfaction of the subjects with the arrangement of their anterior teeth and desire to straighten their teeth was determined using a questionnaire. The subjects were further asked to rank their dental attractiveness in relation to the photographs in the Aesthetic component (AC) of the Index of Orthodontic Treatment Need (IOTN). The need for orthodontic treatment among the subjects was also assessed by the examiner with the Aesthetic component of IOTN. Chi-square tests were used for data analysis.

RESULTS

The result revealed that more than three-quarters (76.9%) of the subjects were satisfied with their dental aesthetics while 23.1% desired to have orthodontic treatment. The boys expressed significantly higher level of dissatisfaction with their dental aesthetics and a greater desire to have orthodontic treatment (P < 0.05). Most subjects (92.3%) rated their dental attractiveness in the "little to no need" orthodontic treatment grade on the AC scale. The normative borderline treatment need was higher than subjective borderline need but there was consistency in distribution of 4.4% in definite need treatment grade by the subjects and examiner.

CONCLUSION

The majority of the children rated their teeth as aesthetically satisfactory but there were gender differences in perception of dental aesthetics and desire for orthodontic treatment among this sample of Nigerian children.

Fears and concerns of individuals contemplating esthetic restorative dentistry

Questionnaires that focus on the fear of dental treatment typically include a narrow list of previous treatment-related factors. By omitting items concerned with psychologic, emotional, and interpersonal traits that impact treatment, practitioners often fail to gain additional valuable information on related anxiety issues. This study was undertaken to identify previously unrecognized or poorly discussed sources of fear and anxiety in patients seeking esthetic dental treatment. The Esthetic Clinic at Tufts University School of Dental Medicine recruited 62 participants who were asked to score their level of anxieties and concerns based on 24 different items on a 0 to 5 Likert scale. In addition, age, gender, and type of procedure in consideration were the only other variables recorded. The item that elicited the highest level of anxiety was "not feeling happy with my new smile." Thirty-eight respondents (61.3%) said they feel "markedly anxious"or "severely anxious" or answered "avoid completely." Concerns "that the outcome might look false and unnatural" or "that the dentist might not redo it if I am not satisfied with the outcome" both received 37 out of 62 (59.7%) similar responses. These results suggest obstacles to treatment exist not only in areas typically investigated but also in factors rarely discussed during the patient-practitioner encounter. The practitioner needs to consider a broader range of issues when addressing the patient's concerns.

Patients' self-perception of tooth shade in relation to professionally objective evaluation

OBJECTIVE

Self-assessment of teeth shade was compared with professional assessment.

METHOD AND MATERIALS

Patients' anterior teeth shade evaluation was conducted first by the patient (n = 193) and then by the clinician using the Vita shade guide.

RESULTS

In 18.7% of participants, self-assessment of teeth shade matched in hue and chroma to the clinician's evaluation. A positive correlation was found between participants' self-assessment of their shade and the clinician's assessment (P = .014; Pearson product moment correlation). Participants assessed their shade darker than the clinician (P < .001; chi-square test). Only 3.6% were highly satisfied with the shade of their teeth, and 83.4% were interested in a future bleaching procedure. Tooth shade was more accurately assessed by women (P = .02) and nonsmokers (P = .03; chi-square test).

CONCLUSION

A patient's preference toward a lighter shade should be addressed during treatment planning to match the patient's expectations for esthetics and increase patient satisfaction of treatment outcome. Patients may prefer white and shiny rather than a natural appearance.

Reliability and validity of the Orofacial Esthetic Scale in prosthodontic patients

PURPOSE

This study evaluated the reliability and validity of the Orofacial Esthetic Scale (OES)-an instrument assessing self-reported orofacial esthetics in prosthodontic patients.

MATERIALS AND METHODS

The OES has seven items addressing direct esthetic impacts in the orofacial region, as well as an eighth global assessment item. The response format was a 0 to 10 numeric rating scale (very dissatisfied to very satisfied with appearance, respectively). OES summary scores ranged from 0 (worst score) to 70 (best score). Test-retest reliability (n = 27) and internal consistency (n = 119) were assessed. Content validation (asking patients about their satisfaction with the questionnaire content, n = 119) and discriminative validation (comparing OES scores between patients and healthy controls, n = 119) were performed. Convergent validity was assessed by correlating patients' own OES scores (n = 29) with ratings from a consensus expert group (n = 4) and with the Oral Health Impact Profile (OHIP) esthetic-item summary score (n = 119).

RESULTS

Test-retest reliability was excellent for the OES scores (intraclass correlation coefficient = .96). Internal consistency was satisfactory for esthetically impaired patients (n = 27, Cronbach alpha = .86). Patients rated their satisfaction with the questionnaire content as 7.8 +/- 1.3 units on a 0 to 10 numeric rating scale (0 = very dissatisfied, 10 = very satisfied). OES scores discriminated esthetically impaired patients (31.4 units) from healthy controls (45.9 units, P < .001). OES scores correlated well with other measures of the same construct (r = .43 for patients' own assessment with an assessment by experts using the OES, r = -.72 for a correlation with the OHIP's three esthetic-related items).

CONCLUSIONS

The OES, developed especially for prosthodontic patients, exhibited good score reliability and validity.

Development of an Orofacial Esthetic Scale in prosthodontic patients

PURPOSE

Despite the interest and need to assess orofacial esthetics in prosthodontic patients, few self-reporting instruments are available to measure this construct, and none describe how prosthodontic patients perceive the appearance of their face, mouth, teeth, and dentures. The development of the Orofacial Esthetic Scale (OES) is reported in this article, in particular its conceptual framework, how questionnaire items were generated, and the scale's measurement model.

MATERIALS AND METHODS

After test conceptualization, the authors solicited esthetic concerns from 17 prosthodontic patients by asking them to evaluate their own photographs. A focus group of 8 dental professionals reduced the initial number of concerns/items and decided on an item response format. Pilot testing in 9 subjects generated the final instrument, the OES. Exploratory factor analysis was performed to investigate OES dimensionality and item analysis to investigate item difficulty and discrimination in 119 subjects.

RESULTS

Prosthodontic patients generated an initial 28 esthetic concerns. These items were reduced to 8 preliminary representative items that were subsequently confirmed during pilot testing. Analysis supported 8 items assessing appearance: face, profile, mouth, tooth alignment, tooth shape, tooth color, gums, and overall impression, measured on an 11-point numeric rating scale (0 = very dissatisfied, 10 = very satisfied). Exploratory factor analysis found only 1 factor and high positive loadings for all items (.73 to .94) on the first factor, supporting the unidimensionality of the OES.

CONCLUSIONS

The OES, developed especially for prosthodontic patients, is a brief questionnaire that assesses orofacial esthetic impacts.

Adaptation of the Oral Aesthetic Subjective Impact Score (OASIS) questionnaire for perception of oral aesthetics in Brazil

PURPOSE

The aim of the present study was to assess the cross-cultural adaptation and reliability and validity of the Oral Aesthetic Subjective Impact Score (OASIS) for the perception of oral aesthetics in Brazilian adolescents.

MATERIALS AND METHODS

The cross-cultural adaptation was developed in agreement with internationally recommended methodology. The psychometric properties were assessed by application of the Brazilian version of the OASIS in 304 adolescents aged 13 to 19 years who were enrolled at two public schools and one private school in Tubarão, Brazil. The internal consistency of the instrument was measured using Cronbach's alpha. The reliability was estimated through stability and homogeneity, using the Intraclass Correlation Coefficient and the Bland-Altman agreement. Validity was determined by comparing the OASIS-Brazil with the aesthetic component of the instrument Oral Impact on Daily Performance (OIDP) using the Spearman Rank Correlation Coefficient.

RESULTS

The internal consistency obtained was 0.52. Inter-observer and intra-observer correlations were strong, 0.87 and 0.83, respectively. The correlation with the aesthetic part of OIDP was 0.44.

CONCLUSIONS

The results showed that the process of cross-cultural adaptation was successful and the adapted instrument showed good psychometric properties.

Self-perception regarding the need for orthodontic treatment among impoverished schoolchildren in Brazil

AIM

The objectives of the present study were to assess predictive factors associated to self-perception regarding the need for orthodontic treatment among 170 impoverished schoolchildren.

MATERIALS AND METHODS

A cross- sectional study was conducted in public schools in the city of Belo Horizonte-MG (Brazil). Children's self-perception regarding the need for treatment was assessed using the Aesthetic Component of the Index of Orthodontic Treatment Need (IOTN-AC) and a questionnaire addressing biopsychosocial factors. The chi-square test and multiple logistic regression were used in the data analysis.

RESULTS

The predictive factors for the self-perception of orthodontic treatment need on the part of the impoverished schoolchildren included ridicule from persons close to the children regarding the appearance of the teeth (OR 2.81; 95%CI 1.2 to 6.4), dissatisfaction with oral aesthetics due to the alignment of the teeth (OR 2.45; 95%CI 1.1 to 5.4) and missing teeth (OR 3.02; 95%CI 1.0 to 9.23).

CONCLUSION

The alignment of the teeth, missing teeth and ridicule from others regarding the appearance of the teeth are the factors that most strongly influence self- perception regarding the need for orthodontic treatment among impoverished schoolchildren.

Perception of dental aesthetics in paediatric dentistry

AIM

Assessing the perception of the aesthetic components of the oral health by paediatric patients at different stages of the child psychological development of Piaget.

MATERIALS AND METHODS

Twenty children aged between 21 months and 11 years, of both sexes, patients of a private clinic, were selected. The present study group consisted of patients treated for oral pathologies. A set of similar supplies was given to all children and they were asked to do a drawing, whose theme was "beautiful teeth and ugly teeth". The drawings were evaluated according to the classification of the cognitive development of Piaget.

RESULTS

Children of all ages clearly represent their perception of what "beautiful teeth" and "ugly teeth" are. These representations provide the dental professional a clear vision of the child's feeling about dental aesthetics.

CONCLUSION

The drawings are a useful source of information for assessing the aesthetic perception of paediatric patients. The knowledge of the children's aesthetic perception is relevant to paediatric dentists because children are conscious about their dental aesthetic appearance and that of the other children.

Oral health-related quality of life and dental esthetics in Amsterdam schoolchildren

PURPOSE

The purpose of this study was to examine the oral health-related quality of life (OHRQoL) of schoolchildren in Amsterdam, The Netherlands, and to assess the relationship between OHRQoL and self-reported dental esthetics.

METHODS

The Child Oral Health Impact Profile (COHIP) was completed by 510 seventh and eighth graders of public primary schools. Subjects also assessed their own dentition with the Esthetic Component of the Index of Orthodontic Treatment Need (AC-IOTN). Gender differences on COHIP subscales and the AC-IOTN were examined using Mann-Whitney U tests. Correlations between the COHIP subscales and the AC-IOTN were assessed with Spearman's rank correlation coefficient.

RESULTS

Boys scored significantly lower on the subscales "oral symptoms" and "emotional well-being" than girls. Correlations between OHRQoL and the AC-IOTN were low but significant for boys for the domains "oral symptoms" (0.137) and "emotional well-being" (0.186) and for girls for the domains "functional well-being" (0.148), "emotional well-being" (0.195), and "peer interaction" (0.215).

CONCLUSIONS

Dutch schoolchildren in Amsterdam generally reported good oral health-related quality of life. Boys seemed to experience a slightly lower impact of oral symptoms and better emotional well-being than girls. Children's self-perceived dental esthetics did not seem to constitute a relevant variable to explain their level of OHRQoL.

Agreement of quantitative subjective evaluation of esthetic changes in implant dentistry by patients and practitioners

PURPOSE

To evaluate the agreement of quantitative subjective evaluation of esthetic changes in implant dentistry and differences in perception among patients and practitioners.

MATERIALS AND METHODS

Four standardized clinical preoperative and postoperative pictures placed in random order were shown to 30 patients treated with dental implants, on two separate occasions, to subjectively evaluate the esthetic changes using both a graded scale and a visual analogue scale (VAS). The photographs included the front views of the overall smile and, when available, magnified pictures of the area treated including the two neighboring teeth. The same photographs were shown to 10 independent clinicians, who used the same scoring system. Agreement was assessed by evaluating intraobserver and interobserver agreement with a weighted Kappa statistic.

RESULTS

In general, agreement was moderate to substantial among patients but only fair among clinicians, with only one practitioner being consistently reproducible. Patients had better agreement than clinicians, but they only evaluated themselves, whereas the clinicians each had to evaluate 30 patients. The agreement of all patients together compared to each individual clinician was poor. The overall agreement between clinicians was also poor.

CONCLUSIONS

This study of evaluations of pretreatment and posttreatment photographs by 30 patients and clinicians showed that: (1) patient responses were more in agreement, but patients evaluated only their own results; (2) practitioner responses were less in agreement than patient response, but clinicians evaluated all 30 patients; and (3) agreement between patients and clinicians was poor.

The factors effecting satisfaction of dental appearance and self-perceived need for orthodontic treatment in 10-11 and 14-15 year-old Lithuanian schoolchildren

Assessment of need for orthodontic treatment is complex and the opinion about it might differ between the orthodontist and children. Personal perception of the need for orthodontic treatment may be influenced by a variety of social, economical and cultural factors. The aim of this study was to investigate whether there is an association between normative and self-perceived orthodontic treatment need, and to evaluate the influence of age, gender and socioeconomic background on satisfaction of dental appearance and demand for orthodontic treatment. The study included 2024 schoolchildren: 1193 (657 girls and 536 boys) 10-11 year-old and 831 (450 girls, 381 boys) 14-15 year-old. The objective need for orthodontic treatment was found to be 42.6 percent while self-perceived need 35.3 percent among Lithuanian schoolchildren. Girls thought that they needed treatment more frequently than boys independent of age and living area.

[Does Jesus have metal-free teeth in a country of the toothless?: dentistry of vanities and desires]

This paper describes how dentistry in Brazil currently participates in the transformations of the object of its activity into commodities with which consumers can indulge their aesthetic desires. It explores the construction of the dental object of desires and its relationship with the dentist and the patient-consumer in the contemporary world. The paper makes explicit the role of the mega-dental congresses, which provide a biotechnological self-service that allure and seduce, creating uniform consumer values eager for the new offerings from dental surgeons. Also analyzes the role of the media in dental practices. It concludes that the individuation of the dental surgeon has generated a petrified ontology and fragmented epistemology. The paper presents some pressing tasks for the academic and professional sectors and society as a whole, such as the development of strategies and discussion about communication related to oral health.

[The dentist between medicine and cosmetology. Ethical shortcomings of the esthetics boom in dentistry]

Dentistry has evolved from a genuine medical practice to a mere business. From an ethical point of view it is asked whether this evolution creates more problems than it solves. The paper elaborates four arguments against this evolution and shows that aesthetics in dentistry which works only according to market categories runs the risk of loosing the view for the real need of patients. Dentistry which comprehends itself as part of a market will be nothing else than a part of a beauty industry which has the only aim to sell something, but not the aim to help people. Such a dentistry makes profit from the ideology of a society which serves only vanity, youthfulness and personal success and which is losing the sight for real values. The real value of man cannot be reduced to his appearance and medicine as an art should feel the obligation to resist these modern ideologies and should help people to get a more authentic attitude to themselves. If modern dentistry fails to think about these implications it will lose its identity as medicine, which would be too great a loss.

Correlations between the changes in patients' dental-facial morphology at the end of the orthodontic treatment and the psychological variables

The purpose of this research was to assess the impact that the improvement of patients' dental-facial morphology has at the end of the orthodontic treatment upon the following psychological variables: self-esteem, current self-related thoughts as well as upon the variables of social self-esteem and performance. The number of patients included in the study was of 168 (82 children and 86 adolescents) who carried out the orthodontic treatment. At the end of the active treatment, we applied to all patients the assessment instruments for the level of self- esteem and self-related current thoughts: the Rosenberg's Self-Esteem Scale and the Heatherton & Polivy Current Thoughts Scale. As far as the patients in the study are concerned, the improvement of their facial aspect at the end of the treatment showed a significantly positive correlation with the variables of global self-esteem, self-related current thoughts, social self-esteem and performance, with the exception of the girls in children study group who showed no correlations between physical aspect and the performance variable.

Multivariate analysis of patient satisfaction factors affecting the usage of removable partial dentures

The purpose of this retrospective cohort study was to investigate patient satisfaction factors that affect the usage of removable partial dentures (RPDs) using a multivariate analysis. Sixty-seven patients, who had RPDs inserted at the Tohoku University Hospital between 1996 and 2001, participated in this study. Data were collected from patients' clinical records and a questionnaire. Of the 15 factors examined, significant associations were found between RPD usage and pain, color of the artificial teeth, and arrangement of the artificial teeth. These findings suggest that RPD usage is related to patient satisfaction with esthetics and an absence of pain.

Are ratings of dentofacial attractiveness influenced by dentofacial midline discrepancies?

AIMS

To assess the attractiveness of dentofacial midline discrepancies during smiling, and to determine if the ratings were influenced by the gender of the judges.

METHODS

Twenty non-dental undergraduate students (10 males, mean age: 33.5 years; 10 females, mean age: 31.2 years) and 20 orthodontists (10 males, mean age: 36.6 years; 10 females, mean age: 34.3 years) assessed frontal photographs of the same smiling adult female with coincident midlines, and images of the same person with the upper dental midline shifted 2 mm and 4 mm to the right and left of the facial midline. The judges scored the attractiveness of the smile using 5-point scale.

RESULTS

Both the students and the orthodontists considered that the images were less attractive as the dentofacial midline discrepancy increased. More orthodontists than undergraduate students, and more female orthodontists than male orthodontists, considered a 4 mm discrepancy between the dental and facial midlines as unattractive.

CONCLUSION

Dental to facial midline discrepancies reduce dentofacial attractiveness. Discrepancies of 2 mm or more are likely to be noticed by both orthodontists and non-dental university students. Orthodontic treatment objectives should include correction of the dental midline discrepancies to within 2 mm of the facial midline.

[Satisfaction about physical appearance and teeth. Results of a nationwide study]

In a study involving a group of 907 randomly selected Dutch individuals, satisfaction about one's physical appearance and satisfaction about the appearance of one's teeth were assessed. Furthermore, the relationship between body esteem and happiness was explored. Three quarters of the respondents were satisfied about their physical appearance, while 70% was satisfied about the appearance of their teeth. Women and people with a non-Dutch background were significantly less likely to be satisfied about their physical appearance than men and those with a Dutch background. Individuals 30 years old and younger were more likely to be satisfied about their teeth than those who were older. Almost two third of the respondents (64%) reported that the appearance of their teeth contributed positively to their happiness. Women and people with a non-Dutch background were most likely to indicate that the appearance of their teeth contributed to their happiness. Satisfaction about general physical appearance and appearance of the teeth were significantly associated with happiness. Prospective studies are needed to examine to what extent esthetically motivated dental treatments make people happy and enhance their general well-being.

Awareness of malocclusion and desire for orthodontic treatment in 11 to 14 year-old Nigerian schoolchildren and their parents

OBJECTIVES

To investigate Nigerian children's and their parents' satisfaction with the children's facial and dental appearances and their desire for orthodontic treatment, and to compare their assessments of treatment need with those determined by an orthodontist.

METHODS

The subjects were 242 11-14 year-old schoolchildren randomly selected from private and public schools in the Ife Central Local Government area, Nigeria. A questionnaire was used to obtain information from the children and their parents of their liking of the facial and dental appearances of the children and the need and desire for orthodontic treatment. The children, the parents and an orthodontist used the Aesthetic Component (AC) of the Index of Orthodontic Treatment Need (IOTN) to assess the need for treatment.

RESULTS

More parents liked their child's facial and dental appearances than the children liked themselves. Almost twice as many schoolchildren thought they needed (27 per cent) and desired (29 per cent) orthodontic treatment than their parents (115 per cent). Low, but statistically significant correlations, were found between the children's, their parents' and an orthodontist's assessments of treatment need using the AC scale. Only 8 per cent of the children and 3 per cent of the parents considered that there was a 'moderate-definite' need of treatment. The orthodontist considered 38 per cent of the children had a 'moderate-definite' need of treatment.

CONCLUSIONS

The children's responses suggest greater concern about their facial and dental appearances, a greater perception of the need for orthodontic treatment and greater desire for treatment than their parents. These findings require further investigation as previous studies have reported that parents are usually more motivated for orthodontic treatment than their children.

Bimaxillary protrusion in the Palestinian population

OBJECTIVE

To study the prevalence of bimaxillary protrusion among Palestinians.

MATERIALS AND METHODS

Cephalometric radiographs for 79 normal occlusion adult Palestinian university students were traced.

RESULTS

The interincisal angle was decreased in the Palestinian women compared to the Caucasian means, but this had no impact on lip protrusion.

CONCLUSION

Relative to Caucasian cephalometric norms, Palestinians show no extraoral bimaxillary protrusion features, and therefore, these norms can be applied to Palestinian faces.

Influence of anterior occlusal characteristics on self-perceived dental appearance in young adults

OBJECTIVE

To determine the individual and combined influence of some anterior occlusal characteristics on self-perceived dental appearance in a sample of young adults.

MATERIALS AND METHODS

This cross-sectional study was conducted at a dental clinic of a private university in Lima, Peru. A total of 267 first-year students (16 to 25 years old) were randomly selected. A visual analog scale (VAS) was used to determine the self-perceived dental appearance. Clinical examinations were conducted to determine incisal irregularity, anterior dentoalveolar spacing, midline diastema, anterior missing teeth, overjet, and overbite. Simple and multiple linear regression analyses were performed to determine the individual and combined influence of each anterior occlusal characteristic on self-perceived dental appearance.

RESULTS

From the eight occlusal characteristics and two covariables evaluated, only maxillary and mandible incisal irregularity (P=.001 and .002 respectively), presence of anterosuperior spacing (P<.001), and number of missing anterior teeth (P=.003) were inversely associated with self-perceived dental appearance, whereas gender (male) was directly associated to the dependent variable (P=.021). Specifically, anterior maxillary spacing, maxillary incisal irregularity, mandible incisal irregularity, and the number of missing teeth were, in that order, the anterior occlusal characteristics with the most negative influence on self-perceived dental appearance.

CONCLUSIONS

This study confirmed that occlusal characteristics in the anterior portion of the mouth play a role on dental esthetics. However, it should be emphasized that their grouped influence is minimal (less than 20%).