Saudi Children's and Their Parents' Perception of a Digitally Modified Photograph Model of Different Smiles with Different Anterior Teeth Alignments and Dental Appearances

AIM

Since there is a lack of data on dentofacial esthetic perception in Saudi Arabia, the present research was conducted to study children's and their parent's perceptions of smiles with different dental alignments and dental appearances. In addition, we aimed to determine whether facial attractiveness or dental esthetic dominates the overall esthetic perception. Finally, we aimed to investigate the influence of gender on the judgment of a dental smile.

MATERIALS AND METHODS

Six digitally altered photographs and two dynamic videos of smiling faces of boys and girls with different dental alignments and appearances were shown to 183 children and their parents in malls in Saudi Arabia's Qassim Province. Following the parent's acceptance of the interview, the child was interviewed first, followed by the parent. Their responses were measured using a smile perception questionnaire (SPQ) for children aged 8-10 years. Data were analyzed using the Kruskal-Wallis one-way analysis of variance (ANOVA) and the Wilcoxon signed-rank test.

RESULTS

The results demonstrated that whole-face smiles of both boys and girls with different poor dentofacial esthetics had a significantly lower rating score than lower third-face smiles scores among children and their parents (p ≤ 0.05). Except for a few views, there were no significant differences between children's and their parents' dentofacial esthetic judgments. Moreover, the answers to the smile perception questionnaire 8-10 for the smiling face dynamic videos of boys and girls were not significantly different.

CONCLUSION

Children agreed with their parents in judging the smiles of different dentofacial esthetic perceptions. Overall, esthetics was more influenced by facial esthetics than dental esthetics. Background attractiveness and sexual characteristics do not affect smile perception.

CLINICAL SIGNIFICANCE

The smile is considered one of the major determinants of how the overall esthetic of children will appear. Thus, the comprehensive diagnosis involving the analysis of malocclusion and poor dental appearance psychological effect can be used for patient care improvement. Consequently, dental treatment to improve the dental smile will enhance the children's quality of life and social interaction.

Social attractiveness perception of a cleft lip repair in an adolescent via eye-tracking

PURPOSE

The present study was designed to investigate the perception of unilateral cleft lip (UCL) repair scar using an image of an adolescent and eye-tracking technology.

MATERIAL AND METHODS

Frontal and oblique views of an image of an adolescent with a unilateral upper lip scar result of a corrective surgery. Eighty-five laypeople respondents were divided into three groups: Group A (15-44 years of age); Group B (45-59 years of age); and Group C (≥ 60 years of age). Gaze tracking was carried out to assess the location on the image of greatest fixation, to create dot maps and to follow the trajectory of the gaze. Respondents also assessed six attention questionnaires. The answers and assessment of the VAS were compared. P-values <0.05 were considered significant in the analyses.

RESULTS

The central focus of the visualization was concentrated on the upper lip and the region of the nostril, followed by the eyes. Time until 1st fixation upon right lip and mouth showed differences with regard to different images. Images of the model shown in various guises including smiling or not, in a frontal or oblique views showed significant differences in VAS scoring (p<0.001).

CONCLUSION

The presence of a scar from the UCL repair in an adolescent was noted in the foreground by laypeople. The scar was associated with a lower degree of attractiveness, happiness, and intelligence, as well as with shyness and sympathy, although a visible scar did not influence the perception of "good hygiene habits".

The effect of malocclusion on dating prospects

Objective:

To establish whether the appearance of malocclusion affected dating prospects. The secondary objective was to identify any significant predictors relating to likelihood of dating.

Design:

Cross-sectional study.

Setting:

King’s College London.

Participants:

A total of 232 undergraduate students.

Methods:

Participants were shown images of either one man or one woman. The images had been manipulated using computer software to represent one of three differing dental appearances: post-orthodontic aligned teeth; pre-orthodontic crowded teeth; or pre-orthodontic missing teeth (developmentally absent maxillary lateral incisors). Sealed envelopes were randomly assigned to participants, who rated the individual in the image in relation to: attractiveness; intelligence; happiness; nervousness; and how much they would want to go on a date with them. The response format was a 100-mm visual analogue scale.

Results:

The aligned dental appearance received statistically significant higher ratings of attractiveness ( P < 0.001), intelligence ( P = 0.031), likelihood of dating ( P = 0.017) as well as lower ratings of nervousness ( P = 0.020). There was no statistically significant difference in relation to happiness ( P = 0.43), neither were there any statistically significant differences between the crowded and missing dental appearances. Regression analysis revealed that rated attractiveness was the most significant predictor in relation to likelihood of dating ( P < 0.001).

Conclusion:

Malocclusion did influence dating prospects. Photographs of individuals with aligned teeth were more likely to be rated highly in relation to attractiveness, intelligence and likelihood of dating, when compared with images of malocclusions. The most significant predictor of likelihood of dating was rated attractiveness.

Children's perceptions of smile esthetics and their influence on social judgment

OBJECTIVE

To define a threshold of acceptance of smile esthetics for children and adolescents.

MATERIALS AND METHODS

A systematic search in the medical literature (PubMed, PubMed Central, National Library of Medicine's Medline, Embase, Cochrane Central Register of Controlled Clinical Trials, Web of Knowledge, Scopus, Google Scholar, and LILACs) was performed to identify all peer-reviewed papers reporting data regarding the evaluation of children's and adolescents' perceptions of dental esthetic factors. The search was conducted using a research strategy based on keywords such as "children," "adolescents," "smile aesthetics perception," "smile aesthetics evaluation." Studies analyzing smile esthetics involving at least 10 observers younger than 18 years of age were selected.

RESULTS

Among the 1667 analyzed articles, five studies were selected for the final review process. No study included in the review analyzed perception of smile anomalies in a quantitative or qualitative way, thus no threshold was identified for smile features. Among the analyzed samples, unaltered smiles were always significantly associated with better evaluation scores when compared with altered smiles.

CONCLUSIONS

Smile esthetics influence social perception during childhood and adolescence. However, thresholds of smile esthetic acceptance in children and adolescents are still not available.

Objective assessment of compliance with intra- and extraoral removable appliances

OBJECTIVE

To conduct an objective assessment of the level of compliance in young patients prescribed various types of removable appliances and to determine the influence of device type, treatment duration, and patient age, gender, psychological maturity, and awareness of monitoring on compliance.

MATERIALS AND METHODS

A total of 30 patients were fitted with either a class 2 (Frankel or bionator) or a class 3 (face mask) removable appliance, each bearing a compliance indicator chip, and they were instructed to wear them for 13 hours per day. Compliance was monitored by means of the sensor for an average of 8 months. Of the patients, 14 were informed that their appliance was fitted with a monitoring sensor, and 16 were not. The psychological maturity of all patients was assessed on the Nowicki-Strickland Locus of Control Scale, and the effect on compliance of this score as well as the patient- and treatment-related variables considered were determined via statistical analysis Results: The mean compliance recorded by the chips was 8.6 ± 2.9 hours, far lower than the 13 hours prescribed, and younger patients showed significantly greater compliance than adolescents (P < .01). However, no significant differences in compliance were found between intra- and extraoral appliances, and neither gender, psychological scores, treatment duration, nor awareness of being monitored had any significant effect.

CONCLUSIONS

Compliance is generally very poor in young patients, regardless of their gender and psychological maturity. Although awareness of monitoring does not appear to boost compliance, such systems may be a valuable means of providing a dentist with objective information regarding their patients' compliance.

Negative self-perception of smile associated with malocclusions among Brazilian adolescents

This study estimated the prevalence of negative self-perception of smile because of occlusion abnormalities and investigated their association according to standard clinical criteria. The sample consisted of 1290 randomly selected Brazilian adolescent boys and girls aged 12-16 years. The outcome of interest was dissatisfaction with smile, and data were collected using a standardized questionnaire. Occlusion characteristics were assessed using the dental aesthetic index (DAI). The other study variables were gender, age, and use of dental services. A chi-square test and Poisson multiple regression were used for statistical analysis. Of the 1290 students interviewed and examined, 539 (41.8 per cent) were dissatisfied with their smile; of these, 373 (69.2 per cent) assigned their dissatisfaction to the presence of an occlusal abnormality, and 166 (30.8 per cent) reported reasons other than occlusal abnormalities for their negative self-perception of their smile. In multivariate analysis, the following variables were associated with the outcome of interest: maxillary anterior irregularity [prevalence ratio (PR) = 1.40; 95 per cent confidence interval (CI) = 1.29-1.80], incisal spacing (PR = 1.37; 95 per cent CI = 1.19-1.57), vertical open bite (PR = 1.34; 95 per cent CI = 1.15-1.55), mandibular anterior irregularity (PR = 1.29; 95 per cent CI = 1.14-1.46), permanent anterior teeth missing (PR = 1.21; 95 per cent CI = 1.05-1.39), and incisal diastema (PR = 1.14; 95 per cent CI = 1.01-1.31). The negative self-perception of smile was statistically associated with severity of occlusal disorders according to the DAI scores, which suggests that self-perception should be used together with standard clinical criteria when decisions about orthodontic treatments are made in public health care systems.