Perception of Dental Students and Laypersons to Altered Dentofacial Aesthetics

Perception of dental appearance and aesthetic analysis among patients, laypersons and dentists

BACKGROUND

Current concepts of beauty are increasingly subjective, influenced by the viewpoints of others. The aim of the study was to evaluate divergences in the perception of dental appearance and smile esthetics among patients, laypersons and dental practitioners. The study goals were to evaluate the influence of age, sex, education and dental specialty on the participants' judgment and to identify the values of different esthetic criteria. Patients sample included 50 patients who responded to a dental appearance questionnaire (DAQ). Two frontal photographs were taken, one during a smile and one with retracted lips. Laypersons and dentists were asked to evaluate both photographs using a Linear Scale from (0-10), where 0 represent (absolutely unaesthetic) and 10 represent (absolutely aesthetic). One-way analysis of variance (ANOVA) and t-test analysis were measured for each group. Most patients in the sample expressed satisfaction with most aspects of their smiles and dental appearance. Among laypersons (including 488 participants), 47 pictures "with lips" out of 50 had higher mean aesthetic scores compared to pictures "without lips". Among the dentist sample, 90 dentists' perception towards the esthetic smile and dental appearance for photos "with lips" and "without lips" were the same for 23 out of 50 patients. Perception of smile aesthetics differed between patients, laypersons and dentists. Several factors can contribute to shape the perception of smile aesthetic.

AIM

To compare the perception of dental aesthetic among patients, laypersons, and professional dentists, to evaluate the impact of age, sex, educational background, and income on the judgments made by laypersons, to assess the variations in experience, specialty, age, and sex on professional dentists' judgment, and to evaluate the role of lips, skin shade and tooth shade in different participants' judgments.

METHODS

Patients sample included 50 patients who responded to DAQ. Two frontal photographs were taken: one during a smile and one with retracted lips. Laypersons and dentists were asked to evaluate both photographs using a Linear Scale from (0-10), where 0 represent (absolutely unaesthetic) and 10 represent (absolutely aesthetic). One-way ANOVA and t-test analysis were measured for each group.

RESULTS

Most patients in the sample expressed satisfaction with most aspects of their smiles and dental appearance. Among laypersons (including 488 participants), 47 pictures "with lips" out of 50 had higher mean aesthetic scores compared to pictures "without lips". Whereas among the dentist sample, 90 dentists' perception towards the esthetic smile and dental appearance for photos "with lips" and "without lips" were the same for 23 out of 50 patients. Perception of smile aesthetics differed between patients, laypersons and dentists.

CONCLUSION

Several factors can contribute to shape the perception of smile aesthetic.

Evaluating smile aesthetic satisfaction and related smile characteristics in dental students

Aim

This study aimed to assess the association between self-rated smile satisfaction and the smile dimensions among dental students.

Method

An analytical cross-sectional study was conducted on 216 Vietnamese dental students. A standardized photograph was taken of each student with their frontal social smiles to assess aesthetic dimensions. A single-session self-administered questionnaire containing five questions about smile aesthetic satisfaction related to various aspects was administered to all students. Differences in smile characteristics and satisfaction scores between the two genders were evaluated. The impact of smile characteristics on satisfaction scores was assessed using multiple linear regression models.

Results

Most dental students had a high smile line, parallel smile arcs, an upward upper lip curvature, a non-touching labiodental relationship, a dental midline that coincided with the midline of the face, and eight teeth displayed during smile. Most participants were satisfied with their smiles, and the self-rated satisfaction score was 67 out of 100. Self-perceived overall smile satisfaction was associated with the "smile arc", the "upper lip curvature", the "number of teeth displayed during smile", and the "dental midline". Female students had a statistically significant correlation between self-perception and smile characteristics, such as upper lip curvature, dental midline shift, and smile line.

Conclusions

The smile arc, upper lip curvature, and dental midline shift affected self-perceived satisfaction among dental students. Female students showed an association between the smile parameters and self-perceived satisfaction.

Influence of gingival display on smile attractiveness assessed by Saudi Arabian laypersons and dental professionals

This study was undertaken to evaluate the influence of changes in the gingival display of the maxillary teeth on smile attractiveness assessed by Saudi Arabian dental professionals and laypeople. A total of 138 dental professional and 182 laypeople rated the attractiveness of male and female smiles in a computerized survey. A smiling photograph of a male and a female dental students were selected and digitally manipulated to create changes the amount of gingival display from 4 mm of gingival display to 4mm of gingival covered by the upper lip in 1 mm increments. Each photo was accompanied by a visual analog scale (VAS) for rating. Among dental professionals, 61% rated the female photo with a 1-mm low lip line as the most attractive smile (VAS score ± SE, 7.3 ± 3.18), while 52.7% of laypeople considered the smile with a 2-mm low lip line as the most attractive (6.7 ± 3.4). Regarding male smile photos, 61.6% of dental professionals found the 1-mm low lip line the most attractive (7.3 ± 3.18). The same rating was given by 48.3% of laypeople (6.1 ± 3.6) (p ≤ 0.009). The least attractive smile photo was the smile showing 4 mm of gingiva for male and female smiles. More than half of the laypeople believed that an attractive smile highly affects social life and communication. The Saudi Arabian population appears to be sensitive to the amount of gingival display. The difference in female smile assessment between dental professionals and laypeople highlights the importance of dentist-patient consensus regarding decisions for esthetic treatments. Esthetic treatment is of a major concern for both dentist and patient. The careful assessment of smile pillars including gingival display must be tailored to each patient.

Effect of the ethnic, profession, gender, and social background on the perception of upper dental midline deviations in smile esthetics by Chinese and Black raters

BACKGROUND

The purpose of this study was to compare the perception of upper dental midline deviation on the attractiveness of a smile among raters from different ethnicities, professions, genders, and ages and measure to what extent the presence or absence of the associated smiling structures influence the raters' evaluations.

METHODS

A male subject (26 years of age) with adequate smile characteristics was selected by 3 experienced orthodontists, and 561 raters from 2 different ethnic groups (281 Chinese raters and 280 Black raters) rated the subject's smile after the subject's upper dental midline was digitally altered from 0 to 5 mm using a 5-point Likert scale on 12 smile photographs divided into two groups: group 1, in the presence of smile related structures, two-thirds of the nose, lips, and chin (NLC), and group 2, in the absence of smile related structures, the lips only (L).

RESULTS

There were statistically significant differences (p < 0.05) between the two ethnicities, in 2 mm and 4 mm in-group NLC and 5 mm in-group L, as well as the raters' profession to each midline shift of both groups (NLC) and (L) for both ethnicities except for 0 mm. Regarding the role of associated smile structures, the smile photos were observed in the presence of smile-associated structures, and in its absence (NLC × L), statistically significant differences (p < 0.05) were found when the deviation was 5 mm among the Chinese raters; in 1 mm, and 4 mm among the Black raters. Among different genders, statistical differences were only reported (p < 0.05) for Chinese raters for 5 mm in NLC, while statistical differences were observed for 2 mm and 3 mm in NLC for Black raters. For age categories, differences were observed (p < 0.05) for 4 mm, 5 mm in NLC and 4 mm, and 5 mm in L for Chinese raters, while 5 mm in NLC and 1 mm in L for Black raters.

CONCLUSION

Perception of the upper dental midline deviations was influenced by the factors of ethnicity, profession, presence or absence of smile-associated structures, as well as the gender and age of the raters.

[Esthetic perception of the smile according to gingival exposure in university students in Lima, Peru, 2020]

Objective

To determine the esthetic perception of the smile according to gingival exposure in undergraduate university students of dentistry and other degrees of different ages and sex in Lima, Peru 2020, and descriptively evaluate the main variables such as age and sex.

Methodology

A woman's smile was photographed following esthetic parameters, digitally modifying gingival exposure and obtaining six digital images. The images were rated by 512 students of dentistry and other degrees by means of a virtual survey using the Visual Analog Scale (values 0 to 10).

Results

The students perceived the 0.5 mm gingival exposure smile as more attractive and the 2.5 mm gingival exposure smile as unattractive. According to age, students aged 18 to 23 years perceived the 0.5 mm gingival exposure smile as more attractive and the 2.5 mm gingival exposure smile as less attractive, while students aged 24 to 29 years perceived the 1 mm gingival exposure smile as more attractive and the 2 mm gingival exposure smile as unattractive. According to gender, both found the 0.5 mm gingival exposure smile more attractive and the 2.5mm gingival exposure smile unattractive.

Conclusions

University students of dentistry and other degrees had the same perception of the smile in relation to gingival exposure, with a smile of 0.5 mm gingival exposure being considered attractive and the 2.5 mm smile unattractive. Younger students considered the smile with 0.5 mm gingival exposure more pleasant. Students of both sexes had the same esthetic perception of the smile.

Patterns of Facial Profile Preference in a Large Sample of Dental Students: A Cross-Sectional Study

The objective of this study was to explore dental students’ facial profile preferences in a large sample of students. Nine hundred and nineteen dental students of four dental schools were involved. As part of a larger study on dentofacial esthetics, six photo series consisting of one unaltered and four altered variants of the same female profile were distributed among the students. The altered features were ones that are esthetically significant according to the literature. The students had to indicate the photo in each series that they preferred. The data were analyzed in a regression model in which preference in the given photo series was the dependent variable and gender, grade of studies, and dental school were the factors. Eight hundred and sixty-one students (93.7%) responded. Gender and dental school were not associated with the observed preferences, but the grade of studies was associated for three of the modified parameters: chin prominence, the sagittal position of the maxillary dental arch, and the simultaneous modification of the prominence of the chin and the nose. This study has confirmed several earlier observations, and new observations have also been made. We have demonstrated that the anteroposterior position of the maxillary incisors may be an important determinant of profile esthetics, even if this position does not influence the situation of the soft tissues and if the forehead cannot be used as a reference. We have also shown that the harmony between the nose and the chin overrides the importance of their individual dimensions.

Esthetic Smile Perception Among Dental Students at Different Educational Levels

Purpose

To evaluate the perception of six esthetic components of the smile among dental students and whether such a perception was influenced by different education levels and gender.

Materials and Methods

This was an analytical cross-sectional study. A self-administered questionnaire was applied to all students (n=182) at clinical levels (year four and five) to evaluate a total of 6 ideal images (smile arc [SA], buccal corridor [BC], gingival display [GD], midline diastema [MD], crown length [CL] and width [CW]). In addition, students were asked to evaluate 20 altered images of these ideal images. A 10-point visual analogue scale was used to assess the ideal images, with the right end of the scale labeled “attractive smile” and represented by the number 10 and the left end of the scale labeled “unattractive smile” and represented by the number 0. The opposite scoring was applied for the altered esthetics smile images. Descriptive statistics was run to report sample characteristics, and the Mann-Whitney U-tests were performed to compare clinical levels and gender on aspects of esthetic smile.

Results

The response rate was 80% (77 females and 68 males). Students at level five scored statistically significantly (p<0.001) higher towered attractive esthetic smile in ideal SA, while students at level four scored statistically significantly (p=0.016 and 0.006, respectively) higher towered attractive esthetic smile in ideal GD and CL. At altered smile esthetics images evaluation, fifth year dental students scored statistically significantly (p=0.030, 0.026 and 0.028, respectively) higher towered unattractive esthetic smile in two altered images of SA and one of BC. In contrast, fourth year dental students scored statistically significantly (p=0.022, 0.048, 0.027, respectively) higher towered unattractive esthetic smile in one altered image of GD, midline diastema and crown width. Males in year four were more likely to score higher than females for ideal images meanwhile females in year five scored higher than males towards attractive smile in ideal images. Males and females differences in scoring ideal images on both levels were generally non-significant (P>0.05) although males were statistically significantly to score higher than females towards unattractive images in both levels (p<0.05).

Conclusion

Dental students at the fifth-year level of study had higher perception of esthetic components of smile than those at the fourth-year level. At each level of study, female dental students apparently had higher perceptions of smile esthetics than males.

Is Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ) Valid for the Indian Population?-A Psychometric Study

Objectives:

A culturally adapted and validated Oral Health-Related Quality of Life (OHRQoL) inventory helps to reliably compare patient perceptions among different populations. The Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ) evaluates the impact of dental aesthetics on OHRQoL. This study aimed to develop a regional version of PIDAQ (PIDAQ_Mal) for the Indian population and to assess differences in perceptions due to malocclusion in different population groups.

Materials and Methods:

PIDAQ_Mal was derived through the translation process and pilot-tested to assess test–retest reliability. Psychometric properties were tested on 285 subjects (31.2% males, 68.8% females; age range 18–25 years). Normative treatment need was assessed using Index of Orthodontic Treatment Need (IOTN)-Dental Health Component and subjective assessment using IOTN-Aesthetic Component (AC) and Perception of Occlusion Scale (POS). PIDAQ_Mal mean domain scores were compared with those of the previously validated versions to assess difference in perceptions.

Results:

Internal consistency and test–retest reliability were good (Cronbach’s α = 0.83–0.88; Intraclass Correlation Coefficient = 0.74–0.91). IOTN-AC and POS scores showed significant correlation with PIDAQ_Mal scores ensuring convergent validity (P < 0.001). Discriminant validity was confirmed by statistically significant differences (P < 0.001) in PIDAQ_Mal scores between subjects with no treatment need and moderate/definite need. Factor analysis derived four domains with one item showing cross-loading. Difference in mean domain scores among the previously validated versions of PIDAQ confirmed socio-cultural differences in perceptions due to malocclusion.

Conclusion:

PIDAQ_Mal was found to be reliable and valid for the Indian subjects and can be used as a condition-specific OHRQoL measure. Socio-cultural differences in perceptions were brought to light using the translated scale.