Dental esthetic satisfaction in adults

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.

A Pilot Study About the Effect of Laser-Induced Fluorescence on Color and Translucency of Human Enamel During Tooth Bleaching

Objective: To probe into the effect of laser-induced fluorescence (LIF) on color and translucency of human enamel during tooth bleaching. Materials and methods: Twenty enamel slabs were randomly assigned to be whitened by acidic 30% hydrogen peroxide (HP), neutral 30% HP, alkaline 30% HP, and distilled water, respectively, monitored by a colorimeter and Raman spectrometer simultaneously. Afterward, the parameter differences of color, translucency, Raman relative intensity, and LIF intensity between baseline and post-treatment of each bleaching cycle were calculated. Results: The results demonstrated that the three bleaching groups resulted in increasingly prominent whitening outcome over time compared with control group, and no statistical difference was detected between them. Accordingly, the bleaching groups also engendered a same decrease tendency in fluorescence intensity (FI). However, less demineralization effect occurred on the enamel surface in neutral HP group. The correlation analysis further excluded the effect of demineralization on all the optical parameters (p > 0.05). Besides, various degrees of dependency were detected between FI and translucency parameter (TP), masking effect (ME), C*ab, W*, b*. In addition, ΔFI was associated with parameters of ΔC*ab, ΔW*, Δb*, ΔE, Δa*, and ΔME. ΔFI% was correlated with ΔC*ab, Δb*, ΔW*, and ΔE values. Conclusions: Thirty percent HP with different pH values could result in same variation tendency of enamel color, translucency, and FI. Plus, FI showed a strong association with enamel color and translucency alteration, which is promising for future application as a nondestructive testing method to evaluate bleaching effect and might be a novel way to investigate tooth bleaching mechanism.

Perception of Professional Female College Students Towards Smile arc Types and Outlook about their Appearance

Aims and Objectives

The aim of this study is to assess the perception of female students about the type of smile arc as well as their outlook about different parameters of esthetics.

Materials and Methods

A study was conducted among female students of King Khalid University, Abha, Saudi Arabia. One section of the questionnaire contained pictures having three types of smile arc wherein the respondents had to select any response ranging from 1 to 4 (1 for beautiful, 2 for good, 3 for average, and 4 for poor); besides it included 12 questions regarding the viewpoints of respondents about their smile and dental esthetics. The collected data were analyzed using the statistical package for social services version 16.0 (SPSS Inc., Chicago, IL, USA, 2001).

Results

The dental students accounted for least mean score of 1.807 ± 0.8174 for consonant smile arc while it was 2.692 ± 0.8053 and 2.235 ± 0.9074 for information technology (IT) and medical students, respectively. When the individuals were asked whether they had a pleasant smile or not; only 53.8% of the dental students, 76.9% of the IT students, and 66.7% of the medical students responded positively.

Conclusion

It was concluded that most of the female dental students were able to identify the consonant smile arc as being more beautiful than the flat and reverse smile arcs whereas lesser medical and IT students could perceive the smile arcs in the same manner. It was also observed that almost all the study participants were quite conscious about their smile attractiveness and dental esthetics.

Relationship between the psychosocial impact of dental aesthetics and perfectionism and self-esteem

Background

Awareness of the influence of personality traits such as self-esteem and perfectionism on the aesthetic self-image can help clinicians to improve their patients’ satisfaction and quality of life. The main objective of this study was to examine the relationship between self-esteem, perfectionism and the psychosocial impact of dental aesthetics, and their association with gender.

Material and Methods

A descriptive-analytical cross-sectional study was conducted in a sample of 301 students of the Faculty of Medicine and Dentistry of the University of Valencia, aged between 18 and 30 years. Each participant was asked to complete a survey comprising three questionnaires: PIDAQ (Psychosocial Impact of Dental Aesthetics Questionnaire), MPS (Multidimensional Perfectionism Scale) and RSS (Rosenberg Self-esteem Scale). The response rate was 79%.

Results

The mean age was 20.8 years; 226 were women (75 %) and 75 were men (25 %). A negative correlation (Pearson = -0.387) was found between the total PIDAQ score and self-esteem. The correlation with perfectionism was found to be positive (Pearson = 0.281). On comparing the questionnaire and subscale scores by gender, the only statistically significant differences were in perfectionism (men 97.4, women 89.1) and self-confidence (men 22.1, women 23.5).

Conclusions

The students most affected by poor dental aesthetics had lower self-esteem and higher levels of perfectionism. The men presented higher levels of perfectionism than the women, while the latter displayed greater self-confidence in their dental aesthetics. Clinicians should pay greater attention to these traits and to their implications for treating these patients.

Key words:Psychosocial impact of dental aesthetics questionnaire, multidimensional perfectionism scale, rosenberg self-esteem scale, students.

Oral health self-perception in quilombola communities in Rio Grande do Sul: a cross-sectional exploratory study

Objective:

There's a shortage of evidence on the oral health of quilombolas. This study aims to describe oral health self-perception, as well as to verify its associated factors in quilombola communities in the state of Rio Grande do Sul.

Methods:

The data for this cross-sectional health survey were collected by application of a questionnaire. Since this study was part of a survey on nutritional security, the probabilistic cluster sample was estimated for the outcome of nutritional insecurity, comprising 583 individuals across quilombola communities in Rio Grande do Sul. The association between the outcome of negative oral health self-perception and sociodemographic, general health, and oral health variables was measured by prevalence ratios obtained through Poisson regressions with robust variance and 95% confidence intervals.

Results:

Negative self-rated oral health was reported by 313 (53.1%) of the individuals. Satisfaction with chewing ability and satisfaction with oral appearance were associated with a higher prevalence of negative perception of oral health, while there was no association between the outcome and number of teeth. Use of alcohol had a borderline association with the outcome.

Conclusion:

Satisfaction with appearance and chewing ability are factors associated with oral-health self-perception of the quilombolas in Rio Grande do Sul.

Self-Evaluated Dental Appearance Satisfaction among Young Adults

BACKGROUND

Dental appearance satisfaction is important among young adults because judgment concerning the personal characteristics of individuals is influenced by their dental appearance in the absence of other information.

AIM

The aim of the study was to determine the self-evaluated dental appearance satisfaction among young adults.

SUBJECTS AND METHODS

This cross-sectional survey of financial industry prone undergraduates of University of Benin was conducted between July and September, 2010. The self-administered questionnaire which assessed information on demographic characteristics, smoking habit, alcohol use, previous dental visit, dental appearance satisfaction, tooth shape, size, arrangement and strength was the tool of data collection. The data was subjected to descriptive, Chi-square and regression statistics using statistical package for the social sciences version 17.0 (Chicago, IL, USA). (P < 0.05) was considered to be significant.

RESULTS

A total of 399 undergraduates which are made up of 179 (44.9%) males and 220 (55.1%) females with mean age of 24.66 (4.20) years participated in this study. Self-evaluated dental appearance satisfaction was expressed by 79.4% (317/399) of the participants. The significant predictors of self-evaluated dental appearance satisfaction were skin color (P = 0.03, odds ratio [OR] =2.57, 95% confidence interval [CI] =1.09-6.09) and perceived tooth strength (P = 0.02, OR = 5.83, 95% CI = 1.40-24.28) among males and alcohol consumption (P = 0.04, OR = 0.45, 95% CI = 0.21-0.95] and perceived size of tooth (P = 0.02, OR = 2.37, 95% CI = 1.15-4.89) among females. The significant predictors of self-evaluated dental appearance satisfaction among the participants were ethnicity (P = 0.04, OR = 0.55, 95% CI = 0.32-0.96), skin color (P = 0.04, OR = 1.74, 95% CI = 1.03-2.93), perceived tooth size (P = 0.03, OR = 1.82, 95% CI = 1.07-3.09) and strength (P = 0.01, OR = 3.42, 95% CI = 1.58-7.41).

CONCLUSION

Ethnicity, tooth arrangement, size and strength need to be given detailed consideration in tooth replacement as they emerged as the significant predictors of self-evaluated dental appearance satisfaction among young adults.

Color stability of denture teeth and acrylic base resin subjected daily to various consumer cleansers

OBJECTIVE

This study evaluated color stability of acrylic denture teeth and base resins after 48 weeks of commercial denture cleanser simulation.

MATERIALS AND METHODS

Two brands of denture teeth (Trubyte Portrait IPN, TP; SR Vivodent DCL, SR) in shades A1, B1, and C1 and three acrylic base resins (Lucitone, LU; Paragon, PA; Valplast, VA) prepared to manufacturer's specifications were exposed 10 hours daily to four cleansers (Clorox Bleach, CB; Polident 3 minute, PO3; Efferdent, EF; and Kleenite, KL) and distilled water control, approximating consumer overnight use. Color measurements used the standard Commision International de l'Eclairage (International Commission on Illumination, CIE L*a*b*) color space (0, 4, 12, 24, 36, and 48 weeks.) Color differences (ΔE*) at 48 weeks were subjected to four-way analysis of variance (ANOVA). Mean values were compared with Fisher's (protected least significant difference) intervals (0.05 significance level).

RESULTS

Mean color differences (ΔE*) demonstrated color changes in each material. ANOVA-indicated color changes in teeth were significantly affected by both cleansers and teeth brand (p < 0.05), but not shade. Color changes in base resins were significantly affected by cleansers (p < 0.05), but not brand alone. Overall, KL produced the least color change while CB and PO3 produced the most for all materials.

CONCLUSIONS

After 48 weeks of daily simulation, TP teeth were more color stable than SR in all cleansers except EF (p < 0.0001). Base resin VA was less color stable than LU and PA. Cleanser KL resulted in the lowest color changes.

CLINICAL SIGNIFICANCE

All tested materials yield clinically acceptable color changes (ΔE* < 3.5); all cleansing methods tested can be recommended, although Kleenite demonstrated the least change after 48 weeks.

Dental esthetics and its impact on psycho-social well-being and dental self confidence: a campus based survey of north Indian university students

To evaluate the subjects perceived satisfaction of their dental appearance and to compare it with a various attitudes and practices which may affect social and psychological behavior and dental self confidence. This was a questionnaire based cross-sectional study done in the campus of Aligarh Muslim University, Aligarh (India). 426 students participated in the study. Questions were pooled in from various components of psychosocial impact of dental esthetics questionnaire (PIDAQ) for various attitudes and practices. Quantitative analysis was done using descriptive analysis and Chi square test using SPSS software. Majority of subjects (57.7 %) was highly satisfied with their smile, more than one-third (37.3 %) were satisfied and there were only 4.9 % subjects who were not satisfied with their smile. Tooth color was the most common (27.9 %) smile component causing dissatisfaction amongst the subjects. More than two-fifth (42.5 %) liked to show their teeth, one-half (49.5 %) liked to see their teeth in mirror, photographs and videos, almost one quarter (23.9 %) subjects used to hide their teeth while smiling. As compared to females, significantly higher proportion of males was conscious of opposite sex while smiling. The proportion of subjects which was highly satisfied with their smile was significantly higher for the item 'like to show their teeth and who liked to see their teeth in mirror, photographs and video' whereas for all the other items the proportion of respondents which was not satisfied with their smile was significantly higher. Self perceived satisfaction of dental esthetics has positive impact on person's social and psychological behavior and dental self confidence.

Patients' and dentists' perception of dental appearance

The purpose of this study was to compare the patients' and dentists' perception of dental appearance. Based on internationally accepted guidelines about dental esthetics, a questionnaire was developed to measure "dental appearance" (QDA). Eleven items defined a QDA sum score (0 = "absolutely satisfied", 44 = "absolutely dissatisfied"). The QDA was completed by 16 patients (eight women, eight men, mean age 63 ± 9 years) before and after a complete oral rehabilitation. Forty-two dentists evaluated the esthetics before and after rehabilitation on a visual analog scale (VAS, 0 = "absolutely unesthetic", 100 = "absolutely esthetic"). The patients' quoting showed a significant esthetic improvement (QDA sum score) from 22 before treatment to 3.5 after treatment (P ≤ 0.001). Although most of the dentists judged an improvement in most of the patients dental appearances, no significant correlation could be found between patients' and dentists' judgment regarding dental appearance (r = -0.13-0.53, P > 0.05). When evaluating the influence of age, gender, and experience on rating dental appearance, no significant differences (P > 0.05) could be found.

Sex differences in denture satisfaction

OBJECTIVES

Males and females differ in their responses to many health conditions and treatments. The aim of this randomized clinical trial was to determine whether there are differences in the way that male and female edentulous elders rate their satisfaction with new mandibular implant overdentures (IODs) and conventional dentures (CDs), at 6 and 12 months following delivery.

METHODS

Edentulous elders (n=256) were randomly assigned to receive maxillary conventional dentures and either mandibular overdentures supported by two implants with ball attachments or conventional dentures. Participants rated their general satisfaction, as well as other features of their dentures (comfort, stability, ability to chew, aesthetics, etc.) prior to treatment and 6 and 12 months after delivery.

RESULTS

Ratings of satisfaction with IODs were significantly higher than with CDs. Six months after delivery, females in the CD group rated their general satisfaction and satisfaction with ability to chew and aesthetics significantly lower than did the males. The sex differences in the CD group remained at 12 months after delivery. However, males and females in the IOD group rated their general satisfaction and all six subcategories equally.

CONCLUSIONS

Elderly females are less satisfied with conventional dentures than elderly males with regards to aesthetics and ability to chew, but equally satisfied with implant overdentures. At 6 and 12 months after delivery, elderly edentulous males and females wearing mandibular implant overdentures were significantly more satisfied than those wearing conventional dentures.

Social Perceptions of Individuals Missing Upper Front Teeth

Although it is assumed that there are negative social consequences for individuals missing visible front teeth, no study of the way in which edentulous individuals were perceived in a social context and the potential social repercussions could be located. This initial study concerned college students' perceptions of individuals missing visible upper front teeth. 200 volunteers, 19 to 50 years of age ( M = 20.6, SD = 4.4), rated five photographs depicting tooth presence or absence, from a full dentition to missing as many as four upper front teeth, on social traits including attractiveness, health status, educational attainment, satisfaction with life, active social life, aggressiveness, intelligence, trustworthiness, amount of caring, friendship, dating, and likelihood to live as a neighbor. Analysis suggested a person missing visible teeth was more negatively perceived on all social traits than a person with full dentition. Results were strongest when students were proposed to be linked to the edentulous individual in a personal way, i.e., dating or living as neighbor. Men and women agreed on perceptions of social traits and dentition condition. These results suggest the presence of strong Western cultural values, whereby those who are missing teeth may experience significant barriers to personal and social success.

Smile attractiveness. Self-perception and influence on personality

OBJECTIVES

To investigate self-perception of smile attractiveness and to determine the role of smile line and other aspects correlated with smile attractiveness and their influence on personality traits.

SUBJECTS AND METHODS

Participants judged their smile attractiveness with a patient-specific questionnaire. The questionnaire contained a spontaneous smiling photograph of the participant. Objective smile-line height was measured using a digital videographic method for smile analysis. Personality was assessed with the Dutch Personality Index.

RESULTS

Cronbach's alpha for the smile judgment questionnaire was .77. The results showed that size of teeth, visibility of teeth, and upper lip position were critical factors in self-perception of smile attractiveness (social dimension). Color of teeth and gingival display were critical factors in satisfaction with smile appearance (individual dimension). Participants, smiling with teeth entirely displayed and some gingival display (two to four millimeters), perceived their smile line as most esthetic. Smiles with disproportional gingival display were judged negatively and correlated with the personality characteristics of neuroticism and self-esteem. Visibility and position of teeth correlated with dominance.

CONCLUSION

The results of this research underpin the psychosocial importance and the dental significance of an attractive smile.

Satisfaction With Dental Appearance Among Diverse Groups of Dentate Adults

Objectives: To quantify (a) the prevalence of dissatisfaction with dental appearance in a diverse sample of dentate adults and (b) the associations between dissatisfaction with dental appearance, sociodemographic factors, and other measures of oral health. Methods: Data were taken from the Florida Dental Care Study , a population-based longitudinal cohort study of oral health and related behaviors. The sample included 873 participants at baseline. Descriptive analysis and logistic regression were conducted to analyze the baseline data in the current report. Results: Females, problem-oriented dental attenders, and participants who had not completed high school were significantly more dissatisfied with their dental appearance than their respective counterparts. Dissatisfaction with dental appearance was also independently associated with six specific clinical and self-reported measures of oral health. Discussion: Dissatisfaction with dental appearance was common in this population-based sample of middle-aged and older adults, and was significantly associated with key sociodemographic and oral health factors.

Perceptions of dental esthetics of Asian orthodontists and laypersons

INTRODUCTION

The aim of the study was to determine the impact of anterior dental crowding, overjet, overbite, dental spacing, and type of malocclusion on dental esthetic perceptions of Asian orthodontists.

METHODS

Twenty-one Asian orthodontists (10 men, 11 women) and 158 adult laypersons (38 men, 120 women) rated the attractiveness of 50 pairs of black-and-white intraoral photographic prints of various types of malocclusions. Each pair included a frontal and a right buccal view of the dentition at maximum intercuspation. Raters used a visual analogue scale (VAS), with "least attractive" (0 mm) and "most attractive" (100 mm) as the 2 extremes, to score the dental esthetics of the photographs. A principal investigator objectively measured the dental traits from study models. Linear regression analysis was performed with VAS scores as the dependent variable and anterior dental crowding, overjet, and overbite measurements as the independent variables. Independent sample t tests were used to determine the effect of dental spacing on the VAS scores. The Kruskal-Wallis test was used to determine the effect of type of malocclusion (Class I, Class II Division 1, Class II Division 2, Class III) on VAS scores.

RESULTS

Increased overjet (>6 mm) and severe maxillary dental crowding (>8 mm) were found to be significantly correlated with laypersons' VAS scores (P <.05). Reverse overjet was found to be significantly correlated with orthodontists' VAS scores (P <.05). No significant correlation was found between overbite, dental spacing, and VAS scores. Class III malocclusions were significantly perceived to be the most unesthetic by orthodontists.

CONCLUSIONS

Overjet was the major occlusal trait that influenced the perceptions of dental esthetics of both laypersons and orthodontists.

Effect of an antibacterial adhesive on the bond strength of three different luting resin composites

OBJECTIVES

Effect of a dentin adhesive system containing antibacterial monomer-MDPB (Clearfil Protect Bond) on the shear bond strength of all-ceramic-IPS Empress 2 restorations luted with three different dual-polymerizing systems (Variolink 2, RelyX ARC and Panavia F 2.0) to dentin was investigated.

METHODS

One hundred and eight all-ceramic discs (2 x 3mm; IPS Empress 2) were fabricated and ultrasonically cleaned. The buccal surfaces of 108 non-carious extracted human premolars were flattened to expose dentin and subsequently polished with 600-grit wet silicon carbide paper. Three dual-polymerizing luting systems had test groups and control groups consisting of 18 samples each. For the test groups Clearfil Protect Bond was applied to the exposed dentin surfaces. Control groups received the original bonding procedures of each adhesive system. After the all-ceramic samples were luted to the teeth, thermocycling was performed 5000 times. Shear bond strengths were tested using Shimadzu Universal Testing Machine until failure. Analysis of fractured dentin surfaces were performed using Optical Microscope at x10 and x1000 magnifications and the images were analyzed with Image Analyzer. Data was analyzed with one-way ANOVA and Bonferroni test at a significance level of p<0.05.

RESULTS

Mean shear bond strength data of the groups in MPa were; Variolink: 20.45+/-4.75, Variolink+Clearfil Protect Bond:29.32+/-2.37, RelyX ARC:18.82+/-3.19, RelyX ARC+Clearfil Protect Bond:25.58+/-4.05, Panavia F 2.0:17.11+/-2.98, Panavia F 2.0+Clearfil Protect Bond:24.40+/-7.46. Application of the antibacterial adhesive increased the shear bond strengths of all three dual-polymerizing systems to dentin (p=0.00). The surface analysis showed that most of the specimens showed the adhesive failure mode between the dentin and the composite luting agent interface.

CONCLUSION

The antibacterial adhesive system Clearfil Protect Bond can be safely used to prevent the potential risk of complications resulting from bacterial activity regardless of affecting the bond strength of IPS Empress 2 restorations luted with the dual-polimerizing systems used in this study.

Restoring dentate appearance: A literature review for modern complete denture esthetics

Despite the fact that solutions to functional and comfort problems are often available, successfully restoring the appearance of an edentulous patient remains a challenge. This review of the literature demonstrates the limited amount of useful evidence-based information available for restoration of dentate appearance in edentulous individuals. The English language peer-reviewed literature from 1880 to the present was reviewed. Articles were identified through previous literature reviews, an extensive hand search, and a search of MEDLINE using the key words esthetics and denture esthetics. Three main areas of information were found: published guidelines for achieving natural appearance, patient preference studies, and studies that have collected and analyzed anatomic norms.

In vitro fracture strength of teeth restored with different all-ceramic crown systems

STATEMENT OF PROBLEM

There is insufficient knowledge of the strength of all-ceramic crowns bonded to natural teeth to warrant the use of all-ceramic crowns in place of metal-ceramic crowns.

PURPOSE

The purpose of this study was to evaluate and compare fracture resistance of crowns made of 3 different types of 2 all-ceramic crown systems-0.4-mm and 0.6-mm aluminum oxide coping crowns and zirconia ceramic coping crowns-and metal-ceramic crowns.

MATERIAL AND METHODS

Forty intact, noncarious human maxillary central incisors were divided into 4 groups (n=10): Group MCC (control), metal-ceramic crown (JRVT High Noble Alloy); Group AC4, crown with 0.4-mm aluminum oxide coping (Procera AllCeram); Group AC6, crown with 0.6-mm aluminum oxide coping (Procera AllCeram); and Group ZC6, crown with 0.6-mm zirconia ceramic coping (Procera AllZirkon). Teeth were prepared for complete-coverage all-ceramic crowns so that a final dimension of 5.5 +/- 0.5 mm was achieved incisocervically, mesiodistally, and faciolingually. A 1.0-mm deep shoulder finish line was used with a rounded internal line angle. All restorations were treated with bonding agent (Clearfil SE Bond) and luted with phosphate-monomer-modified adhesive cement (Panavia 21). Fracture strength was tested with a universal testing machine at a crosshead speed of 2 mm per minute with an angle of 30 degrees to the long axis of the tooth after restorations were stored in 100% relative humidity of a normal saline solution for 7 days. The mode of fracture was examined visually. Means were calculated and analyzed with 1-way ANOVA and Tukey's HSD (alpha=.05).

RESULTS

The means of fracture strength were: Group MCC, 405 +/- 130 N; Group AC4, 447 +/- 123 N; Group AC6, 476 +/- 174 N; and Group ZC6, 381 +/- 166 N. There was no significant difference between groups ( P =.501). The mode of failure for all specimens was fracture of the natural tooth.

CONCLUSIONS

There was no significant difference in the fracture strength of the teeth restored with all-ceramic crowns with 0.4- and 0.6-mm aluminum oxide copings, 0.6-mm zirconia ceramic copings, and metal ceramic crowns.

Diagnostic and technical approach to esthetic rehabilitations

The success of an esthetic rehabilitation depends on the understanding of the patient's needs and on effective communication among the entire dental team. The involvement of the dental technician since the beginning of the treatment plan is one of the keys for success. This article describes a systematic approach to oral rehabilitations involving esthetic areas. Technical suggestions for the construction of the diagnostic wax-up, the provisional, and the final ceramic restorations are illustrated in a logical sequence.

Adult patients' view of orthodontic treatment outcome compared to professional assessments

One important aspect in evaluating the outcome and quality of orthodontic treatment is the patient's own assessment. The objective of this study was to evaluate the course and outcome of orthodontic treatment in adults from the patient's vs the operator's point of view. In a previous study, the orthodontic treatment of 88 adults was evaluated using the IOTN and PAR Index before and after treatment. Fifty-nine patients answered treatment questionnaires on 1. the reason for seeking treatment, 2. dentofacial aesthetics, 3. treatment outcome, 4. course of treatment, 5. attitude, 6. social well-being. Depending on the original treatment goal, the patient population was divided into an Ideal Group and a Compromise Group. In 75% of the patients, dissatisfaction with dental aesthetics was the prime motive for seeking treatment; correlations with PAR parameters (overjet and maxillary anterior teeth) were weak. In general, a high degree of patient satisfaction with orthodontic treatment was registered. As regards satisfaction with post-treatment dental aesthetics there were no significant differences between the groups. Comparison of professional assessment with the subjective rating by patients revealed discrepancies in that the patients' rating of outcome tended to be more positive. The differentiation between ideal and compromise treatment goals proved useful. In the Compromise Group, a high level of patient satisfaction was attained with a shorter treatment duration and lower appliance involvement. 92% considered their major pre-treatment need to have been met, and 95% would have had the treatment performed again.

Esthetics: patients' perceptions of dental attractiveness

PURPOSE

The importance of dentofacial attractiveness to the psychosocial well-being of an individual has been well established. Very little information is available regarding dental patient perceptions of a pleasing esthetic image. The purpose of this study was to identify factors distinctive to attractive smiles versus unattractive smiles, as perceived by patients.

MATERIALS AND METHODS

Standardized format photographs (5 x 7 in, matte finish, at f-32 and 1:2 magnification) of eight male and eight female smiles, framing only lips and teeth, were viewed by 297 subjects. The smiles exhibited differences in symmetry, tooth shade, number of teeth displayed, and height of maxillary lip line, and included both restored and unrestored teeth. Respondents ranked the photographs in order from most to least appealing appearance. Respondents viewed each series of photographs in a similar lighting and time period. A questionnaire identified the respondent's age, sex, race, education, income, and home town. Twenty-five demographic groups were established from the information in the questionnaire. Data were analyzed using stepwise discriminant analysis to determine the combination of smile characteristics that best predicted the ranking.

RESULTS

The same female smile was chosen as the most attractive by 24 of the 25 demographic groups. This smile is characterized by natural teeth having light shade, high lip line, a large display of teeth, and radiating symmetry. Two female smiles typified by darker shade and asymmetry were rated by all groups as being least attractive. Two male smiles were judged equal as the most pleasing esthetically. Respondents favored those smiles characterized by light shade, a moderate display of teeth, moderate lip line, and a symmetrical arrangement of teeth. One male smile characterized by darker shade was rated as least attractive.

CONCLUSIONS

In all cases, tooth shade was the most important factor, followed in sequence by unrestored natural teeth and number of teeth displayed. No correlation was found to exist between specific demographic groups and smile variables.

Relation between clinical dental status and subjective impacts on daily living

Although clinical dental status has weak correlations with subjective impacts, some of them are significant. Those variables which had significant correlations could be used as a starting point to understand clinical and social characteristics of people who experience dental problems. This is indeed the basis for the current research. The study compares psychosocial impacts on the quality of people's life with their respective oral status. To that end, a socio-dental indicator, the 'Dental Impact of Daily Living' (DIDL), involving five dimensions, together with a scale which assesses dimension impacts, was developed. The resulting instrument was validated and the reliability tested. The instrument generates a total final score, in addition to scores for each dimension. The method was tested in Brazil on a sample of 662 people, aged from 35 to 44 years, of two social classes, both sexes, and with three different levels of dental caries status or with a full upper denture. To test whether DIDL discriminated between groups with different levels of subjective impact, we analyzed how oral status, social class, and gender varied according to impacts. Different levels of oral status had different impacts on people's daily life. On the basis of the results, it is reasonable to suggest that oral status and social and psychological dimensions should be considered simultaneously when in assessment of people's dental needs.

Body and orofacial cathexis in edentulous complete-denture-wearing clients

This description cross-sectional study examines cathexis, or satisfaction, with the body and the orofacial region in relationship to eight major demographic and health status variables in a nonprobability sample of 34 male and 47 female edentulous subjects aged 36 to 77 years. Kiyak's 27-item Body Cathexis Scale (BCS), including an innovative five-item Orofacial Cathexis Scale (OFCS), was shown to be reliable for use in elderly clients at least to age 77 (Cronbach's alpha = .95). More research is needed to validate the OFCS. Overall scores were in the neutral range, with teeth being the most negatively cathected body part. Longer periods of edentulism were associated with more dissatisfaction with the teeth. Body and orofacial cathexis were highly positively correlated. Chronic illness, education level, race, and religion were not significantly related to cathexis. Edentulism, especially recent edentulism in the elderly, female gender, and divorced marital status could be important indicators for body image disturbance.

Comparisons between dentist ratings and self-ratings of dental appearance in an elderly population

Little is known about dental appearance in terms of the elderly population. The purpose of this paper is to compare self-reported dental appearance with dentist-rated appearance for individuals over 65. The subjects (N = 550) were participants in the Los Angeles based Medicare Screening and Health Promotion Trial. Most were female (57.3%), white (89.0%), and married (62.0%), with a mean age of 74.5 years. About one-third had incomes greater than $25,000. Results are based on a 45 minute telephone interview and onsite dental screening. Findings show that 40% of the self-ratings on a five point scale were higher than the dentist ratings, and 22% were lower. Bivariate analyses showed that both sets of ratings were related to dental status variables, self-reported health, and education. High self-ratings were also associated with being white and having a positive mental health status, while high dentist ratings were associated with patients who were younger, married, and who had higher income and social network scores. Comparison of results from two multiple regressions showed unique predictors for the self-ratings (marital status and GOHAI scores) and for the dentist ratings (sex and income). These discrepancies can raise barriers to effective treatment planning in the elderly, which could affect utilization and satisfaction.

Perception of personal dental appearance in young adults: relationship between occlusion, awareness, and satisfaction

Information about the individual perception of a patient's own occlusion is considered of importance in orthodontics. One hundred thirty young adults (mean age, 18.1 years) were clinically examined and interviewed with the purpose of relating self-awareness and satisfaction to the actual occlusal status and determining whether dissatisfaction is based on realistically perceived anomalies. From study casts taken at the time of examination, six anterior traits were recorded as either malocclusion, minor deviation, or near-ideal occlusion according to two sets of criteria. Self-awareness was assessed by analyzing agreement between the subjects' reports on the presence of the six traits and the corresponding recordings. Satisfaction was evaluated from three questions with fixed alternative answers. The majority of the young adults (63%) were characterized as having near-ideal occlusion or only minor deviations. Only mild and moderate malocclusions were present in the sample since severe malocclusions are routinely treated during childhood. The subjects were generally aware of anterior traits. Almost all the subjects (98%) with near-ideal occlusion or minor deviations expressed satisfaction. Malocclusion was present in 14 of the 16 subjects who were dissatisfied, and dissatisfaction was based on realistically perceived anomalies. However, traits rated as malocclusion were present in 30% of the satisfied subjects, which may in part be explained by the mild degree of malocclusion in the sample. Awareness of occlusal traits varied among the satisfied subjects.