World Journal of Dentistry

Register      Login

VOLUME 13 , ISSUE 3 ( May-June, 2022 ) > List of Articles


Perception of Dental, Smile and Gingival Esthetic Components by Dental Specialists, General Dental Practitioners, Dental Assistants and Laypersons: A Cross-sectional Study

Maged S Alhammadi, Esam Halboub, Abdullsalam A Al-Dumaini, Sultan MA Malhan, Faris Alfaife, Jabril Otudi

Keywords : Dental professionals, Esthetics, Gingival, Perception, Smile

Citation Information : Alhammadi MS, Halboub E, Al-Dumaini AA, Malhan SM, Alfaife F, Otudi J. Perception of Dental, Smile and Gingival Esthetic Components by Dental Specialists, General Dental Practitioners, Dental Assistants and Laypersons: A Cross-sectional Study. World J Dent 2022; 13 (3):250-260.

DOI: 10.5005/jp-journals-10015-1918

License: CC BY-NC 4.0

Published Online: 11-04-2022

Copyright Statement:  Copyright © 2022; The Author(s).


Aim: This study aimed to evaluate perception of dental, smile, and gingival esthetic components by dental specialists, general dental practitioners, dental assistants, and laypersons. Material and methods: Seven standard photographs representing dental, smile, and gingival components were manipulated digitally. The sample composed of 465 [74 dental specialists (DS), 152 general dental practitioners (GDP), 97 dental assistants (DA), and 142 laypersons (LP)] assessed the normal and the digitally manipulated images on a visual analog scale ranging from 1 to 5 where 1 is the less pleasant image and 5 is the standard normal image. The data was analyzed using Mann-Whitney and Kruskal-Wallis tests, and multiple linear regression analyses. Results: Out of 100, the overall rate was 81.42 ± 10.8% with no statistical gender differences. Regarding the individual components, females exhibited significant perception for “midline diastema,” while males showed significantly better perception for “gingival marginal height.” General dental practitioners (GDP) showed significantly higher perception score than DS, DA, and LP did. Out of the seven evaluated components, five were differently perceived in favor of the GDP followed by DS and the lowest were for LP. Linear regression analyses revealed that the “participant\'s category” (GDP vs others) was the only independent determinant of the overall esthetic perception in addition to six individual esthetic components. Conclusion: GDP showed more favorable perception of dental, gingival, and smile esthetics than laypersons and other dental professionals with considerable variations. Clinical significance: The patients’ perception toward esthetics is to be considered over that perceived by dental professionals during daily dental procedures and smile design.

PDF Share
  1. Rodrigues Cde D, Magnani R, Machado MS, et al. The perception of smile attractiveness. Angle Orthod 2009;79(4):634–639. DOI: 10.2319/030508-131.1
  2. Dunn WJ, Murchison DF, Broome JC. Esthetics: patients’ perceptions of dental attractiveness. J Prosthodont 1996;5(3):166–171. DOI: 10.1111/j.1532-849x.1996.tb00292.x
  3. Parrini S, Rossini G, Castroflorio T, et al. Laypeople's perceptions of frontal smile esthetics: a systematic review. Am J Orthod Dentofacial Orthop 2016;150(5):740–750. DOI: 10.1038/sj.bdj.2017.75
  4. Broer PN, Juran S, Liu YJ, et al. The impact of geographic, ethnic, and demographic dynamics on the perception of beauty. J Craniofac Surg 2014;25(2):e157–e161. DOI: 10.1097/SCS.0000000000000406
  5. Rodrigues CDT, Magnani R, Machado MSC, et al. The perception of smile attractiveness: variations from esthetic norms, photographic framing and order of presentation. Angle Orthod 2009;79(4):634–639. DOI: 10.2319/030508-131.1
  6. Anderson C, John OP, Keltner D, et al. Who attains social status? Effects of personality and physical attractiveness in social groups. J Pers Soc Psychol 2001;81(1):116–132. DOI: 10.1037//0022-3514.81.1.116
  7. Tosun H, Kaya B. Effect of maxillary incisors, lower lip, and gingival display relationship on smile attractiveness. Am J Orthod Dentofacial Orthop 2020;157(3):340–347. DOI: 10.1016/j.ajodo.2019.04.030
  8. Flores-Mir C, Silva E, Barriga MI, et al. Lay person's perception of smile aesthetics in dental and facial views. J Orthod 2004;31(3):204–209; discussion 1. DOI: 10.1179/146531204225022416
  9. Chang CA, Fields HW Jr, Beck FM, et al. Smile esthetics from patients’ perspectives for faces of varying attractiveness. Am J Orthod Dentofacial Orthop 2011;140(4):e171–e180. DOI: 10.1016/j.ajodo.2011.03.022
  10. McLeod C, Fields HW, Hechter F, et al. Esthetics and smile characteristics evaluated by laypersons. Angle Orthod 2011;81(2):198–205. DOI: 10.2319/060510-309.1
  11. Silva BP, Jiménez-Castellanos E, Martinez-de-Fuentes R, et al. Laypersons’ perception of facial and dental asymmetries. Int J Periodontics Restorative Dent 2013;33(6):e162–e171. DOI: 10.11607/prd.1618
  12. Ker AJ, Chan R, Fields HW, et al. Esthetics and smile characteristics from the layperson's perspective: a computer-based survey study. J Am Dent Assoc 2008;139(10):1318–1327. DOI: 10.14219/jada.archive.2008.0043
  13. Del Monte S, Afrashtehfar KI, Emami E, et al. Lay preferences for dentogingival esthetic parameters: a systematic review. J Prosthet Dent 2017;118(6):717–724. DOI: 10.1016/j.prosdent.2017.04.032
  14. Abu Alhaija ES, Al-Shamsi NO, Al-Khateeb S. Perceptions of Jordanian laypersons and dental professionals to altered smile aesthetics. Eur J Orthod 2011;33(4):450–456. DOI: 10.1093/ejo/cjq100
  15. Kumar S, Gandhi S, Valiathan A. Perception of smile esthetics among Indian dental professionals and laypersons. Indian J Dent Res 2012;23(2):295. DOI: 10.4103/0970-9290.100456
  16. Pithon MM, Santos AM, Viana de Andrade AC, et al. Perception of the esthetic impact of gingival smile on laypersons, dental professionals, and dental students. Oral Surg Oral Med Oral Pathol Oral Radiol 2013;115(4):448–454. DOI: 10.1016/j.oooo.2012.04.027
  17. Correa BD, Vieira Bittencourt MA, Machado AW. Influence of maxillary canine gingival margin asymmetries on the perception of smile esthetics among orthodontists and laypersons. Am J Orthod Dentofacial Orthop 2014;145(1):55–63. DOI: 10.1016/j.ajodo.2013.09.010
  18. Alhammadi MS, Halboub E. Perception of facial, dental, and smile esthetics by dental students. J Esthet Restor Dent 2018;30(5):415–426. DOI: 10.1111/jerd.12405
  19. Ioi H, Kang S, Shimomura T, et al. Effects of vertical positions of anterior teeth on smile esthetics in Japanese and korean orthodontists and orthodontic patients. J Esthet Restor Dent 2013;25(4):274–282. DOI: 10.1111/jerd.12032
  20. Jon LYTC, Morante DRH, Bernabé E, et al. Esthetic perception towards different combinations of facial contours and upper incisor shape. Braz J Oral Sci 2009;8(4). DOI: 10.20396/bjos.v8i4.8642059
  21. Sharma N, Rosenstiel SF, Fields HW, et al. Smile characterization by U.S. white, U.S. Asian Indian, and Indian populations. J Prosthet Dent 2012;107(5):327–335. doi: 10.1016/S0022-3913(12)60085-7
  22. Springer NC, Chang C, Fields HW, et al. Smile esthetics from the layperson's perspective. Am J Orthod Dentofacial Orthop 2011;139(1):e91–e101. DOI: 10.1016/j.ajodo.2010.06.019
  23. Wolfart S, Thormann H, Freitag S, et al. Assessment of dental appearance following changes in incisor proportions. Eur J Oral Sci 2005;113(2):159–165. DOI: 10.1111/j.1600-0722.2005.00206.x
  24. Barros ECdS, Carvalho MDOd, Mello KCFR, et al. The ability of orthodontists and laypeople in the perception of gradual reduction of dentogingival exposure while smiling. Dental Press J Orthod 2012;17(5):81–86. DOI: 10.1590/s2176-94512012000500012
  25. Cooper GE, Tredwin CJ, Cooper NT, et al. The influence of maxillary central incisor height-to-width ratio on perceived smile aesthetics. Br Dent J 2012;212(12):589–599. DOI: 10.1038/sj.bdj.2012.522
  26. Foulger TE, Tredwin CJ, Gill DS, et al. The influence of varying maxillary incisal edge embrasure space and interproximal contact area dimensions on perceived smile aesthetics. Br Dent J 2010;209(3):E4. DOI: 10.1038/sj.bdj.2010.719
  27. Ghaleb N, Bouserhal J, Bassil-Nassif N. Aesthetic evaluation of profile incisor inclination. Eur J Orthod 2011;33(3):228–235. DOI: 10.1093/ejo/cjq059
  28. Machado AW, Moon W, Gandini LG, Jr. Influence of maxillary incisor edge asymmetries on the perception of smile esthetics among orthodontists and laypersons. Am J Orthod Dentofacial Orthop 2013;143(5):658–664. DOI: 10.1016/j.ajodo.2013.02.013
  29. Thomas JL, Hayes C, Zawaideh S. The effect of axial midline angulation on dental esthetics. Angle Orthod 2003;73(4):359–364. DOI: 10.1043/0003-3219(2003)073<0359:TEOAMA>2.0.CO;2
  30. Moore T, Southard KA, Casko JS, et al. Buccal corridors and smile esthetics. Am J Orthod Dentofacial Orthop 2005;127(2):208–213; quiz 61. DOI: 10.1016/j.ajodo.2003.11.027
  31. Ioi H, Nakata S, Counts AL. Effects of buccal corridors on smile esthetics in Japanese. Angle Orthod 2009;79(4):628–633. DOI: 10.2319/080708-410.1
  32. Zhang Y-f,Xiao L, Li J, et al. Young people's esthetic perception of dental midline deviation. Angle Orthod 2010;80(3):515–520. DOI: 10.2319/052209-286.1
  33. Yin L, Jiang M, Chen W, et al. Differences in facial profile and dental esthetic perceptions between young adults and orthodontists. Am J Orthod Dentofacial Orthop 2014;145(6):750–756. DOI: 10.1016/j.ajodo.2014.01.021
  34. Pinzan-Vercelino CRM, Costa ACS, Ferreira MC, et al. Comparison of gingival display in smile attractiveness among restorative dentists, orthodontists, prosthodontists, periodontists, and laypeople. J Prosthet Dent 2020;123(2):314–321. DOI: 10.1016/j.prosdent.2019.03.023
  35. Al Taki A, Khalesi M, Shagmani M, et al. Perceptions of altered smile esthetics: a comparative evaluation in orthodontists, dentists, and laypersons. Int J Dent 2016;2016:7815274. DOI: 10.1155/2016/7815274
  36. Sadrhaghighi H, Zarghami A, Sadrhaghighi S, et al. Esthetic perception of smile components by orthodontists, general dentists, dental students, artists, and laypersons. J Investig Clin Dent 2017;8(4). DOI: 10.1111/jicd.12235
  37. Kokich VO, Kokich VG, Kiyak HA. Perceptions of dental professionals and laypersons to altered dental esthetics: asymmetric and symmetric situations. Am J Orthod Dentofacial Orthop 2006;130(2):141–151. DOI: 10.1016/j.ajodo.2006.04.017
  38. Pinho S, Ciriaco C, Faber J, et al. Impact of dental asymmetries on the perception of smile esthetics. Am J Orthod Dentofacial Orthop 2007;132(6):748–753. DOI: 10.1016/j.ajodo.2006.01.039
  39. Olivares A, Vicente A, Jacobo C, et al. Canting of the occlusal plane: perceptions of dental professionals and laypersons. Med Oral Patol Oral Cir Bucal 2013;18(3):e516–e520. doi:10.4317/medoral.18335
  40. Padwa BL, Kaiser MO, Kaban LB. Occlusal cant in the frontal plane as a reflection of facial asymmetry. J Oral Maxillofac Surg1997;55(8):811–816. DOI: 10.1016/s0278-2391(97)90338-4
  41. Kokich VO Jr, Kiyak HA, Shapiro PA. Comparing the perception of dentists and lay people to altered dental esthetics. J Esthet Dent 1999;11(6):311–324. DOI: 10.1111/j.1708-8240.1999.tb00414.x
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.