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
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.
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.
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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