Abstract
To assess orthodontic clinicians' knowledge and attitudes towards dentogingival aesthetics and to explore characteristics that predict the knowledge of dentogingival aesthetics. Cross-sectional questionnaire. On-line survey of members of the British Orthdontic Society. An 11-item online questionnaire was sent to orthodontic practitioners for completion. The questionnaire covered respondent demographics and questions relating to both knowledge and attitudes towards dentogingival aesthetics (six parameters). Descriptive statistics were calculated for study characteristics and summary values for the survey items. Responses to the eight knowledge-based questions were converted to a binary outcome (correct and incorrect answer). The maximum score that could be achieved was eight. Multivariable modelling was used in order to examine associations between the study characteristics and the aggregate score. A total of 252 responses were obtained resulting in a response rate of 17%. Within this cohort, the respondents were primarily women (52.8%) and aged 30-40 years (35.7%). The mean score for the eight knowledge-based questions was 3.8 ± 1.8 (range = 0-8). Knowledge of the ideal gingival margin position of the anterior teeth was high (92.4%). Knowledge of the other five dentogingival aesthetic parameters was variable. In the multivariable analysis, lower knowledge scores were predicated by respondents who did not have a special interest in dental aesthetics (-0.54; 95% confidence interval [CI] = -1.01 to -0.07; P = 0.02), who could not recall attending courses, lectures or seminars on dental aesthetics in the past five years (-0.80; 95% CI = -1.43 to -0.17; P = 0.01) and with increasing age (-0.43; 95% CI = -0.62 to -0.23; P < 0.001). Knowledge of ideal dentogingival parameters is generally suboptimal among orthodontists in the UK. The reported lack of knowledge of the ideal dentogingival parameters may also influence respondents' attitudes towards the importance of dentogingival aesthetics. Further teaching or courses related to dentogingival aesthetics is desired by orthodontic clinicians.
Highlights
An aesthetic smile is significantly influenced by the quality of the component dental and gingival elements and their conformity to accepted norms (Rufenacht and Berger, 1990)
Lower knowledge scores were predicated by respondents who did not have a special interest in dental aesthetics (−0.54; 95% confidence interval [CI] = −1.01 to −0.07; P = 0.02), who could not recall attending courses, lectures or seminars on dental aesthetics in the past five years (−0.80; 95% CI = −1.43 to −0.17; P = 0.01) and with increasing age (−0.43; 95% CI = −0.62 to −0.23; P < 0.001)
Lower knowledge scores were predicated by respondents who did not have a special interest in dental aesthetics (–0.54; 95% confidence interval [CI] = –1.01 to −0.07; P = 0.02), who could not recall attending courses, lectures or seminars on dental
Summary
An aesthetic smile is significantly influenced by the quality of the component dental and gingival elements and their conformity to accepted norms (Rufenacht and Berger, 1990). Orthodontic treatment can influence DG architecture resulting in non-ideal gingival aberrations. Alignment of maxillary incisors with triangular crown morphology and some loss of attachment (Atherton, 1970), labial movement of teeth during the management of Class II division 2 malocclusion, palatally impacted canines or mesially rotated teeth (Sharma and Park, 2010) can all lead to open gingival embrasures as a result of apical movement of the gingival tissues (Kandasamy et al, 2007). An open gingival embrasure or ‘dark triangle’ between the maxillary central incisors has been reported to be present in 38% and 42% of adult and adolescent patients, respectively, after orthodontic treatment (Burke et al, 1994; Kurth and Kokich, 2001)
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