Perception of Acceptable Range of Smiles by Specialists, General Dentists and Lay Persons and Evaluation of Different Aesthetic Paradigms.

Abstract

One of the most important goals of restorative dentistry is to restore the patient's aesthetic. Smile analysis is subjective and it differs from person to person. An aesthetic smile involves a harmonious relationship between various parameters including the hard and soft tissues. The aim of the study was to identify the acceptable range of several smiles (alone and in conjunction with the face) by specialists, general dentists as well as lay persons; and to identify the values of different criteria i.e., the Golden Proportion (GP), the Recurrent Esthetic Dental proportion (RED), Width to Height ratio (W/H ratio), the Apparent Contact Dimension (ACD), and lateral incisor position in a smile. Hundred photographs of 50 subjects were taken, 50 of the smile alone and 50 of the individual's frontal view of face. The photographs of the smiles and the faces were assessed for the aesthetic acceptability by 30 evaluators including 10 specialists with advanced training, 10 general dentists and 10 lay persons. Irreversible hydrocolloid impressions were made of the dentitions of all the individuals using stock trays and were poured in dental stone. Measurements were made on the facial surface of the teeth on the models and were recorded in millimeters using a sharp tipped digital vernier calliper. Data was analyzed to evaluate the presence of different parameters assessed in the smiles. Mean and standard deviation values for the percentage of only the agreeable smiles were calculated in both individual smile analysis and in conjunction with the face. The non agreeable smiles were excluded from further statistical analysis. Pearson Correlation Coefficient was calculated to compare the values obtained in all the three groups. More number of smiles were considered agreeable by the general dentists when compared to the specialists and the number even increased in case of evaluation by lay persons. Greater number of smiles was found to be agreeable when they were evaluated in conjunction with the face. Rather than assessment of individual numeric parameter that defines an ideal aesthetic smile, a smile to be aesthetic should harmonize with the composition of the face.