Abstract

OBJECTIVE: Smile esthetics has become a major concern among patients and orthodontists. Therefore, the aim of this study was: (1) To highlight differences in perception of smile esthetics by clinicians, orthodontists and laypeople; (2) To assess factors such as lip thickness, smile height, color gradation, tooth size and crowding, and which are associated with smile unpleasantness. METHODS: To this end, edited photographs emphasizing the lower third of the face of 41 subjects were assessed by three groups (orthodontists, laypeople and clinicians) who graded the smiles from 1 to 9, highlighting the markers that evince smile unpleasantness. Kruskall-Wallis test supplemented by Bonferroni test was used to assess differences among groups. Additionally, the prevailing factors in smile unpleasantness were also described. RESULTS: There was no significant difference (P = 0.67) among groups rates. However, the groups highlighted different characteristics associated with smile unpleasantness. Orthodontists emphasized little gingival display, whereas laypeople emphasized disproportionate teeth and clinicians emphasized yellow teeth. CONCLUSION: Orthodontists, laypeople and clinicians similarly assess smile esthetics; however, noticing different characteristics. Thus, the orthodontist must be careful not to impose his own perception of smile esthetics.

Highlights

  • Smile esthetics has become a major concern among patients and orthodontists

  • » Assessing factors such as lip thickness, smile height, color gradation, tooth size and crowding, which are associated with smile unpleasantness

  • Table 1 shows the values obtained by descriptive statistical analysis for subjective smile assessment

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Summary

Introduction

Smile esthetics has become a major concern among patients and orthodontists It has been the main reason why patients seek orthodontic treatment.[1] The perception of beauty is associated with pleasure while seeing an object or a person, and while hearing a sound. For this reason, beauty is seen as a highly subjective feeling that results from individual factors such as sex, race, education and personal experiences, as well as social factors such as the environment and the media which has been increasingly responsible for globalizing the concept of beauty.[2] Assessing beauty is a highly subjective matter. Smile analysis includes assessing patient’s smile arc, tooth and gingival display, presence of buccal corridor space (BCS), coincidence between facial and dental midlines, tooth proportionality, gingival esthetics, tooth color and occlusal plane inclination.[3]

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