Esthetic Dental Treatment Research Articles

Social media impact on students’ decision-making regarding aesthetic dental treatments based on cross-sectional survey data

This study investigated the influence of social media on patients regarding aesthetic dental treatments according to sex, type of treatment, and time since their last treatment. A cross-sectional study was conducted using a web-based survey. Participants were students over 18 years of age who were social media users and had undergone aesthetic dental treatment. 504 responses were included. Data evaluation was made using Pearson chi-square test. The level of significance was set at p < .05. 29.37% of the respondents indicated that social media influenced their decision to have their aesthetic treatment. Regarding the influence of social media, no differences were observed between males and females, nor by type of aesthetic treatment. Participants who had undergone an aesthetic dental treatment within the last year were more influenced by social media than those who had undergone it more than two years ago. Posts from dental clinics or dentists were the type of content that most influenced participants. Social media can influence some patients' decision to undergo aesthetic dental treatment, thus dental practices and dentists should consider the increasing importance of social media in their daily practice.

The Relationship of Aesthetic Dentistry Practices with Depression and Social Appearance Anxiety in Young Women.

This study aimed to evaluate the relationship between depression and social appearance anxiety in young female patients who applied for aesthetic dental treatment. The study was conducted in a single centre and included 56 female patients aged 18-35 years. The mean age of the participants was 22.27 ± 5.62 years. Participants were informed before treatment, and the Beck Depression Inventory (BDI), Social Appearance Anxiety Scale (SAAS), and Visual Analogue Scale (VAS) were administered. Immediately after the treatment and 1 month later, the SAAS and VAS were administered again. The Kruskal-Wallis test was used for the comparison of the data obtained and the Friedman test was used for temporal comparison. Multiple comparisons were made with Dunn's test. After aesthetic dental treatment, all participants' satisfaction with the appearance of their teeth increased, and social appearance anxiety decreased (p 0.001). The group with the lowest pretreatment satisfaction level was the group with moderate/high-level depressive symptoms. There was no correlation between the severity of depression and the increase in satisfaction after treatment (r &#61; 0.247; p &#61; 0.066). Satisfaction levels were similar in all depression groups after treatment. The group with the highest level of social appearance anxiety before and after treatment was the group with moderate/high-severity depressive symptoms. A moderate positive correlation was found between depression severity and social appearance anxiety (r &#61; 0.4; p &#61; 0.002). The severity of depressive symptoms seen before treatment does not affect the level of satisfaction after treatment. There is a decrease in social appearance anxiety after aesthetic dental treatment. There is a positive relationship between social appearance anxiety and depression severity.

Laypersons' Assessment of Smile Esthetics in Young Individuals in Ha'il, Saudi Arabia.

When planning esthetic dental treatments, understanding smile preferences is important for dental professionals. This study aimed to evaluate the impact of selected smile characteristics on the attractiveness of young Saudis as assessed by Saudilaypersons and explore gender-preferred changes in smile attractiveness. This observational study assessed the dynamic smile attractiveness of 168 Saudi individuals (84 males and 84 females), selected through non-probability convenience sampling. Dynamic smiles were elicited by viewing comedic content and captured with a camera standardized for consistent positioning. Videos were edited and adjusted to images, and the frames with the most pronounced smiles were chosen. The intra-rater reliability was assessed using intra-class correlation coefficients (ICCs) and Cohen's kappa tests (κ). The highest and lowest 25th percentiles were categorized as attractive and unattractive smiles, respectively, on the visual analog scale (VAS) by laypersons. Six smile characteristics - anterior smile line, smile arc, upper lip curvature, posterior teeth displayed, smile index, and smile symmetry - were quantitatively evaluated from these images for each participant and classified into attractive and unattractive groups based on laypersons' VAS evaluations. Continuous variables were tested with the Mann-Whitney U test, and for the categorical variables, the Chi-square test was applied. The significance was set at 5%. The four randomly selected out of the 22 raters had good VAS reliability; ICCs varied from 0.661 to 0.94, with an average of 0.737, and Cohen's kappa tests for smile characteristics showed values from 0.617 to 0.89. Good agreement was also found with the smile index, with ICCs of 0.775, and dynamic smile symmetry, with ICCs of 0.872. Laypersonsrated female smiles as more attractive compared to male smiles (P = 0.004). Low or average anterior smile lines (P = 0.001 for males; P = 0.03 for females), parallel smile arcs (P = 0.001 for males; P = 0.02 for females), and higher smile indexes (P = 0.001 for males; P = 0.004for females) were significantly attractive, showing no significant gender differences. Conclusions:Laypersons reliably rated the young Saudis' dynamic smiles as attractive. Of the rated smile characteristics, those with a low or average anterior smile line, parallel smile arcs, and a larger smile index were deemed more attractive. This study's findings show no significant gender differences in the impact of the studied smile characteristics on attractiveness. This study's findings can help dental professionals customize treatment plans that meet patients' expectations.

Analysis of the psychoemotional status of patients as a prognostic factor of satisfaction with the results of aesthetic dental treatment. (Literature review)

Analysis of the psychoemotional status of patients as a prognostic factor of satisfaction with the results of aesthetic dental treatment. (Literature review)

Aesthetic management of discoloured incisors in children.

Children can often present with discolouration of their teeth, commonly affecting their permanent maxillary central incisors. These opacities can often cause children to suffer with psychosocial and confidence related issues. With long waiting lists in secondary care, many children may face increased waiting times to receive aesthetic dental treatment. It is important that the dental professional is aware of the different causes of discolouration, the possible treatment options and when to consider a referral to secondary care.

Gambaran Body Dysmorphic Disorder Pasien Perawatan Estetika Gigi di RSGM-P FKG Universitas Trisakti

Background: Body dysmorphic disorder is a psychiatric disorder related to physical appearance and is commonly found in dental aesthetic treatment. Some signs of a tendency toward BDD are obsessive behaviour towards imperfect physical appearance, repetitive behaviour, trying to cover up physical defects, and so on. Dental treatment for these patients' aesthetic complaints will not improve their problems. Objective: To describe the symptoms of body dysmorphic disorder in patients with aesthetic dental treatment. Methods: The study was conducted on aesthetic dental treatment patients at RSGM-P Faculty of Dentistry, Trisakti University. This type of research is descriptive observational. The total sampling technique was used to determine the sample, by distributing hardcopy Dysmorphic Concern Questionnaire offline to 40 respondents. Results: It was found that 80% of all respondents had a tendency towards body dysmorphic disorder. This tendency was most commonly found in female respondents, in the late adolescent, and adult age groups and the majority were in fixed denture treatment. The symptoms that occur are very concerned about several aspects of physical appearance. Conclusion: The most common symptom found in the majority of respondents with a tendency towards BDD in this study was obsessive thoughts that they are very concerned about several aspects of their physical appearance.

Aesthetic dental treatment, orofacial appearance, and life satisfaction of Finnish and Brazilian adults.

To study the probability of seeking/undergoing aesthetic dental treatment (ADT) and compare self-perception of orofacial appearance (OA) based on sex, age, and monthly income; and to estimate the impact of OA on life satisfaction (LS) among Finnish and Brazilian adults, considering the indirect effect of receiving ADT and the moderating effects of those sociodemographic variables. This was an online cross-sectional study. Orofacial Esthetic Scale (OES), Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ) and Satisfaction with Life Scale (SWLS) were used. Probability of seeking/receiving ADT was calculated using logistic regression and odds ratio (OR). OA scores were compared according to sociodemographic characteristics (ANOVA, α = 5%). Structural equations models estimated the impact of OA on LS. 3,614 Finns [75.1% female, 32.0 (SD = 11.6) years] and 3,979 Brazilians [69.9% female, 33.0 (SD = 11.3) years] participated in the study. Women were more likely to receive ADT than men in both countries (OR>1.3). However, no statistically or practical significant differences were observed in OA between sexes (p>0.05 or p<0.05, ηp2 = 0.00-0.02). In Finland, demand for ADT (OR = 0.9-1.0) and OA scores (p>0.05) were the same among different ages and monthly income. In Brazil, younger individuals (OR>1.6) and those with higher monthly income (OR>2.7) were more likely to receive ADT, while those with lower income had a greater psychosocial impact of OA (p<0.05; ηp2>0.07). Individuals who were more satisfied with their own OA and had less psychosocial impact from OA had higher levels of LS (β = 0.31-0.34; p<0.01; explained variance: 9.8-13.1%). Demand for ADT is influenced by sociodemographic and cultural factors. Greater societal pressure on physical appearance is observed among women in Western countries. In countries with high socioeconomic inequalities, consumerism and social prestige are involved in this demand. Self-perception of orofacial appearance plays a significant role in individuals' subjective well-being. Therefore, the planning of aesthetic treatments in the orofacial region should consider the patient's perceptions and social context.

Patient Satisfaction in Relation to Esthetic Outcome of Dental Treatment: A Systematic Review and Pooled Analysis

ABSTRACT Introduction: Esthetics is often an essential yet ignored aspect of dental treatment. In the present study, an attempt was made to evaluate patient satisfaction in terms of esthetic outcome of dental treatment. MaterialS and Methods: For this purpose, a systematic review was carried out by searching, MEDLINE, PubMed, and Scopus databases using the keywords “esthetics,” “orthodontic treatment need,” “dental treatment need,” “satisfaction,” and “determinants.” A total of 1075 studies were shortlisted, out of which a total of 927 were excluded in the preliminary assessment itself. A further 779 were excluded during the process of identification of themes and concepts and another 73 were out of sampling frame/inappropriate methodology. Of the remaining 75, a total of 44 studies were related with expectation and perceptions and thus only 31 (2.9%) studies were left that had evaluated esthetics as the treatment outcome. Among these, 9 studies each were related with orthodontic and prosthodontic/implantology treatment, respectively, while 6 studies were related with general dental treatment, and the remaining 7 were related with specialized/esthetic procedures. Results: The overall patient satisfaction rate was 67.3%. It was highest in the prosthodontics and dental implantology group (75.1%) and lowest in patients availing of generalized dental (32.4%). Conclusion: Patient satisfaction was affected by gender, pretreatment appearance, patient personality characteristics, type of disorder, patient education, previous bad experience, treatment time, cost of treatment, use of appliance/treatment modality/material, practice location and environment, dentist personality, quality of treatment, patient’s esthetic perception, negligence/regularity, smoking, and oral health factors. CLINICAL RELEVANCE TO INTERDISCIPLINARY DENTISTRY The article targets to describe the patient expectations with respect to esthetic dental treatment and how patient’s satisfaction is affected by different esthetic dental treatments availed by them for various purposes. The article also highlights the various dental treatment options availed by the patients and their esthetic outcome.

Digital Diagnostic Wax-up as a Part of Esthetic Dental Treatment in Front Area: a case report

Introduction Digital diagnostic wax up is a 3D representation of the final dental treatment result as far as esthetics (shape, size, color, position, outline), occlusion and function, marginal adaptation are concerned and it is overlaid onto a 3D digital pre-op model. Aim To present the role of the digital diagnostic wax up as a part of dental treatment of front teeth based on a case report Materials and Methods Dental treatment in the front area due to esthetic indications is reported. A young patient is seeking for a whiter and brighter smile. Results The clinical protocol for fabrication of digital diagnostic wax up used in this case is described. Although the veneers provide better long term esthetic result, the patient chose bonding due to no prep approach and lower expenses. The digital diagnostic wax-up was used for printing a 3D model which is needed for fabrication of a silicone index for the composite resin injectable technique. Conclusion The digital diagnostic wax up helps the dentist and the patient to visualize the desired changes. The communication between dental office, lab and patient is a lot easier. Editing is done easily and fast using the software until the perfect result is achieved and accepted by the whole team. It is a precise, time and money saving method that leads to predictable final result and satisfaction of the dental treatment.

Oral and Craniofacial Anomalies of Fraser Syndrome: Prosthetic Management

Fraser syndrome (FS, MIM 219000) is a rare autosomal disorder characterized by systemic and oro-facial malformation, usually comprising cryptophthalmos, laryngeal malformations, syndactyly, and urogenital defects. We presented a 21-year-old FS case with partial missing teeth seeking aesthetic dental treatment. Clinical examination revealed bilateral cryptophthalmos, extensive syndactyly of hands and feet broad nose with the depressed nasal bridge, and surgically corrected bilateral cleft lip. She presented class III jaw relation and reduced the vertical height of the face. Prosthetic rehabilitation of the patient was done with upper and lower overlay dentures made from acrylic resin (VIPI BLOCK TRILUX®, VIPI Industria, Pirassununga, SP, Brazil) using computer-aided design (CAD) and computer-aided manufacturing (CAM) process. At the follow-up visit, the patient presented improved aesthetics and function. Proper management and rehabilitation of FS patients are challenging, but standard guidelines for oral health management are currently lacking. This article presents a case of Fraser syndrome presenting oral and craniofacial anomalies, and prosthetic rehabilitation was done. We also provided recommendations for the optimal oral health care for the FS patients. Functional adaptation and rehabilitation have significant roles in the various functions, survival, and quality of the life of FS patients. Integrated medical-dental care is needed in such patients with support from family members, friends, and colleagues.

Color alteration with ceramic veneers according to the tooth type and preparation step: A clinical analysis

Statement of problemAchieving accurate tooth color is important in esthetic dental treatments; however, clinical studies evaluating how ceramic veneer procedures affect color alterations are lacking. PurposeThe purpose of this clinical study was to assess the color alteration during treatment with ceramic veneers and to correlate these changes with the tooth treated and veneer thickness. Material and methodsTen patients who underwent esthetic treatment were enrolled as participants. Color analysis with the VITA spectrophotometer was performed at baseline, after tooth preparation, immediately after cementation (Final 1), and after 6 to 12 months of follow-up (Final 2). Data of L∗, a∗, b∗, shade guide unit (SGU), ΔEab, ΔE00, and variation in SGU (ΔSGU) were obtained. Thickness of the veneer was also recorded. Each participant was considered as a statistical block, and the mean results for each tooth (maxillary central incisors, lateral incisors, and canines) were presented. Data were evaluated by the mixed model for repeated measures and Tukey-Kramer post hoc test (L∗, a∗, b∗), generalized linear models (thickness, ΔEab, ΔE00, SGU), Friedman test (ΔSGU), and the Pearson test was used to correlate veneer thickness and color change (ΔEab, ΔE00, ΔSGU) (α=.05). ResultsAmong the teeth treated, no differences were found in ceramic thicknesses. The mean thickness was 1.03 mm for central incisors, 0.96 for lateral incisors, and 0.89 for canines. The b∗ values increased significantly after preparation and decreased after cementation (P<.001). For ΔEab, ΔE00, and ΔSGU, there was no statistically significant difference between the types of tooth at each respective time of analysis (P>.05). Regardless of the tooth, a decrease in the SGU score was detected after cementation (P=.015). After tooth preparation, there was significant correlation (P<.05) between ceramic thickness and ΔSGU (r=0.36). ConclusionsTreatment with ceramic veneers resulted in color change, mainly with respect to the b∗ axis (yellow), producing objective differences in the ΔE analysis. Although ceramic thickness correlated with the VITA scale change (ΔSGU) after tooth wear or preparation, ceramic thickness did not differ among tooth types and did not correlate with changes in color parameters after cementation. (P>.05).

The versatility of flowable composites. Part 1: theory and new classification

The increase in consumer demand for restorative and aesthetic dental treatment has resulted in a gradual upsurge of dental professionals relying on flowable composites (FCs) to meet consumer needs. All main manufacturers in the worldwide dental market offer flowable products together with the packable type. Scientific and technological improvements of FCs properties and handling characteristics have not only seen FCs grow in popularity but resulted in the development of different generations and types of dental FCs suitable for wide range of clinical applications. CPD/Clinical Relevance: It is useful for the dental practitioner to be aware of the classifications, composition and overview of FCs.

Self-perception of orofacial appearance: Brazil–Finland cross-national study

Objective (i) To study the measurement invariance of Orofacial Esthetic Scale (OES) and Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ), (ii) to compare the perception of orofacial appearance (OA) and (iii) to study the frequency of individuals who have sought or received aesthetic dental treatment between Brazil and Finland. Methods This was a cross-sectional observational study with snowball non-probability sample selection. Students and staff from universities in Finland and Brazil were invited to participate. Data were collected online using a demographic questionnaire, OES and PIDAQ. The samples consisted of 3636 Finns (75.0% female; age: 32.0 years) and 1468 Brazilians (72.6% female; age: 33.2 years). The frequency of receiving aesthetic dental treatment was estimated. If configurational invariance was observed, cross-national measurement invariance was verified by multigroup analysis. When measurement invariance was attested, factor scores were compared using Welch’s t-test. Results OES showed configurational and measurement invariance and no significant difference between the countries. Despite similarity in satisfaction with OA, 71.9% of Brazilians had received aesthetic dental treatment, while 59.4% of Finns had never sought such treatments. PIDAQ did not present configurational invariance between the countries. Conclusion Although there is no difference in satisfaction with OA, seeking and receiving aesthetic dental treatment is significantly greater for Brazilians. Psychosocial impact of OA is perceived differently in the studied countries.

Effect of Social Media on Patient's Perception of Dental Aesthetics in Saudi Arabia.

Introduction Social media became an influential tool that affects people's way of communication and became a significant source of information for the society. The study aimed to evaluate the impact of SM on patients seeking aesthetic dental treatment. Methodology. The study employed a large-scale online survey of 1940 patients attending and/or seeking dental treatment at KAUFD and Jeddah private clinics. The targeted age of participants ranged from 18 years and above. The study data were collected using a three-part questionnaire. Results More than half of the patients were females in both groups (52.7%). The majority of patients used SM for communication and entertainment purposes. It was also found that the most popular platform used by patients was Snapchat (71.1%), followed by Instagram (66.9%). A lot of patients did not like their teeth appearance (38.5%). Moreover, patients preferred to have “bleaching” as an aesthetic treatment to improve their smiles (63.8%). Conclusion The impact of SM on Saudi Arabian citizens and Saudi Arabia residents can be considered as high. Patients are influenced by SM applications and are seeking aesthetic treatment as an outcome. It is the responsibility of dentists to educate patients about the best treatment options.

Communication tools and patient satisfaction: A scoping review.

ObjectiveThis scoping review aimed to present an overview of the literature on communication tools in esthetic dentistry. A variety of communication tools have been proposed to include patients in the shared decision‐making (SDM) workflow. Only little is known about implementing communication tools in dentistry and their impact on patient communication and patient satisfaction. A systematic literature search was performed in Medline, Embase, Cochrane, and World of Science to identify if communication tools have an impact on patient satisfaction.Material and MethodsThe search included studies from January 1, 2000 to March 3, 2020 published in English, focusing on patient communication tools and patient satisfaction in esthetic dentistry.ResultsOut of 6678 records, 53 full‐texts were examined. Ten studies were included. Data of the included studies were extracted systematically and subsequently analyzed. All studies found that patient communication utilizing specific communication tools positively impacted either patient satisfaction, patient‐dentist relationship, information retention, treatment acceptance, quality of care or treatment outcome.ConclusionsAdditional communication tools besides conventional verbal communication are able to enhance patient satisfaction, improve quality of care and establish a better patient‐dentist relationship. It seems essential to further develop standardized communication tools for SDM in dental medicine, which will allow the comparison of research on this topic.Clinical significanceThis scoping review shows the importance of patient involvement in the decision‐making process for improved patient satisfaction with esthetic dental treatments. With an increased implementation of communication tools, patient satisfaction and SDM may further improve in the future.

The Effectiveness of Different Clinical Methods of Application for In-office Bleaching Materials with Hydrogen Peroxide: A Systematic Review

Background: In the past few years, there has been an increase in demand for esthetic dental treatment. Vital tooth-bleaching is one of the most popular cosmetic procedures requested by patients in daily dental practice. There are various materials and protocols for treating discolored teeth since the introduction of vital tooth-bleaching to dental practice. In-office bleaching can be performed clinically using hydrogen peroxide alone or it can be combined with carbamide peroxide as a home bleaching technique. Hence the aim of this systematic review was to evaluate the effectiveness of different application protocols.&#x0D; Methodology: A comprehensive search was performed using online databases (PubMed and ADA Center for Evidence-Based Dentistry) to obtain clinical trials relevant to the research question. The readers validated the studies that met the inclusion criteria. The included studies were evaluated using the risk of bias assessment instrument. In addition, the strength of recommendation of clinical trials was evaluated using Ex-GRADE.&#x0D; Results: After reviewing 89 studies, duplicates were removed and inclusion and exclusion criteria were applied. Finally 10 clinical studies were accepted in this review. Acceptable sampling was performed to obtain the clinical trials with strong evidence.&#x0D; Conclusion: A qualitative assessment for the included studies proved the hypothesis of the research in that the best clinical outcomes of in-office bleaching is achieved with a single application of hydrogen peroxide.

Psychosocial impact of dental aesthetics on dental patients

This study aimed to evaluate the contribution of demographic and clinical characteristics on the psychosocial impact of dental aesthetics of dental patients. The psychosocial impact of dental aesthetics was assessed by the Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ). Data validity was estimated using confirmatory factor analysis (CFA). Reliability was assessed using standardised Cronbach's alpha coefficient (α). A structural model was developed to assess the contribution of demographic and clinical characteristics to the results. The fit of the model was evaluated and the z test (α=5%) was used to estimate the significance of the contributions (β). A total of 505 dental patients (80% female; age: 36.3,SD =11.4) participated in the study. Data showed adequate validity (CFA: χ2 /df=3.3, Tucker-Lewis index [TLI]=0.92, comparative fit index [CFI]=0.92 and root mean square error of approximation [RMSEA]=0.07) and reliability (α=0.77-0.92). The fit of the structural model was adequate (χ2 /df=2.8, TLI=0.89, CFI=0.91, RMSEA=0.06). People of a lower economic level, with incomplete dentition, who did not undergo previous aesthetic dental treatment, and who did not like their own smile showed greater psychosocial impact of dental aesthetics. Demographic and clinical characteristics should be considered in the evaluation of the impact of dental aesthetics on individuals'. Moreover, PIDAQ is an alternative tool for clinical evaluation of the psychosocial impact of dental aesthetics because it provides valid and reliable data.

Direct Composite Resin Restoration of Anterior Maxillary Teeth and Esthetic Smile Design: A Case Report and Esthetic Smile Design: A Case Report

Dental esthetic complex involves more than one caries with malformed shape and malposition. Dental trauma most commonly affects maxillary anterior teeth, and subsequently affects the esthetics, functions, and psychological well-being of the individual. Composite resins have become an integral part of contemporary restorative and minimally invasive dentistry. Objective: To summarize the successful use of direct composite resin restoration in the management of a 29-year old male patient. Case Report: A 29-year old male patient presenting with multiple secondary caries and crown fractures in the anterior maxillary teeth, resulting in an unaesthetic smile. Comprehensive esthetic dental treatment was carried out. The patient was highly satisfied with the results even after eleven months of follow-up. Conclusion: restorative success with composite resins, the dental treatment plan should be carefully executed with attention to factors such as dental convexities and contours, re‑establishment of function, and esthetics. Smile design should always be a multifactorial decision-making process that allows the clinician to treat patients with an individualized and interdisciplinary approach.

Effect of Short- and Long-term Use of Home and In-Office Bleaching with Carbamide Peroxide and Hydrogen Peroxide on Bleaching with Carbamide Peroxide and Hydrogen Peroxide on Enamel Microhardness Enamel Microhardness

Bleaching is a well-known esthetic dental treatment performed to lighten the tooth shade. Among different cosmetic dental procedures, including direct and indirect tooth-colored restorations, bleaching is likely the most conservative approach. Bleaching has been accepted well by patients and proven as a safe and effective approach. Objective: Tooth bleaching can be conducted at home or in offices. This study was performed to compare the enamel microhardness before bleaching and one and eight weeks after the application of different bleaching agents. Methods: Forty human premolars were randomly divided into four groups, and their buccal surface underwent a Vickers microhardness test before and after bleaching. Bleaching was performed with 40% hydrogen peroxide (HP) in-office bleaching agent (n = 10), 15% HP at-home bleaching agent (n = 10), and 15% carbamide peroxide (CP) at-home bleaching agent (n = 10) for two weeks. Ten samples were stored in artificial saliva and set as the control group. The microhardness of the samples was measured again one and eight weeks after bleaching. Results: The microhardness significantly decreased in the four groups one week after bleaching. Conclusion: The enamel microhardness was temporarily decreased by in-office bleaching. However, the microhardness increased with time and returned to the baseline value. Although the enamel microhardness initially reduced, it increased eight weeks after 15% CP at-home bleaching agent was applied.

Full oral rehabilitation of a child under general anesthesia. A case report

INTRODUCTION: Untreated caries lesions, painful treatment, and emergency cases in children at pre-school age may lead to increased anxiety and fear of future dental treatment. Many children have unfavorable behavior. The main difference in the treatment of children and adults is behavior management. In cases of lack of cooperation from the child and inefficiency of the methods of behavior management it is necessary for the dental treatment to be done under general anesthesia. AIM: The aim of this article is to show the possibility for high esthetic dental treatment under general anesthesia. MATERIALS AND METHODS: The object of the clinical study was an uncooperative child with atypical form of early childhood caries (ECC), whose behavior was modified through pharmacological agents. For the restorations of the decayed teeth, a highly esthetic nanohybrid composite Tokuyama Estelite Asteria was used. RESULTS: A 4-year-old child came to the dental office with pain of dental origin. The child was definitely negative, uncooperative, with strong fear of dental treatment. The lack of cooperation during the examination imposed that the dental restoration of carious lesions with composite restorations and extractions of teeth diagnosed with pulp necrosis should be done under general anesthesia. CONCLUSION: Тreatment under general anesthesia improves the conditions for highly esthetic nanohybrid restorations and avoids the eventual psychological trauma the child might get during the conventional methods of treatment. Achieving high esthetic and long-lasting results without any complications is the main goal of the treatment under general anesthesia.