Objective: The aim of the present study was to evaluate personal satisfaction of adult dental patients about their smiles aesthetics in comparison to dental professionals view. Method: One hundred twenty adult patients (76 male and 44 female) visiting the screening clinics of Riyadh colleges of dentistry and Pharmacy were asked to evaluate their smiles by completing a questionnaire containing five questions concerning five aesthetic elements which are: Overall smile; color; shape; alignment of their teeth; and appearance of their gum during smiling. They were asked to rate each of the five categories in Visual Analog Scale (VAS) graded from 0 to 10. A smiling photograph was taken for each patient to be evaluated by two restorative specialists using the same scale. Patients and dental professional mean evaluation scores were statistically analyzed for any significant differences. Result: The average age of the patients was 39.1 years. The mean patients’ satisfaction with their own smiles was [6.47] on the VAS which was statistically higher than the average of dentists’ evaluation scores [4.95] (p < 0.05). Patients were most satisfied with the gingival show when smiling [6.8] and least satisfied with teeth color [6.01]. The patients gave a statistically higher evaluation scores than the dental professionals in the five categories of the study which indicates higher satisfaction regarding their own smile aesthetics (p < 0.05). Female patients were less satisfied about their smiles [5.98] than the male participants [6.74]. Patients visiting the clinic for aesthetic reasons gave a lower evaluation scores [5.65] than those visiting the clinic for non-aesthetic reasons [6.67]. Conclusion: Patients’ satisfaction about their dental aesthetics was statistically higher than the dental professional assessments. Dental professionals appear to be more critical in their evaluation of patients smile aesthetics. Age showed no significant relation with the level of satisfaction while gender and reason of dental visit showed a significant relation with patients smile satisfaction.
One of the main goals of dental treatment is to provide the patient with functional, healthy and esthetic dentition. The field of dental aesthetics is a complicated t with a. branch of dentistry because of the subjective nature of dental aesthetic judgment. We should not forget that perception varies from person to person and this could be influenced by many factors including age, personal experience, education, media, and social environment [
In addition to the subjective judgment and in contrast to the laypeople, dental professionals usually rely on aesthetic scientific rules in expressing their opinions about smile aesthetics. It is common understanding that dental appearance has been shown to influence other people judgment of person’s facial attractiveness as well as personal characteristics [
Several studies have compared smile assessments between dental patients and dentists. The investigators in these studies used photographs, often with software-imaging programs to assess the importance of the shape, symmetry and proportions of maxillary central incisors; the presence and shape of the interdental papilla; the presence of a midline diastema; the gingival to-lip relationship; and the impact of the buccal corridor [
Teeth color is a highly significant factor in perception of smile attractiveness. It is known that laypeople prefer smiles with lighter teeth shade [
Tooth color usually is the category which shows the majority of the patients’ dissatisfaction [
Limited information is available about patients’ perception toward their ideal smile in the Kingdom Saudi Arabia (KSA). Furthermore, very few studies have been published regarding the difference between how patients view their own smiles and how dentists assess these smiles based on a scientific background. The aim of this study was to evaluate personal satisfaction of the adult patients visiting dental clinics of Riyadh Colleges of Dentistry and Pharmacy (RCsDP) about their dental and smile aesthetics and to compare their assessment with dental professionals’ evaluation.
The subjects in this study were adult patients visiting the screening clinic of RCsDP, Riyadh, KSA in the period from 6th march to 17th march 2016.One hundred twenty adult patients were included in the study.
Adult patients.
Not under orthodontic treatment and with no dental veneers.
No missing teeth in the anterior teeth.
A smile self-evaluation questionnaire specially designed for this study containing-in addition to personal data-five questions about five elements of dental aesthetic used in the study. The participants were asked to mark on a10cm horizontal line how satisfied they are with their overall smile; shape; teeth; color; alignment of their teeth; and appearance of gum during smiling. For each of the five components of the questionnaire, they were asked to rate their satisfaction in Visual Analog Scale (VAS) graded from 0 to 10 where 10indicated most satisfied and zero the least. The VAS method has been used in other investigations and is a tool of proven scientific validity.
The participants were asked to evaluate their smile aesthetics from memory, without viewing their smile in the mirror during this study. The subjects completed the survey on site in the screening clinic.
A standardized smiling frontal photograph was taken at the completion of the survey to be evaluated by two dental restorative specialists from department of restorative den-
image 1. Sample of smiling photographs for the participants in the study.
tistry using the same scale (Image 1).
No names or identifiers were written on the questionnaire. A completed questionnaire indicated the consent to participate in the study. Anonymity and confidentiality were assured.
Descriptive analysis was undertaken to present an overview of the findings of the characteristic of the population and their perception toward their own smile aesthetics. The Statistical Package for Social Sciences Software release 20.0 (SPSS Inc., Chicago, IL, USA) was used for data analysis. Parametric test was used to compare the mean values of patients and dentist scores with the assumption of normal distribution (p > 0.05). Independent sample t-test was used to examine differences in mean scores of patients satisfaction and dentists evaluations. The confidence level was set at p ≤ 0.05.
This study was approved by the ethics committee in RCsDP. The participants were given a description about the study and how their photographs would be used and subsequently given consent forms to allow use of their photographs in this study.
One hundred twenty adult patients (76 male and 44 female) with mean age of 39.1 years participated in the study. The mean (±SD) patients’ satisfaction scores about their own smiles was (6.47 ± 1.54) on VAS which was significantly higher than the dental professionals evaluation scores (4.95 ± 1.33) (p = 0.00). Patients were most satisfied with their gum while smiling with a score of 6.80 (2.06±) and least satisfied with tooth color with a score of 6.01 (±1.96). Restorative dental specialists gave the highest evaluation for gum show during smiling (5.95 ± 2.10) and lowest score was for smile overall (4.45 ± 1.67). When comparing the level of patients’ satisfaction about their smiles to doctors view in the five categories of the study separately, results revealed that patients gave significantly higher evaluation scores in the five categories of the study as presented in
Category | Mean Patients Evaluation | Mean Dentists Evaluations | Sig. (P value) |
---|---|---|---|
Smile overall | 6.66 ± 1.75 | 4.45 ± 1.67 | 0.000 |
Shape | 6.55 ± 1.94 | 4.62 ± 1.69 | 0.000 |
Color | 6.01 ± 1.96 | 5.09 ± 1.58 | 0.004 |
Alignment | 6.31 ± 2.16 | 4.65 ± 1.86 | 0.000 |
Gum | 6.80 ± 2.06 | 5.95 ± 2.10 | 0.000 |
Average | 6.47 ± 1.54 | 4.95 ± 1.33 | 0.000 |
Gender | Number (%) | Mean Evaluation scores | SD | Sig. (P Value) |
---|---|---|---|---|
Male (n = 76) | 76 (63.3%) | 6.74 | 1.48 | 0.009 |
Female (n = 44) | 44 (36.7%) | 5.98 | 1.53 |
Reason for current dental visit | Number of patients (%) | Smile evaluation mean | SD | Sig. (P Value) |
---|---|---|---|---|
Aesthetic | 24 (20%) | 5.65 | 1.65 | 0.003 |
Non-aesthetic | 96 (80%) | 6.67 | 1.45 |
and satisfaction about their smiles (
The current study was designed to assess patients’ satisfaction about their smiles and compare their evaluation with dental professional assessments of the patient smile recorded on photographs. Visual Analog Scale (VAS) was utilized as the method of evaluation of the smiles for both patients’ and dental professionals. The VAS is a valid and reliable method that can be applied to evaluate patients’ and dentists’ perceptions about dental aesthetics.VAS has been widely used in the assessment of dental aesthetics for public and it found to be suitable for the purpose of discriminating the levels of self as-
Age Group(Yrs.) | Number (%) | Mean Evaluation | SD | Sig (P Value) |
---|---|---|---|---|
18 - 30 | 34 (28.3%) | 6.50 | 1.67 | 0.385 |
31 - 41 | 47 (39.2%) | 6.24 | 1.56 | |
>41 | 39 (32.5%) | 6.71 | 1.38 |
sessment of dental aesthetics, as employed in the present study. VAS as a measurement tool is characterized by being simple to administer.
It must be emphasized that dentists and the patients did not evaluate the smiles in the same way. The esthetic perception of a smile is very personal and varies according to the sensibility of each subject. Patients’ subjective evaluation to their smiles could be influenced by media, cultural background, level of education and socioeconomic status while dentists rely on aesthetic principals for the ideal smile. The patients were asked to evaluate their smiles from their memories and not using photographs or mirrors.
Results of the current study showed that dental professionals appear to be more critical in evaluating patients smile aesthetics than the patients themselves. This could be attributed that their scientific background about principals of smile aesthetics make them capable of picking out small dental defects that is not noticeable by the patients. Another reason that may explain that difference is that dental professionals looks to the general oral health of the patients through these photographs such as observing presence of plaque, calculus, inflamed gingival, which are not perceived by most of the patients. In our study, a statistically significant difference existed between patients’ satisfaction about their smiles and dental professionals view in the five categories of the study (smile overall, shape, color, gum show during smiling, alignment). The finding that the dentists gave lower evaluation cores for smile aesthetics than the patients is similar with the reports of most studies did this comparison [
The mean doctors’ evaluation scores on VAS was below 5 which clearly reflects generalized dissatisfaction with the patients’ smile aesthetics.
The gum show during smile is one of the most important aspects of smile aesthetics. The acceptable gum show during smiling can vary widely between different persons and dental professionals. Kokish and Colleagues investigated the gingival display and reported that 3 mm of g. display represent the threshold of acceptability. The mean participants satisfaction scores about gum was the highest among the five categories included in the smile evaluation in the present study. This could indicate a relative satisfaction of the patients about their gum show during smiling and this could be attributed to that patients may not giving the gum a lot of concern in evaluating their smiles .
Female patients appears to be more critical than male patients and they gave lower evaluation rates than male which is similar to the findings of Tin (2011) [
In our study, Patients appears to be not sufficiently aware about smile aesthetics and further educational efforts should be carried out in order to improve their awareness about ideal smile. Other factors may affect patients’ perception toward their smiles recommended to be investigated. Such factors include level of education, self confidence and its relation to smile aesthetics, occupational factors and psychological influence of smile aesthetics on the person.
It could be proposed that patients in higher educational level may able to perceive their smile defects better than lower levels. One limitation in this study was the lack of correlation between the socioeconomic status, level of education, cultural background and smile perception. Future researches is needed to explore the impact of these factors on patients’ perception of smile aesthetics. Furthermore, It is not clear from this study at what level of satisfaction or dissatisfaction the patients might seek dental aesthetic care.
It appears from the present study that dental professionals appear to be more critical in their evaluation of patients smile aesthetics. Dental professionals gave lower smiles evaluation scores than the patients themselves in the five elements of the study. Female patients’ and patients visiting the clinic for aesthetic reason found to have significantly less satisfaction about their own smiles if compared to male and patients visiting the clinic for non-aesthetic reason respectively. Age didn’t show any statistically significant relation with dental aesthetic satisfaction. Highest mean score-level of satisfaction-of the patients was in the category of gingival and the least was in the teeth color. While the highest mean evaluation scores of the dental professionals was for gum show during smiling and least mean scores was for smile overall category.
There is no conflict of interest.
Alamassi, B.Y., Al Onazi, M.S. and Al Zoman, A.A. (2016) Satisfaction of Adult Patients about Their Smile Aesthetics Compared to Dental Professionals Observation. Open Journal of Sto- matology, 6, 236-244. http://dx.doi.org/10.4236/ojst.2016.611029