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Patients' satisfaction with dental esthetics

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Esthetics has become an important issue in modern society, as it seems to define one's character. In the past, functional demands were the main consideration in dental treatment. Today, with the decrease in caries prevalence, the focus has shifted toward dental esthetics. The authors conducted a study to evaluate the factors influencing patients' satisfaction with their dental appearance and with the results of esthetic treatment. The authors surveyed a population of 407 adults (mean age, 21 years). They distributed a questionnaire regarding satisfaction with current dental esthetics and previous esthetic treatments. Of the 407 subjects, 152 (37.3 percent) were dissatisfied with their dental appearance. Tooth color was the primary reason for dissatisfaction (133 [89.3 percent] of 149 subjects), followed by poor tooth alignment (36 [23.7 percent] of 152 subjects), although 110 (27 percent) of the 407 subjects had received orthodontic treatment. The authors found no correlation between patients' satisfaction with their dental appearance and having undergone any procedure to whiten their teeth. Nevertheless, 134 (88.2 percent) of the dissatisfied subjects reported that they would like to undergo this procedure. Tooth color was a major factor with regard to dental esthetics. Most subjects were interested in improving their appearance and whitening their teeth. When planning treatment, dentists should take into consideration esthetic objectives in addition to function, structure and biology. This requires the clinician to rely on several disciplines in dentistry to deliver the highest level of dental care, which should lead to a higher level of patient satisfaction.
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Background. Esthetics has become an important
issue in modern society, as it seems to define one’s
character. In the past, functional demands were the
main consideration in dental treatment. Today, with
the decrease in caries prevalence, the focus has shifted
toward dental esthetics. The authors conducted a study to evaluate the
factors influencing patients’ satisfaction with their dental appearance
and with the results of esthetic treatment.
Methods. The authors surveyed a population of 407 adults (mean age,
21 years). They distributed a questionnaire regarding satisfaction with
current dental esthetics and previous esthetic treatments.
Results. Of the 407 subjects, 152 (37.3 percent) were dissatisfied with
their dental appearance. Tooth color was the primary reason for dissatis-
faction (133 [89.3 percent] of 149 subjects), followed by poor tooth align-
ment (36 [23.7 percent] of 152 subjects), although 110 (27 percent) of the
407 subjects had received orthodontic treatment. The authors found no
correlation between patients’ satisfaction with their dental appearance
and having undergone any procedure to whiten their teeth. Nevertheless,
134 (88.2 percent) of the dissatisfied subjects reported that they would
like to undergo this procedure.
Conclusions. Tooth color was a major factor with regard to dental
esthetics. Most subjects were interested in improving their appearance
and whitening their teeth.
Clinical Implications. When planning treatment, dentists should
take into consideration esthetic objectives in addition to function, struc-
ture and biology. This requires the clinician to rely on several disciplines
in dentistry to deliver the highest level of dental care, which should lead
to a higher level of patient satisfaction.
Key Words. Esthetics; tooth whitening; tooth fracture; orthodontic
treatment; caries.
JADA 2007;138(6):805-8.
Until recently, restorative
dentistry considered
mostly functional
demands (for example,
repairing the destructive
effects of dental caries). However,
with the decrease in caries preva-
lence,1-3 the focus has shifted gradu-
ally from functional dentistry per se
to esthetic dentistry. As a result,
the perception of tooth appearance
in modern society could influence
the changes in patients’ needs.4
Several authors have reported
discrepancies between the treat-
ment needs perceived by patients
and those assessed by dental profes-
sionals.5-9 Osterberg and colleagues10
reported that esthetic rather than
functional factors determine a
patient’s subjective need to replace
missing teeth. Many patients find
the six anterior teeth indispensable
but will accept edentulous spaces in
posterior regions.11-17 In our beauty-
conscious society, a smile has great
impact. When a patient’s smile is
destroyed by dental disease, the
result often is loss of self-esteem
and damage to his or her overall
physical and mental health.18
Because most areas of dentistry
deal increasingly with esthetics, we
conducted this study to evaluate the
factors that influence patients’ sat-
isfaction with dental esthetics and
the impact of basic dental treat-
ments on their satisfaction with
their dental appearance.
SUBJECTS, MATERIALS
AND METHODS
The study population consisted of
407 adults (242 men [59.4 percent],
ABSTRACT
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Dr. Samorodnitzky-Naveh is a clinical instructor, Department of Oral Rehabilitation, The Maurice and
Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Israel, and Medical Corps, Israel
Defense Forces.
Dr. Geiger is a lecturer, Department of Oral Rehabilitation, The Maurice and Gabriela Goldschleger
School of Dental Medicine, Tel Aviv University, Israel.
Dr. Levin is a clinical instructor, Department of Oral Rehabilitation, The Maurice and Gabriela Gold-
schleger School of Dental Medicine, Tel Aviv University, Israel, and Unit of Periodontology, Department
of Oral and Dental Sciences, Rambam Medical Center, Haifa, Israel. Address reprint requests to Dr.
Levin, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv,
Israel 69978, e-mail “liranl@post.tau.ac.il”.
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Patients’ satisfaction with dental esthetics
Gili R. Samorodnitzky-Naveh, DMD; Selly B. Geiger, DMD; Liran Levin, DMD
RESEARCH
JADA, Vol. 138 http://jada.ada.org June 2007 805
Copyright ©2007 American Dental Association. All rights reserved.
esthetic treatments such as orthodontic
treatment, tooth whitening and ante-
rior restorations. The survey also asked
patients to report impairments in tooth
appearance (for example, crowding,
dental caries, restorations, malalign-
ment, tooth fractures). To ensure
anonymity, the clinic staff did not
record subjects’ names on the question-
naires. All subjects answered the ques-
tionnaire (for a 100 percent response
rate).
We collected and analyzed the data
by using statistical software (SPSS ver-
sion 11.0, SPSS, Chicago).
RESULTS
As shown in Table 1, more than 60 per-
cent of subjects were satisfied overall
with their dental appearance. Never-
theless, only 175 subjects (43 percent)
were satisfied with their tooth color.
Table 1 also shows subjects’ responses
with regard to specific esthetic con-
cerns, such as tooth malalignment.
Among the 152 subjects (37.3 percent)
who were dissatisfied with their dental
appearance, 133 (89.3 percent) of 149
reported that tooth color was the
reason. Women were more satisfied
than men with their general tooth
appearance (65.4 percent versus 59.8
percent, respectively; P= .04). More
men than women reported having frac-
tured anterior teeth (21.9 percent
versus 15.7 percent, respectively;
P= .03). Overall, 56 subjects (13.8 per-
cent) reported that they hid their teeth
when smiling.
Table 2 shows subjects’ previous
esthetic dental treatments. One hun-
dred ten subjects (27 percent) reported having
received orthodontic treatment, with more women
than men reporting that they received this treat-
ment (36.5 percent versus 19.6 percent; P< .001).
Thirty-six (23.7 percent) of the 152 subjects who
were dissatisfied with their dental appearance
reported being dissatisfied with the alignment of
their teeth (26 of these subjects reported having
received orthodontic treatment). More women
than men reported that they had undergone tooth
whitening (17 percent versus 11.2 percent, respec-
tively; P< .03). When asked about dental treat-
165 women [40.5 percent]), 18 through 26 years of
age (mean [±standard deviation] age, 21 ±3.5
years), who had appointments at a military
dental clinic. There was no common background
regarding place of birth, education or socioeco-
nomic setting. The Ethics Committee of the
Medical Corps, Israel Defense Forces, approved
the study.
The survey addressed patients’ satisfaction
with regard to dental esthetics issues, such as
satisfaction with tooth appearance, color and
alignment, as well as satisfaction with previous
RESEARCH
806 JADA, Vol. 138 http://jada.ada.org June 2007
TABLE 1
Subjects’ self-reported estimation of tooth
appearance.
QUESTION PERCENTAGE OF SUBJECTS (N = 407)
Yes No
Are you satisfied with your
tooth appearance?
Are you satisfied with your
tooth color?
Do you feel your teeth are
crowded?
Do you feel your teeth are
poorly aligned?
Do you feel your teeth are
protruding?
Do you suffer from dental
caries in your anterior
teeth?
Do you have nonesthetic
restorations in your anterior
teeth?
Do you have fractures in
your anterior teeth?
Are you hiding your teeth
while smiling?
62.7
43.0
18.8
23.2
16.4
22.8
15.0
19.7
13.8
37.3
57.0
81.2
76.8
83.6
77.2
85.0
80.3
86.2
TABLE 2
Subjects’ self-reported previous esthetic
dental treatments.
PREVIOUS TREATMENT PERCENTAGE OF SUBJECTS (N = 407)
Yes No
Orthodontic Treatment
Tooth Whitening
Crowns on Anterior Teeth
Anterior Tooth Implant
Root Canal Treatment in
Anterior Teeth
27.0
13.1
9.9
3.9
15.2
73.0
86.9
90.1
96.1
84.8
Copyright ©2007 American Dental Association. All rights reserved.
ments they would like to receive (Table
3), most subjects were interested in
improving their tooth appearance and
in whitening their teeth. Of the sub-
jects who reported being dissatisfied
with the general appearance of their
teeth, 88.2 percent said they would like
to have their teeth whitened.
Stepwise logistic regression revealed
that subjects’ general dissatisfaction
with the appearance of their teeth was
influenced mostly by tooth color (odds
ratio = 13.1; P< .001), followed by
self-reported poorly aligned teeth,
hiding teeth when smiling and self-
reported caries in anterior teeth (Table
4). We should point out, however, that
hiding teeth when smiling is a reflec-
tion of dissatisfaction, not a cause of it.
DISCUSSION
Esthetics has become an important
aspect of dentistry. Until about the last
two decades, clinicians considered
esthetics to be far less important than
function, structure and biology. Today,
however, if a treatment plan does not
include a clear view of its esthetic
impact on the patient, the outcome could be disas-
trous.4Clinicians should begin a treatment plan
with well-defined esthetic objectives, and they
then should consider the impact of the planned
treatment on function, structure and biology.
Such planning requires the clinician to rely on
several disciplines (such as prosthodontics, peri-
odontics and orthodontics) to deliver the highest
level of dental care to the patient.
The main objective of our study was to report
patients’ esthetic perceptions of their teeth. Dif-
ferences in esthetic perceptions among dentists,
dental students and laypeople have been exam-
ined in the literature. Generally, studies have
found that dentists are more sensitive with
regard to identifying deviations from the so-called
ideal appearance than are laypeople.9,19-24
Carlsson and colleagues25 and Wagner and col-
leagues26 found that people who were not dentists
had a stronger preference for white teeth than did
dentists. In addition, Vallittu and colleagues27
reported that various groups of patients had dif-
ferent attitudes toward the appearance of their
teeth. In our study, subjects’ self-reported satis-
faction with the general appearance of their teeth
was influenced mainly by tooth color.
We found that women were more satisfied with
the general appearance of their teeth than were
men. In a survey of attitudes regarding dental
esthetics, Vallittu and colleagues27 found that
tooth appearance was more important to women
than to men. We should point out, however, that
our cohort consisted of more men than women
because of the military setting of the study.
We conducted this study in a young cohort
(mean age, 21 years) of subjects who arrived at
the dental clinic for a scheduled meeting. We can
assume that most of the subjects had received
dental treatment in the past. This might have
contributed to the discrepancy we found between
overall satisfaction with tooth appearance (62.7
percent) and satisfaction with tooth color (43 per-
cent). Nevertheless, 13.8 percent of subjects
reported that they hid their teeth when smiling.
A major goal of dental treatment should be to re-
establish esthetics and enable patients to feel con-
fident about smiling without having to hide their
teeth. (However, it is possible that some patients
may be overly sensitive about the appearance of
their teeth and do not need whitening or other
RESEARCH
JADA, Vol. 138 http://jada.ada.org June 2007 807
TABLE 3
Subjects’ desired esthetic dental treatments.
TREATMENT PERCENTAGE OF SUBJECTS (N = 407)
Yes No
Improvement in Tooth
Appearance (General)
Tooth Whitening
Teeth Alignment
Crowns on Anterior Teeth
77.4
81.8
31.5
13
22.6
18.2
68.4
87
TABLE 4
Factors influencing general dissatisfaction
with tooth appearance.
FACTOR ODDS RATIO
P
VALUE
Are you satisfied with your tooth
color? (Answered “No”)
Do you feel your teeth are poorly
aligned? (Answered “Yes”)
Are you hiding your teeth while
smiling? (Answered “Yes”)*
Do you suffer from dental caries in
your anterior teeth? (Answered “Yes”)
13.1
6.5
3.2
2
< .001
< .001
.003
.03
* Hiding teeth while smiling is a reflection of dissatisfaction, not a cause of it.
Copyright ©2007 American Dental Association. All rights reserved.
esthetic treatments.)
Tooth whitening was the most desirable treat-
ment reported by subjects in this study. This is a
simple and safe procedure. Because of the
increasing demand for improved esthetics, den-
tists should consider the procedure in patients’
overall treatment plans.
CONCLUSIONS
Subjects in this study considered tooth color to be
a major factor with regard to dental esthetics.
Most subjects reported that they were interested
in improving their tooth appearance and
whitening their teeth. Their general satisfaction
with tooth appearance was influenced mainly by
tooth color, followed by self-reported malaligned
teeth, hiding teeth when smiling and self-
reported caries in anterior teeth.
When planning treatment, dentists should con-
sider, along with the patient, esthetic objectives
in addition to function, structure and biology.
This requires the clinician to rely on several disci-
plines in dentistry to deliver the highest level of
dental care, which can lead to a higher level of
patient satisfaction.
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RESEARCH
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Copyright ©2007 American Dental Association. All rights reserved.
... Contrary to the color, Tunisian dental students appreciated the shape of their teeth as well as their dimensions. Men appeared more confident than women, which is inconsistent with previous studies [6,29]. Marunick et al. [30] showed that there is a statistically significant gender difference regarding the shape of teeth. ...
... In addition, several authors confirmed that short or narrow teeth reduce the attractiveness of smiling for both professional dentistry evaluators and non-professionals [32]. Although the shape and alignment of the teeth are considered to be very important aesthetic variables, they are still less important than the color [29]. ...
... Clinical training does not have a statistically significant influence on the different scores assigned to various components. Several studies have also confirmed the importance of teeth in judging the attractiveness of the face, even among participants with no dental training [29,34]. Participants felt that people with less dental disease were more socially competent, had greater intellectual achievement, and had a better psychological balance. ...
... This scale can measure the colour, morphology, and margins of the cemented prosthesis [17]. A survey about patient satisfaction with aesthetic treatment found that the prosthesis colour is usually the primary cause for patient dissatisfaction; 89.3 % of patients were not satisfied with their aesthetic outcome due to the colour of their restoration [18]. Bekhiet et al. recorded excellent patient satisfaction in the natural optical appearance of zirconiastrengthened lithium silicate ceramics (Celtra Press) and LDCs (e.max CAD) [19]. ...
... Samorodnitzky et al. found that the restoration colour is the primary cause for patient dissatisfaction, as 89.3 % of patients were not satisfied with their aesthetic treatment [18]. However, 96.4 % of patients were satisfied about their endocrown colour, and no one expressed a neutral and unsatisfied attitude toward the treatment [20]. ...
... Tooth discoloration was one of the most common issues in cosmetic dentistry since this change impacted the confidence, personality, and social interaction of patients. 1,2 Worth noting is that recently direct composite veneer was popularly implemented for correcting the tooth size, tooth color, and tooth alignment as it presented excellent esthetic outcome, acceptable durability, tooth structure preservation, as well as it was budget-saver than ceramic veneer. It is thus recommended for the young adult patients with large pulp, and the patient with financial issue. ...
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The purpose of this study was to evaluate the masking ability and color stability of resin composites, restored with various layering techniques on discolored tooth at immediate restoration and after thermal aging. For the materials and methods, three hundred and forty disc-shaped specimens of dentin shade and enamel shade of four brands of resin composite included Filtek Z350 XT, Harmonize, Ceram X Duo, and Estelite Quick were prepared with five layering thicknesses in millimeters (n=17) as followed (Dentin thickness/Enamel thickness); 0.3/0.3, 0.4/0.4, 0.5/0.3, 0.5/0.5 and 0.7/0.3. The masking ability was interpreted through the color difference of resin composites on A4-shade tooth background at immediate restoration (∆ E T0) and after thermocycling (∆ E T1), and the color stability of specimens was measured on A1-shade inherent color background (∆E A1) using CIELab coordinates obtained from a spectrophotometer. Thermocycling was performed at 5 o C and 55 o C in distilled water for 5,000 cycles. Kruskal-Wallis test and Dunn's Bonferroni post hoc test, and Wilcoxon matched-pairs signed rank test were used to determine the significant difference of color difference (p<0.05). The results showed that the median color difference of the layered specimens (∆E T0 , ∆E T1 , and ∆E A1) were as follow; Filtek Z350 XT (1.52-2.00, 1.40-1.87, and 0.94), Harmonize (2.19-5.82, 2.34-5.65, and 1.36), Ceram X Duo (1.26-2.65, 2.13-2.45, and 1.28) and Estelite Quick (3.80-7.70, 4.07-8.10, and 1.16). ∆E T0 and ∆E T1 were significantly different amongst resin composites with layering technique. Moreover, thermocycling significantly affected to the masking ability and the resin composite brands affected to the color stability (∆ E A1) after thermocycling in some layering thicknesses (p<0.05). In conclusion, all resin composite brands demonstrated higher masking ability when increasing the thickness except for Filtek Z350 XT. A minimum 0.6 mm thickness of Filtek Z350 XT and Ceram X Duo, and 1.0 mm of Harmonize can mask the discolored tooth, whereas Estelite Quick showed unacceptable masking ability at all thicknesses. The color stability of all resin composites was clinically acceptable. Filtek Z350 XT showed the highest color stability.
... [2][3][4] This correlation is essential for dental professionals when selecting artificial teeth for prosthetic rehabilitation or aesthetic restorative materials for cosmetic dental treatments, as it helps achieve a more natural appearance that complements the patient's overall facial complexion. 5,6 The perception of tooth color can also vary based on the surrounding facial features, making it a subjective experience influenced by individual preferences and cultural factors. 4 Furthermore, the aging process has a notable impact on both teeth and skin. ...
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Objectives: This study aimed to investigate the influence of tooth shade and skin tone on smile attractiveness among native South Indians. The primary research question was whether there is a significant relationship between these variables and perceived smile attractiveness. Materials and methods: A web-based cross-sectional survey was conducted with approval from the Institutional Review Board of (Thai Moogambigai Dental College and Hospital, Chennai). Standardized smile photographs of two South Indian models (one male and one female) were digitally modified to display four different tooth shades and four different skin tones, resulting in 32 images. These images were incorporated into a Google Form along with a questionnaire and a Visual Analog Scale (VAS) for attractiveness rating. The survey was distributed to 1200 participants, including both dental professionals and the general population, with 1000 valid responses recorded. Statistical analysis was performed using IBM SPSS Statistics, employing parametric tests to evaluate the data. Results: The study found that lighter tooth shades were consistently rated higher in attractiveness for both genders. Lighter tooth shades such as FS1T1 and FS2T1 scored means of 6.88 and 7.27 respectively for females, while darker shades like FS1T4 scored lower with a mean of 4.95. Similarly, males showed a preference for lighter tooth shades with MS1T1 and MS2T1 scoring means of 5.57 and 5.78 respectively compared to darker shades like MS1T4 with a mean of 3.63. Significant differences were noted across age groups and genders, with younger participants and females showing a stronger preference for lighter tooth shades. Conclusions: The study concludes that both tooth shade and skin tone significantly influence smile attractiveness, with a clear preference for lighter tooth shades among the surveyed population. These findings suggest the importance of considering these factors in aesthetic dental treatments to enhance patient satisfaction and achieve optimal results. Clinical relevance: The results underscore the necessity for dental practitioners to take into account both tooth shade and skin tone when planning aesthetic dental treatments. This approach will help in achieving a more harmonious and natural appearance, ultimately improving patient satisfaction with the treatment outcomes. Future research should continue to explore the cultural and individual factors that contribute to these preferences in dental aesthetics.
... Dental appearance is one of the main features that determines the attractiveness of our face and plays a key role in our social interactions. 1 It has been found that the most important factors that influence the perception of beautiful teeth are age, gender, and skin color. 2,3 Shade selection is an important procedure for providing patients with an esthetic restoration that harmoniously blends with the patient's existing dentition. ...
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Shade selection is one of the most important factors that determines the satisfaction of the patient with the dental prosthesis and thus the overall success of the treatment. Conventional methods of shade selection require the presence of existing teeth or past dental/photographic records. In the absence of these, shade selection becomes challenging and must be done subjectively and arbitrarily based on the patient’s age and sex. This study aims to assess the prevalence, satisfaction, and preference of tooth shades, investigating their correlation with age, sex, and skin shade in a diverse sample of 120 participants. Methods A total of 120 participants, evenly distributed among 60 males and 60 females, were surveyed. Participants were categorized into age groups (n=15) and asked about their satisfaction with existing tooth shades and their preferences. Results The most common existing tooth shade was Value 2 (52.5%). Statistical analysis using Chi-square tests revealed that Value 2 was the most desired shade among males and females alike, particularly in the age group of 41 to 50 years (p < 0.001). Shade 2L1.5 was the most prevalent (n=26), with Value 2 (59.16%) being the most sought-after shade, followed by Shade 2L1.5 (n=21), Shade 2M1 (n=18), Shade 1M1 (n=15), and Shade 2R1.5 (n=14). Existing tooth shades of Value 0 were the least common. The highest satisfaction with existing shades was observed in males aged 41 to 50 (n=15), followed by males aged 51 to 60 (n=14) and females aged 31 to 40 (n=12) and 41 to 50 (n=12). Significant differences in satisfaction were noted among males (p < 0.001). Conclusions This study reveals a consistent and strong preference among both males and females for tooth shades classified as Value 2, following the VITA Tooth-Guide 3D Master shade guide. This universal preference suggests the relevance and acceptance of this shade category across diverse patient groups.
... Excessive overjet, dental crowding or spacing; tooth discolouration or enamel dysplasia; a gummy smile; gingival recession with uneven gingival margins or open embrasures; and missing anterior teeth may negatively affect self-esteem, predisposing to psychosocial problems. 7,8,9 If improvement of dental and smile aesthetics is the main motive for Treatment planning for the adult orthodontic patient should start on day one. Comprehensive, patient-centred orthodontic treatment should be delivered by an interdisciplinary team of equally well-trained and skilled specialists. ...
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... Occasionally, this process may entail slight smoothing of tooth structure, although in some cases, it can be accomplished without any removal of tooth structure. 16 There are numerous advantages to using porcelain instead of bonding. Porcelain maintains its color stability; resist even the most intense staining from foods and beverages. ...
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The term "Hollywood smile" refers to a dental aesthetic characterized by impeccably white, straight, and perfectly aligned teeth, often associated with the glamorous appearance of celebrities. Besides its cosmetic appeal, this type of smile embodies confidence, youthfulness, and beauty, emerging as a globally sought-after standard for dental aesthetics. Achieving the Hollywood smile typically involves cosmetic dental procedures such as teeth whitening, veneers, dental bonding, and orthodontic treatments aimed at creating a symmetrical and radiant smile. This review article delves into the methods, technological advancements, and artistic principles employed to craft captivating smiles seen on magazine covers and in movies. Furthermore, it may explore the psychological and cultural dimensions of smile aesthetics, examining why the pursuit of the perfect smile holds such significance in our society. Essentially, it serves as a comprehensive guide for those interested in the intersection of dentistry, aesthetics, and the influence of popular culture.
... The copyright holder for this this version posted August 9, 2024. ; https://doi.org/10.1101/2024.08.08.24311694 doi: medRxiv preprint [23], may cause individuals to have the desire to have white teeth [24]. This underscores the importance of social interactions during a student's time at university [25] and the importance of 254 dental appearances in shaping perceptions and interactions [26]. ...
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Background Young adults are exposed to a variety of risk-related behaviours such as alcohol, smoking, and changes in dietary habits, which may result in unknown outcomes in their oral health. There is limited evidence on whether different risk behaviours are associated with oral health behaviours in the university student population. This study gathers data on the behaviours of students in their first year of university, which will inform the future development of oral health behaviour change interventions for this population. Method This longitudinal quantitative survey involved 205 first-year university students, aged 18-24. They completed questionnaires at baseline and a 6-month follow-up interval providing information regarding self-reported oral health status, hygiene routines, risk behaviours (e.g., diet, smoking, alcohol) and attitudes towards digital health. Results The findings show associations between oral health behaviours with risk behaviours including links with oral care routines, bleeding gums, brushing frequency, with exercise, vaping, and unhealthy food and drink intake. Significant changes over the two-time points were also observed, such as the worsening of the self-reported condition of the teeth (p<0.001), reduction in the self-reported condition of the gums (p=0.004), reduced brushing frequency (p=0.003), less regular dental visits (p=0.013), more students intending to visit their previous dentist rather than finding a new dentist at university (p=0.026), and increased consumption of unhealthy non-alcoholic drinks (p=0.003). Positive changes over time include reduced alcohol consumption frequency and units (p=0.030 and p=0.001), fewer instances of binge drinking (p=0.014), and less frequent consumption of unhealthy foods (p=0.034). Conclusion The findings highlight the complex relationship between oral heal and risk behaviours in this demographic. Poorer oral health behaviours are linked to engagement in risk behaviours. Therefore, oral health behaviours should be targeted alongside other risk behaviours. Tailored interventions should be developed to improve oral health and behaviour among university students.
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Purpose: This study was designed to determine the perceptions of lay people and dental professionals with respect to minor variations in anterior tooth size and alignment and their relation to the surrounding soft tissues. Materials and Methods: Smiling photographs were intentionally altered with one of eight common anterior esthetic discrepancies in varying degrees of deviation, including variations in crown length, crown width, incisor crown angulation, midline, open gingival embrasure, gingival margin, incisal plane, and gingiva-to-lip distance. Forty images were randomized in a questionnaire and rated according to attractiveness by three groups: orthodontists, general dentists, and lay people; 300 questionnaires were distributed. Results: The response rate was 88.2% for orthodontists, 51.8% for general dentists, and 60.6% for lay people. The results demonstrated threshold levels of noticeable difference between the varying levels of discrepancy. A maxillary midline deviation of 4 mm was necessary before orthodontists rated it significantly less esthetic than the others. However, general dentists and lay people were unable to detect even a 4-mm midline deviation. All three groups were able to distinguish a 2-mm discrepancy in incisor crown angulation. An incisal plane cant of 1 mm as well as a 3-mm narrowing in maxillary lateral incisor crown width were required by orthodontists and general dentists to be rated significantly less esthetic. Lay people were unable to detect an incisal plane asymmetry until it was 3 mm, or a lateral incisor narrowing until it reached 4 mm. Threshold levels for open gingival embrasure and gingiva-to-lip distance were both at 2 mm for the orthodontic group. Open gingival embrasure became detectable by the general dentists and lay people at 3 mm, whereas gingiva-to-lip distance was classified by these groups as noticeably unattractive at 4 mm.
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A sociodental investigation was conducted among 254 elderly people living at home in Nottingham. A clinical assessment was made of the subjects' dental treatment needs and this was compared with the subjects' felt and expressed needs. Seventy-eight percent of the sample were clinically judged as needing denial treatment, mainly some form of prosthetic treatment. There was, however, a wide discrepancy between the normative and perceived needs of this elderly population. Only 42% of those who were clinically assessed as needing treatment felt that they required it and only 19% had actually tried to obtain it. Many of the elderly mentioned a number of barriers to obtaining dental care; these included the cost of treatment, fear of the dentist, immobility and the feeling that they should not “bother” the dentist.
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In order to determine the validity of dental data obtained from a questionnaire, 100 subjects randomly selected from 2383 respondents were examined clinically. The quality of dental status was ordered in four groups for the number of missing and replaced teeth and for denture status. For the number of missing and replaced teeth, the observed agreement between the clinical diagnosis and the questionnaire answers was 65% for both the maxilla and the mandible, and the agreement estimated by Kappa was 0.52. However, the disagreement was not randomly distributed, since reporting of better dental status than the actual one was much more common than reporting of poorer status. Regarding denture status, the agreement between self-assessment and clinical diagnosis was good; all removable dentures in situ at the clinical examination were reported by the subjects as some kind of denture, although not always the correct type. The results of the study indicate that the use of self-assessment might be reasonable when measuring denture status, and that self-assessment of the number of missing and replaced teeth is a biased estimate of the clinical diagnosis. Thus appropriate action should be taken when using this type of data.
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The full-face and profile photographic transparencies of 60 subjects (30 male, 30 female) divided equally among Angles Class I, Class II Division 1, and Class III malocclusions, taken before and after orthodontic treatment, were randomly distributed in projector carousels and shown to four panels consisting of orthodontists, dental students, art students, and the parents of children undergoing orthodontic treatment. The faces were rated according to the method of Lundstrom et al. (1987). Full-face views generally were rated more attractive than profile views and Class II and Class III malocclusion subjects were rated lower than Class I malocclusion subjects. While the art student and parent panels were less critical in their appraisal of facial attractiveness, they were less sensitive to the changes brought about by orthodontic treatment than the orthodontist and dental student panels, although all could appreciate an improvement in the Class II Division 1 group.