ArticlePDF Available

The impact of the popular media on cosmetic dentistry

Authors:

Abstract

The popular media's influence on social norms with respect to people's appearance is likely to have played a part in the recent growth of cosmetic dentistry. This study was designed to investigate the manner in which the popular media have affected the perception and delivery of aesthetic dentistry in New Zealand. A nationwide survey was posted to a random sample of 600 general dental practitioners (GDPs) requesting sociodemographic details and information on the types of aesthetic dental procedures provided and the demand for those. Information was also sought on GDPs' awareness of television programmes and reality "makeover" television shows (such as "Extreme Makeover") covering issues related to aesthetic dentistry, together with the impact of such programmes (and that of different print media) on their patients' perceptions of, and demand for, aesthetic dentistry. The response rate was 81.2 percent. A majority of participants perceived an increased demand for tooth whitening (77.8 percent) and veneers (54.8 percent) subsequent to the airing of those television programmes, with 85.2 percent reporting patients mentioning "Extreme Makeover" in relation to aesthetic dentistry. Some 56.8 percent believed that patients had higher aesthetic expectations subsequent to the airing of that programme. An increased demand for tooth whitening was reported by more female than male GDPs, and also by younger practitioners and those who were practising in larger centres. Similar patterns were observed with respect to GDPs recommending tooth whitening for patients. Women's magazines were ranked by GDPs as having the highest impact on patients' perceptions of aesthetic dentistry. The popular media (especially television) appear to have had an impact on the demand for various aesthetic dental procedures in New Zealand.
In toda
y
's societ
y
, most people have the desire to look thei
r
best, since ph
y
sical appearance pla
y
s an important role in
a
n individualʼs self-esteem and success. It is human nature
to attribute positive personalit
y
characteristics to attractive
individuals, and such
p
eo
p
le receive favourable treatment
in a variet
y
of situations (Sarwer et al, 2004). There is also
e
vidence that being ph
y
sicall
y
attractive has other benefits.
Even children consider attractiveness a more important
c
riterion than intelli
g
ence in the selection of friends (Clark
a
nd A
y
ers, 1988), and this attitude often continues into
a
dulthood. There is ample evidence that attractive applicants
a
re more likel
y
to receive
j
ob offers than their less attractive
eers (Cann et al, 1981; Hamermesh and Biddle, 1994; Biddle
a
nd Hamermesh, 1998); this is es
p
eciall
y
true for women
(
Marlowe et al, 1996
)
. Attractive individuals also tend to earn
m
ore (Hamermesh and Biddle, 1994), and are more likel
y
to gain promotion (Biddle and Hamermesh, 1998). Even in
s
ituations where we would like to think that our a
pp
earance
is of no consequence, research suggests that, whether we like
it or not, our appearance reall
y
does seem to matter (Sarwe
r
e
t al, 2004).
T
he quest for an improved appearance has recentl
y
become s
y
non
y
mous with cosmetic intervention, involvin
g
various health professionals in fields such as plastic surger
y
a
nd dermatolog
y
. For an increasing number of people, an
upgrade” in appearance also involves cosmetic dentistr
y
.
A
n “enhanced smile” not onl
y
ma
y
make one look
y
oun
g
er,
but it is also associated with positive attributes such as good
hy
giene, health and success (Priest and Priest, 2004).
Dentistr
y
's image in contemporar
y
fiction and popula
r
c
ulture has undergone a profound change in recent
y
ears
(
Mandel, 1998), havin
g
been
p
ro
p
elled out of the "a
g
e of
a
mputation" and into the "age of augmentation" (Golub-
Evans, 1994). This has been largel
y
due to the widespread
use of dental adhesive technolog
y
introduced in the 1950s
(
Buonocore, 1955). It has been
p
ro
p
osed that dentists will
c
ontinue to experience a growing demand for their services,
largel
y
on the strength of patients' desires for better-looking
s
miles (Christensen, 2002b). This ma
y
be (at least in part)
a
ttributed to the influence of the media on social norms and
e
x
p
ectations
.
Investigations into the impact o
f
the mass me
d
ia on societ
y
h
ave shown that it affects a wide variet
y
of areas, including
m
ental health (Christakis et al, 2004), child development
(
Si
g
norielli, 1990), attitudes toward eatin
g
habits (Thom
p
son
a
nd Heinberg, 1999; Becker et al, 2002), sexual attitudes
a
nd behaviours
(
Zuckerman and Zuckerman, 1985; Ward,
2002), violence among children (Felson, 1996), and suicidal
tendencies
(
Gould and Shaffer, 1986
)
. It is therefore not
unreasonable to assume that the media ma
have a simila
impact on
d
entistr
y
. In
d
ee
d
, in a recent US surve
y
,
d
entists
c
ited media coverage as the main reason for the increase in
d
emand (b
y
an average of 12.5 percent over the previous five
y
ears, with some dentists re
p
ortin
g
an increase of almost 40
A
B
S
TRA
C
T
T
he popular mediaʼs influence on social norms with respect
to
p
eo
p
leʼs a
pp
earance is likel
y
to have
p
la
y
ed a
p
art in the
r
ecent growth of cosmetic dentistr
y
.
Aims
T
his stud
y
was designed to investigate the manner in which
the popular media have affected the perception and deliver
y
of aesthetic dentistr
y
in New Zealand.
M
et
h
o
d
s
A
nationwide surve
y
was posted to a random sample of
6
00 general dental practitioners (GDPs) requesting socio-
d
emographic details and information on the t
y
pes of aesthetic
d
ental
p
rocedures
p
rovided and the demand for those.
I
nformation was also sought on GDPsʼ awareness of television
p
rogrammes and realit
y
“makeover” television shows (such
a
s “Extreme Makeover”) covering issues related to aesthetic
d
entistr
y
, together with the impact of such programmes (and
that of different
p
rint media) on their
p
atientsʼ
p
erce
p
tions of,
a
n
d
d
eman
d
f
or, aesthetic
d
entistr
y
.
R
esu
l
ts
T
he response rate was 81.2 percent. A ma
j
orit
y
of participants
p
erceived an increased demand for tooth whitening (77.8
p
ercent) and veneers (54.8
p
ercent) subse
q
uent to the airin
g
of those television programmes, with 85.2 percent reporting
p
atients mentioning “Extreme Makeover” in relation to
a
esthetic dentistr
y
. Some 56.8 percent believed that patients
h
ad higher aesthetic expectations subsequent to the airing of
that
p
ro
g
ramme. An increased demand for tooth whitenin
g
w
as reported b
y
more female than male GDPs, and also
b
y
y
ounger practitioners and those who were practising in
l
arger centres. Similar patterns were observed with respect to
G
DPs recommendin
g
tooth whitenin
g
for
p
atients. Womenʼs
m
agazines were ranked b
y
GDPs as having the highest impact
on patientsʼ perceptions of aesthetic dentistr
y
.
C
onclusio
n
T
he popular media (especiall
y
television) appear to have
h
ad an im
p
act on the demand for various aesthetic dental
p
rocedures in New Zealand
.
I
NTR
O
D
UC
TI
O
N
Dentistr
y
has evolved over the past 50
y
ears from being
p
rimaril
y
a health service to a h
y
brid profession (Mandel,
1998; Christensen, 2002a), whereb
y
not onl
y
pain and
oral disease are treated, but elective aesthetic services are
increasin
g
l
y
bein
g
p
rovided (Morle
y
, 1999; Priest and Priest,
2
004), often at the request of the patient. Social pressure due to
changing norms ma
y
be the driving force behind this aesthetic
r
evolution, fuelled b
y
the media's portra
y
al of beaut
y
.
T
he impact of the popular media on cosmetic dentistr
y
ANNA H THEOBALD
,
BENEDICTA KJ WONG
,
ANDREW N QUICK AND W MURRAY THOMSON
New Zealand Dental Journal 102, No. 3: 58–63; September 200
6
S
EPTEMBER 200
6
N
EW ZEALAND DENTAL
J
OURNAL
verifiable
cpd paper
58
P
eer-reviewed article. Received Novem
b
er 2005. Revised text
accepted April 200
6.
articles
31038 Sept 06 Dental 1 .indd Sec3:5931038 Sept 06 Dental 1 .indd Sec3:59 9/4/06 12:04:27 PM9/4/06 12:04:27 PM
p
ercent for aesthetic dental procedures) (American Academ
y
of Cosmetic Dentistr
y
, 2004). However, media ex
p
osure ma
y
n
ot alwa
y
s portra
y
dentistr
y
in a positive light: a recent surve
y
conducted b
y
the Australian Societ
y
of Orthodontists (ASO)
h
ighlighted the negative impact of a current affairs television
p
ro
g
ramme on the
p
ublicʼs
p
erce
p
tion of orthodontic treatment
(
Australian Societ
y
of Orthodontists, 2004). Thus, the mediaʼs
influence on dentistr
y
can be both positive and negative
.
T
o date, little is known of the demand for aesthetic dentistr
y
in New Zealand. This stud
y
aimed to investigate the manne
r
in which the
p
o
p
ular media (such as television and
p
rinted
m
e
d
ia) have a
ff
ecte
d
the perception o
f
, an
d
d
eman
d
f
or,
a
esthetic dentistr
y
in New Zealand
.
M
ETH
O
D
A
nationwide postal surve
y
of 600 New Zealand general
d
ental practitioners was carried out between April and June
2
005. The sample was randoml
y
selected from the 2003
New Zealand Dental Re
g
ister (with
p
ermission from the
D
ental Council of New Zealand). Specialist dentists were
e
xcluded from the sampling frame prior to drawing the sample.
The stud
y
was approved b
y
the Universit
y
of Otago Ethics
C
ommittee.
T
he followin
g
information was
g
athered: socio-demo
g
ra
p
hic
d
etails; the t
y
pes of aesthetic dental procedure practised;
the current demand for aesthetic dental procedures among
p
atients in different age groups; the dentists' awareness of
current affairs television
p
ro
g
rammes and realit
y
makeove
r
television shows (that is, programmes in which volunteers
undergo a range of cosmetic and surgical enhancements aimed
a
t dramaticall
y
improving their appearance) covering issues
r
elated to aesthetic dentistr
y
, and the impact such programmes
m
a
y
have had on their
p
atients; and dentists' o
p
inions of which
t
y
pes o
f
printe
d
me
d
ia appear to have the greatest e
ff
ect on
their patients' awareness of aesthetic dentistr
y.
F
or reporting purposes, respondents were grouped b
y
g
ender, number of
y
ears in
p
ractice (0-14, 15-30 and 30+
y
ears), and site of practice (“ma
j
or cit
y
”, “provincial cit
y
a
nd “other centre”). Locations classified as “ma
j
or cities”
included Auckland, Hamilton, Christchurch, Dunedin, Porirua,
Upper Hutt, Lower Hutt, Wellington, North Shore, Waitakere,
Manukau and Pa
p
akura. Locations classified as “
p
rovincial
cities” included Whangarei, Tauranga, Rotorua, Gisborne,
H
astings, Napier, New Pl
y
mouth, Wanganui, Palmerston
North, Masterton, Nelson, Blenheim, Kaikoura, Timaru and
I
nvercar
g
ill. The remainin
g
locations were classified as
“o
t
h
er”
.
P
articipation incentives were offered in the form of seven
p
rize hampers, generousl
y
sponsored b
y
several dental suppl
y
companies. Prize winners were randoml
y
selected from those
w
ho com
p
leted and returned the surve
y.
T
he surve
y
questionnaire was posted with a covering lette
r
e
xplaining the stud
y
ʼs purpose, and a freepost envelope was
included for returning completed forms. One month later, a
s
econd wave of forms was sent to the 2
9
0 dentists who had
n
ot
y
et responded. This was accompanied b
y
an amended
covering letter.
T
he surve
y
responses were entered into an electronic
d
atabase, and then anal
y
sed using the Statistical Package fo
r
the Social Sciences (SPSS; Version 13.0; www.s
p
ss.com).
A
ssociations between categorical variables were tested fo
r
s
tatistical significance using the Chi-square test, with the
a
lpha level set at 0.05. Multiple logistic regression was used
to control confoundin
g
and derive ad
j
usted odds ratios
.
R
E
SU
LT
S
D
escri
p
tion of sam
p
le
O
f the original random sample of 600 general dental
p
ractitioners, 47 were outside the sampling frame, eithe
r
because the
y
were retired or deceased, or because thei
r
q
uestionnaires had been returned due to incorrect address
d
etails. The 449 questionnaires returned from the remaining
5
53 general dental practitioners
y
ielded a response rate of
81.2 percent. The socio-demographic characteristics of the
articipants are summarised in Table I. Respondents were
n
ormall
y
distributed relative to their a
g
e and number of
y
ears
s
ince qualif
y
ing. Their mean age was 46.5
y
ears (s.d. 11.8),
a
nd the mean number of
y
ears in practice was 23.2
y
ears (s.d.
11.5). There were more males than females, at 76.6 percent and
23.4
p
ercent res
p
ectivel
y
. Just under half the sam
p
le had been
in practice for 15 to 30
y
ears, and almost 60 percent practised
in a ma
j
or cit
y
. The proportion of females was greater among
those who had been in practice for 30 or fewer
y
ears
.
A
est
h
et
i
c
d
enta
l
p
roce
d
ures
A
ll participants reported offering at least one t
y
pe of
a
esthetic dental procedure. A further breakdown of the
a
esthetic dental procedures offered according to different
ractitioner characteristics is
resented in Table II. Unless
otherwise indicated, onl
y
statisticall
y
significant differences
a
re described. There was a gender difference for implant
estorations, with more males than females offering these.
T
ooth whitenin
g
and veneers were offered b
y
a lar
g
e
r
roportion of practitioners who had spent fewer
ears in
ractice. With the exception of orthodontics, aesthetic dental
rocedures were offered b
more cit
-based practitioners than
b
y
those in smaller centres
.
T
oot
h
w
hi
ten
i
n
g
Most of the participants (97.0 percent) reported that thei
r
p
atients asked for tooth whitening, while 37.9 percent of
d
entists reported recommending professional tooth whitening
to their
p
atients. Partici
p
ants re
p
orted the hi
g
hest demand
f
or tooth whitening procedures among their 31-40-
y
ear-old
atients (52.0 percent), followed b
those aged 41-50
ears
(
32.4 percent). When asked about their preferred method of
T
able I. Practice characteristics b
y
gende
r
G
ende
r
(row
p
ercenta
g
e)
M
a
l
e
F
e
m
a
l
e
T
o
t
a
l
(column
percentage
)
Y
ears
i
n pract
i
ce
a
0
to 14 68
(
61.3
)
43
(
38.7
)
b
111
(
24.7
)
1
5 to 30 147
(
71.7
)
58
(
28.3
)
205
(
45.7
)
31 or more 115
(
98.3
)
2
(
1.7
)
117
(
26.1
)
Practice settin
g
Ma
j
or cit
y
192 (72.2) 74 (27.8) 266 (59.2
)
P
rovincial cit
y
78 (86.7) 12 (13.3) 90 (20.1
)
O
ther 74 (79.6) 19 (20.4) 93 (20.7
)
T
o
t
a
l 344
(
76.6
)
105
(
23.4
)
449
(
100.0
)
a
Information not supplied b
y
16 individuals
.
b
p<0.00
1
The impact of the media
T
HE
O
BALD ET AL
5
9
31038 Sept 06 Dental 1 .indd Sec3:6031038 Sept 06 Dental 1 .indd Sec3:60 9/4/06 12:04:31 PM9/4/06 12:04:31 PM
tooth whitening, 66.8 percent of GDPs preferred using take-
h
ome tra
y
s, 21.1 percent preferred in-surger
y
whitening, and
the remainder had no preference for either method. Females,
cit
y
-based or
y
ounger practitioners were more likel
y
to offe
r
tooth whitenin
g
to their
p
atients.
Reality makeover television programmes
S
ome 77.8 percent of GDPs perceived an increased demand
f
or tooth whitenin
g
subse
q
uent to the airin
g
of realit
y
makeove
r
television programmes such as “Extreme Makeover”. The
f
indings relating to those programmes are presented in Table
I
II. Nearl
y
all respondents were aware of “Extreme Makeover”
a
t the time of the surve
y
, althou
g
h onl
y
three-
q
uarters had seen
the programme. Respondents reported becoming aware of it
through their patients (52.8 percent), friends and famil
y
(50.0
p
ercent), or colleagues (23.6 percent; multiple responses were
p
ermitted to this item, and therefore the percentages do not
a
dd u
p
to 100
p
ercent). Over half believed that their
p
atients
m
a
y
now have higher aesthetic expectations of their dental
treatment after viewing such programmes, while more than 85
p
ercent have had patients mention that particular programme
w
ith res
p
ect to dental aesthetics. Tooth whitenin
g
and veneers
w
ere the aesthetic dental procedures that were reported to
h
ave had a substantiall
y
increased demand since the airing
of such programmes
.
A
higher proportion of female GDPs reported having
w
atched “Extreme Makeover” and having perceived a greate
r
d
emand for tooth whitening, and this was also true of more
r
ecent graduates (who also reported having more patient
e
n
q
uiries as a result of the
p
ro
g
ramme). Practitioners in ma
j
o
r
c
ities were also more likel
y
to perceive an increased demand
f
or tooth whitening among their patients than those from othe
r
c
entres. Those who had watched “Extreme Makeover” were
m
ore likel
y
to
p
erceive hi
g
her aesthetic ex
p
ectations amon
g
atients, and an increased demand for tooth whitening, veneers
a
nd crowns and bridges. After controlling for age, gender and
location of practice using logistic regression, those who had
w
atched “Extreme Makeover” were more likel
y
to perceive
a
hi
g
her demand for veneers (Odds Ratio 2.6; 95
p
ercent
c
onfidence interval 1.6, 4.5) or for tooth whitening (OR 2.7;
95 percent CI 1.5, 4.6); gender and practice location were no
longer significant predictors, although age was, with olde
r
p
ractitioners less likel
y
to
p
erceive a hi
g
her demand for eithe
r
c
osmetic procedure
.
C
urrent affairs television programmes
T
his section of the surve
y
was based on a s
p
ecific e
p
isode
(
“Straight Talk”) of the current affairs programme “60
Minutes”. It examined the issues of orthodontic extractions,
e
arl
y
treatment and functional appliances. More than one-
T
able II - Aesthetic dental procedures offered, b
y
practitioner characteristics (brackets contain percentages
)
Typ
e o
f
p
rocedure o
ff
ere
d
Tooth whitenin
g
Veneers Aesthetic crowns Implants Orthodontic
s
G
ende
r
Female 94
(
89.5
)
91
(
86.7
)
94
(
89.5
)
44
(
41.9
)
a
19
(
18.1
)
Male 310 (90.1) 288 (83.7) 316 (91.9) 189 (54.9) 67 (19.5
)
Y
ears
i
n pract
i
ce
0
to 14 106
(
95.5
)
a
97
(
87.4
)
a
106
(
95.5
)
59
(
53.2
)
22
(
19.8
)
1
5 to 30 191
(
93.2
)
185
(
90.2
)
191
(
93.2
)
114
(
55.6
)
43
(
21.0
)
31 or more 97
(
82.9
)
89
(
76.1
)
105
(
89.7
)
54
(
46.2
)
19
(
16.2
)
Practice settin
g
Ma
j
or cit
y
246 (92.5) 233 (87.6) 247 (92.9) 148 (55.6) 43 (16.2
)
P
rovincial cit
y
78 (86.7) 73 (81.1) 80 (88.9) 45 (50.0) 23 (25.6
)
O
ther 80 (86.0) 73 (78.5) 83 (89.2) 40 (43.0) 20 (21.5
)
A
ll combined 404 (90.0) 379 (84.4) 410 (91.3) 233 (51.9) 86 (19.2
)
a
P
<0.05
T
able III - Watching of “Extreme Makeover” and subsequent demand for aesthetic dental procedures, b
y
practitioner characteristics (brackets
c
ontain percentages
)
H
ave watched Have had related Perce
i
ved h
ig
her Perce
i
ved h
ig
her Perce
i
ved h
ig
her
“E
xtreme Makeover
pat
i
ent enqu
i
r
i
es pat
i
ent expectat
i
ons pat
i
ent demand for pat
i
ent deman
d
tooth wh
i
ten
i
n
g
for veneer
s
G
ende
r
Female 90
(
85.7
)
a
92
(
87.6
)
65
(
61.9
)
82
(
86.3
)
a
56
(
59.6
)
Male 252
(
73.7
)
287
(
84.4
)
186
(
55.2
)
237
(
75.2
)
166
(
53.4
)
Y
ears in
p
ractice
0
to 14 94
(
84.7
)
a
100
(
90.1
)
a
61 (55.0) 90 (87.4
)
a
6
2 (
6
0.2
)
a
1
5 to 30 171 (83.4) 181 (88.3) 125 (61.3) 159 (80.7) 119 (60.1
)
31 or more 66 (57.4) 84 (74.3) 58 (52.3) 60 (61.2) 35 (37.6
)
Practice settin
g
Ma
j
or cit
y
212 (79.7) 227 (86.3) 153 (58.4) 203 (82.9
)
a
142
(
58.9
)
P
rovincial cit
y
67 (74.4) 78 (86.7) 52 (58.4) 61 (74.4) 43 (52.4
)
O
ther 63
(
69.2
)
74
(
80.4
)
46
(
50.5
)
55
(
66.3
)
37
(
45.1
)
A
ll
co
mb
i
ne
d
342 (76.5) 379 (85.2) 251 (56.8) 319 (77.8) 222 (54.8
)
a
P
<0.05
S
EPTEMBER 200
6
NEW ZEALAND DENTAL JOURNAL
60
31038 Sept 06 Dental 1 .indd Sec3:6131038 Sept 06 Dental 1 .indd Sec3:61 9/4/06 12:04:31 PM9/4/06 12:04:31 PM
third of respondents were aware of the programme (Table
I
V
)
, but fewer than half of these had watched it, while others
h
ad become aware of it mainl
y
through colleagues (16.7
p
ercent) or patients (13.1 percent). The data which follow
a
re based on the 184 who were aware of this programme.
Just over half (50.6
p
ercent) believed that it was harmful to
orthodontics, but most (94.4 percent) believed that it was not
h
armful to their own practice. Since its airing, 45.8 percent
r
eported having related patient enquiries; 23.3 percent
r
eported an increase in their own awareness of functional
app
liances; 16.7
p
ercent re
p
orted an increased
p
rovision of
f
unctional appliances; and 10.2 percent reported a decrease
in the number of orthodontic extractions. Moreover, 40.4
p
ercent reported greater resistance to orthodontic extractions
in their
p
atients, while 44.0
p
ercent believed that the
p
rogramme was biased. While there were no significant
d
ifferences b
y
gender,
y
ears in practice or practice location,
a
greater percentage of practitioners who offer orthodontics
w
ere aware of (and had seen) the programme, and the
y
also
r
e
p
orted havin
g
more related
p
atient en
q
uiries (Table IV).
Moreover, a greater percentage o
f
practitioners in ma
j
or cities
r
eported increased awareness of functional appliances afte
r
the programme was aired. Practitioners in provincial cities
w
ere more likel
y
to have become aware of the
p
ro
g
ramme
through their colleagues
.
P
rint m
ed
i
a
P
ractitioners were asked to rank various com
p
onents
of the print media (from 1 to 5, lowest to highest impact)
a
ccording to their perceived impact on patientsʼ perceptions
of aesthetic dentistr
y
. Womenʼs magazines were deemed to
h
ave the hi
g
hest im
p
act (mean = 3.9), followed b
y
g
ossi
p
m
agazines (3.5), health/fitness magazines (3.5), and aesthetic
d
entistr
y
brochures (3.4). Current affairs magazines (2.7) and
n
ewspapers (2.7) were rated as having the lowest impact.
Nearl
y
all participants (90.1 percent) believed that television
h
as a
g
reater im
p
act than
p
rint media on the demand fo
r
a
esthetic
d
entistr
y
. No
d
i
ff
erence in opinion was note
d
b
y
gender or practice setting, but a significantl
y
lower percentage
(
83.6 percent) of practitioners with 30+
y
ears in practice
s
hared this o
p
inion than their
y
oun
g
er counter
p
arts (where
the proportions b
y
length of time in practice were as follows:
1–14
y
ears, 94.5
p
ercent; 15–30
y
ears, 90.6
p
ercent).
D
I
SCUSS
I
ON
T
his stud
y
has found that the
p
o
p
ular media have a
m
easurable impact on dental practice and GDPsʼ perceptions
of the publicʼs expectations and attitudes towards aesthetic
d
entistr
y
. However, before the findings can be discussed and
laced in context, it is necessar
first to examine the issue
of their
g
eneralisabilit
y
. This, in turn, is de
p
endent u
p
on
the representativeness of the responding sample. At ove
r
80 percent, the response rate was high b
y
modern standards
(
Locker, 2000), and the proportion of female respondents
(
23.4
p
ercent; 95
p
ercent CI 19.5
p
ercent, 27.3
p
ercent) was
s
imilar to the 25.5 percent of female dentists in 2003 (Dental
C
ouncil of New Zealand, 2004). Together, these suggest that
the sample was representative of practising dentists in New
Z
ealand, and that the findings ma
y
be generalised to that
p
o
p
ulation with confidence
.
Aesthetic dental procedures
A
ll practitioners reported offering at least one aesthetic dental
p
rocedure, with onl
y
orthodontics offered b
y
a minorit
y
of
espondents. Implant dentistr
was offered b
ust over half, with
m
ore male practitioners than females doing so. This supports the
f
indings of Reid et al (2005), who noted a similar difference.
A
lmost all of the different t
yp
es of aesthetic dental
p
rocedures
a
nd tooth whitening and veneers in particular—were offered
m
ore extensivel
y
in large cities than in provincial cities or othe
r
locations, perhaps due to cit
y
patients being more appearance-
c
onscious, and the practitioners adapting their service mix to meet
this ex
p
ressed demand. The exce
p
tion was orthodontics, and this is
ossibl
due to orthodontic specialists being largel
concentrated
in the ma
j
or cities, thus requiring practitioners in provincial towns
a
nd other locations to provide a more extensive range of treatment
o
p
tions, includin
g
orthodontics. That more recent
g
raduates
w
ere more likel
y
to offer and recommend procedures such as
tooth whitening ma
y
be due to their older counterparts being less
repared to embrace the new age of aesthetic dentistr
(possibl
d
ue to their having been trained in an era where the primar
y
focus
of treatment was to eradicate disease
)
.
T
able IV - Awareness of “Straight Talk” and subsequent related patient enquiries, b
y
different practitioner characteristics (brackets contain
p
ercentages
)
Aware of “
S
trai
g
ht Talk” Have seen “
S
trai
g
ht Talk” Have had related patient enquirie
s
G
ende
r
Female 44
(
41.9
)
18
(
37.5
)
24
(
54.5
)
Male 140 (40.9) 69 (45.7) 58 (42.0
)
Y
ears
i
n pract
i
ce
0
to 14 48 (4
3
.2) 2
3
(44.2) 2
3
(47.9
)
1
5 to 30 92 (45.1) 36 (37.1) 42 (46.2
)
31 or more 38
(
32.8
)
24
(
54.5
)
14
(
37..8
)
Practice settin
g
Ma
j
or cit
y
114 (42.9) 54 (43.9) 48 (42.9
)
P
rovincial cit
y
39 (43.8) 15 (37.5) 18 (47.4
)
O
ther 31
(
33.7
)
18
(
50.0
)
16
(
50.0
)
T
yp
e of
p
ractitione
r
Does not offer orthodontics 127
(
35.1
)
a
55
(
38.7
)
a
47
(
37.6
)
a
O
ffers orthodontics 57 (67.1) 32 (56.1) 35 (61.4
)
A
ll
co
mb
i
ne
d
184 (41.2) 87 (47.3) 82 (45.8
)
a
P
<0.05
The impact of the media
T
HE
O
BALD ET AL
61
31038 Sept 06 Dental 1 .indd Sec3:6231038 Sept 06 Dental 1 .indd Sec3:62 9/4/06 12:04:32 PM9/4/06 12:04:32 PM
Where patient demand is concerned, the age group with
the hi
g
hest re
p
orted demand for tooth whitenin
g
p
rocedures
w
as patients aged 31 to 50
y
ears old (the “bab
y
boomers”).
A
US stud
y
also reported that this age group had the greatest
d
emand for cosmetic dental procedures (American Academ
y
of Cosmetic Dentistr
y
, 2004). Furthermore, it has been
d
escribed as comprising the largest target market for aesthetic
d
ental services, being both more concerned with retaining a
y
outhful appearance and able to pa
y
for such care (Priest and
P
riest, 2004
)
.
Television and the perceived demand
f
or aesthetic
d
entistr
y
F
emale
p
ractitioners and those with fewer
y
ears in
p
ractice
w
ere more likel
y
to have watched realit
y
makeover television
p
rogrammes such as “Extreme Makeover”. Those who had
w
atched such programmes were also more likel
y
to perceive
a
greater demand, suggesting that the greater awareness
a
mon
g
females and
y
oun
g
er dentists had been at least
p
artl
y
influenced b
y
television.
While there are man
y
positive spin-offs from greater media
coverage of aesthetic dentistr
y
through realit
y
makeove
r
television
p
ro
g
rammes, there are also some ne
g
ative
consequences. Patients' expectations ma
y
be unrealistic, as
the transformations depicted in these programmes are often
p
ortra
y
ed as instant, and treatment appears to be homogenous,
r
egardless of the patient's individual needs. For example,
s
everel
y
mali
g
ned teeth are often seen to under
g
o “instant
orthodontics” to enhance smiles without the waiting time
of conventional orthodontics (Spear, 2004). Our findings
s
uggest that the demand has significantl
y
increased for tooth
w
hitenin
g
and veneers (and it is no accident that these are the
two main treatment modalities used in such programmes).
S
ubsequentl
y
, dentists ma
y
be placed under greater pressure to
give in to patientsʼ demands when the expressed need for such
p
rocedures among patients does not correspond to the clinical
indications for treatment. This can
p
lace the dental
p
rofessional
in a quandar
y
: is it ethical to provide what the patient demands,
irrespective of what is best for them, or ought one to refuse
treatment, or refer the patient to someone who will meet thei
r
d
emands (and thereb
y
risk losin
g
oneʼs
p
atient)?
C
urrent affairs television programmes
O
ur stud
y
indicates that
j
ust over half of the practitioners
w
ho were aware of the
6
0 Minute
s
p
ro
g
ramme “Strai
g
ht Talk”
believed it to be harmful to orthodontics, and almost as man
y
believed it t
o
be biased. A small number believed that it was
h
armful to their practice. An Australian surve
y
of orthodontists
conducted in September 2004 investigated the effects of the
s
ame
p
ro
g
ramme, and re
p
orted that three-
q
uarters believed that
the programme was harmful to the specialit
y
of orthodontics,
w
hile more than one quarter believed that their own practice
a
lso suffered (Australian Societ
y
of Orthodontists, 2004).
These estimates considerabl
y
exceed those of our stud
y
, but
the ASO stud
y
surve
y
ed onl
y
orthodontists. Moreover, the
p
rogramme was aired in both countries in August 2003, but
m
ore time had elapsed (20 months) before the New Zealand
s
tud
y
than before the ASO surve
y
(12 months). Nearl
y
half
(
40.4
p
ercent) of the surve
y
ed GDPs re
p
orted an increased
r
esistance to ortho
d
ontic extractions subsequent to the
p
rogrammeʼs airing, indicating that some members of the
p
ublic were affected b
y
it. This suggests that the media are
p
owerful in influencin
g
p
ublic
p
erce
p
tions, and em
p
hasizes
the need for the profession to take leadership in raising public
a
wareness of the evidence on controversial dental issues, and
in
g
au
g
in
g
p
ublic o
p
inion on such issues.
The print media
Women's magazines were ranked as having the highest
im
p
act on
p
atients'
p
erce
p
tions of aesthetic dentistr
y
,
f
ollowed b
y
gossip magazines. Since it has been shown that
m
ore females request aesthetic dental procedures (American
A
cadem
y
of Cosmetic Dentistr
y
, 2004), this ranking is hardl
y
s
ur
p
risin
g
. While most of our
p
artici
p
ants believed that
television has a greater impact than the print media in this
egard, a smaller proportion of practitioners with 30+
ears
in practice shared this view. This viewpoint ma
y
reflect the
increasing role of (and differential exposure to) television
a
cross
ag
e
g
rou
p
s
.
CO
N
C
L
US
I
O
N
F
emale
p
ractitioners and those with fewer
y
ears in
ractice had perceived a greater demand for various
a
esthetic dental procedures, and were also more likel
y
to
offer them. Cit
y
-based practitioners were also more likel
y
than their more rural counterparts to do so. We conclude
that the
p
o
p
ular media (es
p
eciall
y
television) a
pp
ear to
h
ave ha
d
an impact on the
d
eman
d
f
or various aesthetic
d
ental procedures in New Zealand, affecting mainl
y
tooth
w
hitening and veneers
.
A
C
KN
O
WLED
G
MENT
S
T
he authors would like to acknowledge and thank Henr
y
S
chein Regional, Shalfoon, Oral-B, Gunz Dental, New Zealand
D
ental Su
pp
lies, Oraltec, BD, Arthur Hall Orthodontics and
H
ealthcare Essentials for sponsoring the prize incentives,
a
nd ProudMouth Caring Dentistr
y
for generousl
y
funding
the postage costs. We would also like to thank Mrs Wilma
Neilson for her time and assistance. Finall
y
, all respondents
a
re thanked for takin
g
p
art.
R
EFEREN
C
E
S
A
merican Academ
y
of Cosmetic Dentistr
y
(2004). North American
S
urve
y
: The state of cosmetic dentistr
y
. htt
p
://www.aacd.com/media
/
r
eleases/2004 percent20National percent20Surve
y
.pdf
A
ustralian Societ
y
of Orthodontists (2004). ASO Member Surve
y
2
004.
Australian Society of Orthodontists Newsletter
September
r
2
004, 1
3
.
Becker AE, Burwell RA, Gilman SE, Herzog DB and Hamburg
P
(2002). Eating behaviours and attitudes following prolonged
e
xposure to television among ethnic Fi
j
ian adolescent girls.
B
riti
sh
J
ournal of Psychiatry 180: 50
9
-514
.
Biddle JE and Hamermesh DS (1998). Beaut
y
, productivit
y
and
d
iscrimination: law
y
ersʼ looks and lucre.
J
ournal of La
b
or Economics
1
6: 172-201
.
Buonocore MA (1955). A simple method of increasing the adhesion
of acr
y
lic materials to enamel surfaces (abstract). Journal of Dental
R
e
s
earc
h
34: 74
9.
C
ann A, Siegfried WD and Pearce L (1981). Forced attention to
s
pecific applicant qualifications: impact on ph
y
sical attractiveness
a
nd sex of applicant biases.
P
ersonnel Ps
y
cholo
gy
34: 65-75
.
C
hristakis DA, Zimmerman FJ, DiGiuseppe DL and McCart
y
C
A (2004). Earl
y
television exposure and subsequent attentional
p
roblems in children.
P
e
d
iatric
s
113
(
4
)
: 708-71
3
C
hristensen GJ (2002a). The tooth-whitening revolution.
J
ournal of
the American Dental A
ss
ociatio
n
133: 1277-127
9.
S
EPTEMBER 200
6
NEW ZEALAND DENTAL JOURNAL
6
2
31038 Sept 06 Dental 1 .indd Sec3:6531038 Sept 06 Dental 1 .indd Sec3:65 9/4/06 12:04:40 PM9/4/06 12:04:40 PM
C
hristensen GJ (2002b). Are prosthodontics a vital part of dentistr
y
?
J
ournal of the American Dental Associatio
n
133: 647-648
.
C
lark ML and A
y
ers M (1988). The role of reciprocit
y
and proximit
y
in
j
unior high school friendships.
J
ournal of Youth an
d
A
d
olescence
1
7: 403-11
.
Dental Council of New Zealand (2005). 2004 Workforce Anal
y
sis.
Wellington: Dental Council of New Zealand.
Felson RB
(
1996
)
Mass media effects on violent behaviour. Ann
ua
l
R
eview of Sociolog
y
22: 103-128
.
Felton DA
(
2004
)
. Do no harm
(
editorial
)
.
J
ournal of Prostho
d
ontics
1
3
(
2
)
: 71-72
.
G
olub-Evans J (1994). Unit
y
and variet
y
: essential in
g
redients of a
s
mile design.
C
urrent
O
pinions in
C
osmetic Dentistr
y
2: 1-5
.
G
ould MS and Shaffer D (1986). The impact of suicide in television
movies. Evidence of imitation.
T
he New Englan
d
Journal of Me
d
icine
315: 6
9
0-6
9
4
.
Hamermesh DS and Biddle JE (1994). Beaut
y
and the labor market.
A
m
e
ri
ca
n E
c
onomi
c
R
e
vi
ew
8
4: 1174-
9
4
.
Locker D (2000). Response and non-response bias in oral health
s
urve
ys
.
J
ournal of Public Health Dentistry 60: 72-81
.
Mandel I (1998). The image of dentistr
y
in contemporar
y
culture.
J
ournal of the American Dental Associatio
n
12
9
: 607-613
.
Marlowe CM, Schneider SL and Nelson SE
(
1996
)
. Gender and
a
ttractiveness biases in hirin
g
decisions: are more ex
p
erienced
mana
g
ers less biased?
J
ournal of Applie
d
Psychology 81: 11-
2
1
.
Newton JT, Daven
p
ort-Jones L, Idle M, Patel M, Setchell A et al
(
2001). Patients' perceptions of general dental practitioners: The
influence of ethnicit
y
and sex of dentist.
S
ocial Behaviour an
d
P
ersonalit
y
2
9
: 601-606
.
Morle
y
J (1999). The role of cosmetic dentistr
y
in restoring a
y
outhful appearance.
J
ournal of the American Dental Association
1
30: 1166-1172
.
P
riest G an
d
Priest J (2004). Promoting esthetic proce
d
ures in the
p
rosthodontic practice.
J
ournal of Prostho
d
ontics 1
3
: 111-117
.
Reid D, Leichter JW and Thomson WM (2005). Dental implant use
in New Zealand in 2004.
New Zealand Dental Journal
101: 12-16.
l
S
arwer DB, Magee L and Clark V (2004). Ph
y
sical appearance
a
nd cosmetic medical treatments: ph
y
siological and socio-cultural
influences. Journal of Cosmetic Dermatology 2: 2
9
-3
9.
S
ignorielli N (1990). Children, television, and gender roles. Messages
a
nd impact.
J
ournal of A
d
olescent Health Care 11: 50-58.
S
pear FM (2004). The esthetic correction of anterior dental mal-
a
lignment: conventional vs. instant (restorative) orthodontics.
J
ournal of the Californian Dental Associatio
n
32: 133-141
.
T
hompson JK and Heinberg LJ (1999). The media's influence on bod
y
image disturbance and eating disorders: we've reviled them, now can
w
e rehabilitate them?
J
ournal of Social Issues 55: 33
9
-344
.
Ward LM (2002). Does television exposure affect emerging adults'
a
ttitudes and assumptions about sexual relationships? Correlational
a
nd experimental confirmation.
J
ournal of Youth an
d
A
d
olescence
31: 1-15
.
Z
uckerman DM and Zuckerman BS (1985). Televisionʼs impact on
c
hildren. Pe
d
iatric
s
75: 233-240
.
Anna H Theobald, BDS (Otago)
Benedicta KJ Won
g
, BD
S
(
O
ta
g
o)
Andrew N
Q
uick, B
S
c, M
C
hD
(S
tell
)
W
. Murray Thomson, BDS, MComDent (Otago), MA
(
Leeds
)
, PhD
(
Adel
)
D
epartment of Oral Science
s
S
chool of Dentistr
y
T
he Universit
y
of Otago
P
O Box 647
D
unedi
n
C
orresponding author: Murra
y
Thomso
n
E-mail: murra
y
.thomson@stonebow.otago.ac.nz
The impact of the media
T
HE
O
BALD ET AL
63
31038 Sept 06 Dental 1 .indd Sec3:6631038 Sept 06 Dental 1 .indd Sec3:66 9/4/06 12:04:43 PM9/4/06 12:04:43 PM
... Facial proportions, lip balance, chin−nose balance, nasolabial angle and cheek implants are achieved by orthognathic surgery as well. Moreover, bleaching procedures to whiten teeth, reduction of irregular gum appearance in a smile, Botox to give a fuller look to lips, plasma-rich protein treatments, and many other procedures related to aesthetics are offered in order to satisfy patients: further, the pre-visualisation of the result makes the aesthetic operation more attractive [3][4][5][6][7]. ...
... It was observed over time that in some patients, the main aim of any procedure or even orthognathic surgery was to improve their physical attractiveness; extreme abnormalities or deformity made them feel aesthetically vulnerable in the age of social media and they sought social acceptance [5][6][7][8][9]. In this era, social media has the power to modify people's way of thinking. ...
... Through social media, there is direct access to profiles of celebrities and influencers, who all appear to have 'the perfect smile'. These shifts in people's self-image have created a surge in patients seeking cosmetic treatments [7], and 95% of the dentists agreed that social media has contributed to their patients' knowledge and awareness of aesthetic dentistry, which is in accordance with another study where social media was the means of sharing and receiving information for most patients (54.3%) [26]. In the present study, 82% of the participants were in agreement that social media was a beneficial platform allowing them to educate, advertise, and communicate with patients, which is in accordance with a study conducted in the Gulf where 46.3% of dental professionals, and 65% of patients mentioned that social media platforms could be mainly used for both marketing and community services. ...
Article
Full-text available
The objective of this study was to investigate general dentists’ observations of various aesthetic dental procedures among social media users. A cross-sectional study was conducted at the Department of Prosthodontics, Altamash Institute of Dental Medicine, over a duration of six months. Data were collected using a well-structured questionnaire comprising 21 predefined responses. The questionnaire was uploaded and disseminated through Google Surveys by forwarding web page links through emails and WhatsApp. The data collected were analyzed through Statistical Package for Social Sciences (SPSS-Version 25). The majority (90.7%) of the dental practitioners surveyed believed that there is an increase in the demand for aesthetic dental procedures and social media is a major contributor to it. Moreover, 377 (81.8%) participants agreed that social media is a beneficial platform enabling them to educate, advertise, and communicate with patients. Concerning popular aesthetic procedures, teeth whitening (54.7%), Hollywood smile (17.1%), dental veneers (11.9%), and Invisalign (10.4%) were the most commonly demanded aesthetic procedures. The patients desired these procedures because they were trending on social media platforms. Almost half of the general dental practitioners used social media to post content related to aesthetic dentistry and to promote their work. They preferred using before and after pictures (48.6%) for advertising their content related to aesthetic dentistry. Within the limitations of the study, it is concluded that the demand for aesthetic dentistry is rapidly growing, and social media is the main driving force behind this revolution as the general population has direct access to the profiles of celebrities and influencers, who all appear to have ‘the perfect smile. This shift in people’s self-image has created a surge in patients seeking cosmetic treatments.
... Contradictory articles show esthetic appeal is more lenient toward females than males. 19 A study found that males have better esthetic perception than females regarding different criteria. 20 The divergence may be due to the age of females included. ...
... Contrarily, females are more cosmetically sensitive in the esthetic zone area, but only the posterior teeth were included in our study. 19 Different research published in various databases show that women consider oral health more than men based on their regular visits to dental clinics. 21 In our study, female patients were statistically higher considering their oral health than male counterparts, as women visit dental clinics before developing dental issues for better oral health. ...
Article
Full-text available
Background: Many dental restorative materials are used in dental clinics, while in a new practice, many countries are trying to ban dental amalgam for many reasons. Dental mercury is the main issue for suspending the use of dental amalgam. Another restoration method, the composite restoration for posterior and anterior teeth for esthetic porous, became the alternative to amalgam. Aim: To measure patient satisfaction with two different materials based on multiple criteria using an oral health impact profile (OHIP) form. Method: This is a prospective study on two groups. The patients visiting the clinic with a vital posterior tooth indicated for restoration were requested to participate in the study. The first group received composite restoration of the posterior teeth. Contrarily, the second group underwent an amalgam restoration application. Patient satisfaction was assessed using the OHIP5 to assess different aspects of patient satisfaction. The patients were asked to fill out a form before starting the procedure, and after 4 weeks, the procedure was reported. The operators were requested to fill out their forms based on the procedure done to determine the participant eligibility criteria. Results: Overall 64 subjects were involved in the study among them 35 participants who received composite restoration, 48.5% were female, whereas 51.5% were male. Under other conditions, the patients who underwent amalgam application were 29, and 41.4% were female. Based on the study results, the participants underwent before and after assessment and showed no demands for different aspects with the two different materials. Conclusion: No significant differences using amalgam or composite restoration regarding appearance, functional, and psychological factors in the posterior teeth were noted.
... Consequently, ethical approval was released to begin this research (REC no. 155- [11][12][13][14][15][16][17][18][19] from the Research Ethics Committee, Faculty of Dentistry, King Abdulaziz University. ...
... Dentists may be unable to take advantage of SM activities that benefit both dentists and patients due to a lack of understanding of patients' attitudes toward utilizing SM for dental treatment purposes. A study done in New Zealand among general dental practitioners showed that television affects the population in seeking for various aesthetic dental procedures, mainly bleaching and veneers [14]. Dental practitioners may also face problems managing their professional image and relationships with patients as a result of widespread and rapid access to information [15,16]. ...
Article
Full-text available
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.
... [22] Furthermore, the progression of social media appears to be a new and impressive driving force for esthetic dentistry. [23,24] Regarding the obstacles, as in the case of Nayak et al. and Nazir et al., lack of time was the main barrier limiting participation in CE programs, which was in line with our study. [1,5] Lack of time can be due to continuous work for the whole week. ...
Article
Background: Continuing professional development (CPD) is a life-long learning process for all health-care members including dentists to improve their knowledge and skills in their profession and provide the best quality services. This study aimed to assess the needs, priorities, and obstacles of attending dentists in these programs in Isfahan province, in 2020. Materials and Methods: This descriptive-analytical cross-sectional study was performed on general dentists in Isfahan province. Data were collected through a three-part questionnaire, online and on paper; it included demographic information, prioritization of seven disciplines, and scoring of 33 dental subfields, as well as obstacles limiting participation in the CPD programs. This questionnaire was developed and validated by researchers. Statistical analysis was carried out through Mann–Whitney, Kruskal–Wallis, and Chi-square tests, and a significance level of 0.05 was considered. Results: Of 326 dentists (90.5% response rate) participating in this study, 157 were (48.2%) female, and most of them were in the high work experience group (45.1%). The highest mean scores standard deviation related to the dentist's interest and needs, among the seven dental disciplines, belonged to practice management (6.68 [2.9]), oral and dental reconstruction (6.29 [2.55]), and pediatric dentistry (6.291 [2.87]). On the other hand, lack of time (70.6%), inefficient teaching methods and organization (65%), and irrelevant topics (58.6%) were the most common obstacles limiting dentists in the CPD programs. Conclusion: Based on the results of this study, dentists in Isfahan province reported more interest and need to participate in some fields of CPD courses including practice management, pediatric dentistry, and oral and dental reconstruction. Thus, a system for continuing education based on dentists' needs and preferences is highly suggested.
... Few studies have reported that the elevated esthetic treatment demand is the impact of social media. [10,11] The results of the present study show consistency with their results. This study also reported social media as the main source of information when the participants were asked about veneers treatment. ...
Article
Full-text available
Purpose: This study aims to assess the factors that determine the aspiration for "Hollywood smile" among the residents in five Gulf countries. Materials and methods: A survey was conducted among subjects aged 18-60 years. A self-designed 19 items questionnaire was prepared which consisted of multiple choices and open-ended questions. The first part of the survey included demographic questions. The second part included questions related to Hollywood smile. Descriptive statistics were calculated, and the association between different variables was assessed by Chi-square test where P ≤ 0.05 was considered statistically significant. Results: A total of 2061 subjects participated in the survey. The majority of participants were females (76.81%), 97.28% of them were aware of the term "Hollywood smile," and social media was the source of information. Statistically significant difference was noted among participants who underwent treatment according to residency place, age, educational level, and socioeconomic status (SES) and participants who were willing to undergo treatment in future according to gender, age, and SES. Conclusion: Subjects of younger age, higher education level, and higher SES underwent treatment. However, 23.83% of people were willing to undergo treatment. This reflects the increasing demand for esthetic treatment in future.
... Along still being 'free' for eligible serving personnel, there is also likely to be a desire to maintain a functional dentition into older age, perhaps influenced by population trends and cosmetic awareness in the popular media. [2][3][4][5][6] Tooth loss can result from multiple reasons that include: trauma, periodontal disease, caries, extensive tooth surface loss, cracks/fractures, associated pathosis affecting the crown/root or as a component of multi-disciplinary treatment planning. [7,8] Tooth loss can affect a patients function and quality of life. ...
Article
Introduction: Root canal treatment (RCT) plays an important role in preserving the dentition by deferring other invasive treatments. Data on tooth survival and predictive factors for tooth loss after RCT in the military cohort are lacking. This investigation aimed to determine the proportion of teeth surviving in an 8-year period after RCT and identify potential predictive factors for tooth loss in a UK military cohort. Methodology: A retrospective review of an integrated electronic health record for military patients who had received RCT was performed in a random sample of 205 patients (n=219 root-filled teeth) who had received RCT between 1 January 2011 and 1 January 2012. Tooth survival was defined as tooth presence, regardless of signs or symptoms, and measured from the point of root filling until either the end of the designated study period or time of extraction. Survival was evaluated using Kaplan-Meier estimates and association with tooth loss using the χ2 test. Potentially significant predictive factors were investigated using univariate Cox regression. Results: Tooth survival following RCT was 98% after 24 months; 88% after 48 months; 83% after 72 months; and 78% after 96 months. Four predictive factors were found to affect tooth loss as follows: preoperative pain (HR=3.2; p<0.001), teeth with less than two proximal contacts (HR=3.0; p=0.01), teeth with cores involving more than two surfaces (HR=2.0; p=0.03) and postoperative unscheduled dental attendances (UDA) (HR=2.7; p=0.01). Conclusions: Within the limitations of this study, the presence of preoperative pain; teeth with less than two proximal contacts or with cores involving more than two tooth surfaces; and occurrence of postoperative UDA were found to significantly increase the hazard of tooth loss.
... Similarly, Strajnić et al. (74) concluded that female patients in Serbia were less satisfied with their general dental aesthetics (74). Females' dissatisfaction with their teeth color is echoed by their higher demand for teeth whitening services as found in Croatia, New Zealand, and Saudi Arabia, even among dental professionals (75)(76)(77). Around 1.2% of our participants identified themselves as gender-diverse, which is lower than the estimated share of gender-diverse population in Germany that ranged between 1.9 and 7.4% according to various demographic surveys (78)(79)(80). According to the Dalia Research report, the German genderdiverse population is concentrated in young age groups, as they represented almost 12% of the people aged 14 -29 years and about 6% of the people aged 30 -65 years (79). ...
Article
Full-text available
Germany's 2030-oral health agenda incorporates behavioral targets such as twice-daily toothbrushing and routine dental checkups. Given the professional and social roles of dentists in oral health promotion, the oral health-related knowledge, attitudes, and behaviors (KAB) of dentists and dental students became worth investigation. The present study was designed as a descriptive cross-sectional study that aimed to evaluate oral health KAB of German dental students using the Hiroshima University-Dental Behavioral Inventory (HU-DBI). A total of 508 dental students filled in the questionnaire, out of which 74.2% were females, 38.8% were clinical students, 11.4% reported tobacco smoking at least once week, 26.6% reported drinking alcohol at least once a week, and 82.9% reported suffering from problematic internet use. The overall HU-DBI score was high (7.67 ± 1.32), and it was slightly higher among females (7.70 ± 1.33) than males (7.59 ± 1.29), and gender-diverse students (7.33 ± 1.37). Clinical students (7.88 ± 1.26) had a significantly higher HU-DBI score, especially in the domain of oral health behaviors, compared with preclinical students (7.53 ± 1.34). A significant improvement in oral health behaviors and HU-DBI score was found between the third-vs. the fourth year, which corresponds to the period when prophylaxis, hygiene, and periodontology courses are delivered. Tobacco smoking was significantly associated with poor oral health knowledge, behaviors, and overall HU-DBI score. Problematic internet use and alcohol drinking had slightly lower HU-DBI scores. The findings of the present study call for early implementation of preventive dentistry elements in German curricula and addressing oral health needs of gender minorities in Germany by future epidemiologic studies.
Article
Full-text available
The popularity of tooth whitening is continuing to increase with images of white teeth becoming the norm on social media. However, the mechanistic action of tooth whitening products is not fully understood with several proposed theories as to what causes change in tooth shade. This review aimed to examine the mechanism by which tooth whitening products lead to whiter teeth. The adverse effects of tooth whitening products on the oral mucosa, dentition, and existing dental restorations are also reported. This review found that whitening toothpastes modify tooth colour by using abrasive particles, optical agents, or chemical agents. The efficiency of abrasive particles is dependent on their hardness, shape, size, applied load and concentration. Optical agents such as Blue Covarine modify the visual perception of tooth colour by shifting the net colour towards white on the colour space model. Commercial toothpastes release less than 0.1% hydrogen peroxide, therefore do not produce significant tooth whitening. Hydrogen peroxide was thought to act through either the chromophore effect, interaction with the organic and inorganic tooth structure or via oxidisation of organic tooth tissue. Tooth whitening can also lead to sensitivity, damage to the oral mucosa and gingiva and potentially cause the release of harmful components from restorative materials. This review highlights the importance of understanding the mechanism behind tooth whitening products and allows dental care practitioners to advise appropriate and safe methods to combat intrinsic and extrinsic staining. Abbreviations RDA-Relative dentine abrasivity REA-Relative enamel abrasivity HAP-Hydroxyapatite HGF-Human gingival fibroblasts
Article
Objective To ascertain the effects of priming to consider tooth appearance (i.e. exposure to a ‘tooth whitening television advert’) versus control (a ‘non-dental’ television advert) on social judgements of tooth colour in a group of Caucasians. Methods Two groups of Caucasians randomly assigned to watch either a tooth-whitening advert (experimental, N=67) or a bread advert (control, N=62). All rated the measures of social perceptions: friendliness, popularity, social life, success, intelligence, graduation, introversion/extroversion, happiness, self-confidence, attractiveness, age-estimation and satisfaction, after watching either of the adverts and viewing three digitally modified photographs (Darkened, natural and whitened teeth) of different Caucasian adults (males and females) separately. Results There were no statistically significant differences for all the measures of social perception between the groups. Nevertheless, the questions that inquired about popularity, friendliness, success, intelligence, happiness, self-confidence, attractiveness and satisfaction were consistently rated higher for all three tooth shades in the experimental than the control groups. Further, within the experimental and control groups, higher ratings were given to the faces with whitened teeth than the natural and darkened teeth. Conclusions Priming has little impact on dentally induced social judgements as this study failed to demonstrate statistically significant differences. Nevertheless, both groups gave the highest subjective ratings for the faces with whitened teeth and the tooth-whitening advert group associated the faces in the photographs with higher subjective ratings than the non-dental advert group irrespective of the tooth shade. One reason for this could be the way media affects the psychological well-being. Clinical significance statement The almost universal exposure to idealised tooth appearance in the media may increase demand for aesthetic treatments. Standardising the colour of the tooth plays a huge impact and making individuals to view a tooth whitening advert just prior to a procedure might influence patient choices.
Article
Full-text available
Background Hollywood smile has gained popularity in recent times to improve aesthetics among the general population. Since patients’ perceptions of dental aesthetics play a vital role in planning and evaluating cosmetic dental treatment, it is essential to understand their knowledge, awareness, and factors that influence their perceptions of dental aesthetics. Objectives The objective of this study was to assess the knowledge, awareness, and perceptions of Hollywood smile among the general population in Saudi Arabia. Methods A close-ended questionnaire consisting of demographic information and 20 questions related to Hollywood smile was circulated through social media in Saudi Arabia. Statistical analyses of the data obtained were performed using Statistical Package for Social Sciences software (SPSS version 17, USA). Frequencies, percentages, and mean and standard deviation were calculated using descriptive statistics. Pearson chi-squared test was employed to test the association between the demographic variables, such as age, gender, and education levels, with the questionnaire items. Results A total of 4104 participants responded to the study questionnaire. The responses to the questionnaire revealed that nearly half of the participants were not satisfied with their dental appearance (48.6%). The majority of the participants had heard or known about Hollywood smile (98%). About 42% of study participants were aware of the complications involved in the procedure. The results revealed that the younger generation (18 to 30 years) had more awareness and felt more need for dental aesthetics (p=0.001). The proportion of male participants who underwent Hollywood smile correction were more than females (p=0.001). Graduates showed more awareness regarding smile, dental aesthetics, and Hollywood smile than the other categories (p=0.001). Conclusion This study has shown that the younger generation, female participants, and graduates had more awareness regarding smile, dental aesthetics, and Hollywood smile.
Article
Full-text available
Early television exposure and subsequent attentional problems in children . Christakis DA, Zimmerman FJ, Di Giuseppe DL & McCarty CA. ( 2004 ) Pediatrics , 113 , 708 – 713 . Cross-sectional research has suggested that television viewing may be associated with decreased attention spans in children. However, longitudinal data of early television exposure and subsequent attentional problems have been lacking. The objective of this study was to test the hypothesis that early television exposure (at ages 1 and 3) is associated with attentional problems at age 7. We used the National Longitudinal Survey of Youth, a representative longitudinal data set. Our main outcome was the hyperactivity subscale of the Behavioural Problems Index determined on all participants at age 7. Children who were > 1.2 standard deviations above the mean were classified as having attentional problems. Our main predictor was hours of television watched daily at ages 1 and 3 years. Data were available for 1278 children at age 1 and 1345 children at age 3. Ten percent of children had attentional problems at age 7. In a logistic regression model, hours of television viewing per day at both ages 1 and 3 were associated with attentional problems at age 7 [1.09 (1.03–1.15) and 1.09 (1.02–1.16), respectively]. Early television exposure is associated with attentional problems at age 7. Efforts to limit television viewing in early childhood may be warranted, and additional research is needed.
Article
The literature on the effect of exposure to media violence (including exposure to violent pornography) on aggressive behavior is critically reviewed. Evidence and theoretical arguments regarding short-term and long-term effects are discussed. Three points are emphasized: 1. Exposure to violence in laboratory and field experiments is as likely to affect nonaggressive antisocial behavior as it does aggressive behavior. The pattern is consistent with a sponsor effect rather than a modeling effect: an experimenter who shows violent films creates a permissive atmosphere; 2. the message that is learned from the media about when it is legitimate to use violence is not much different from the message learned from other sources, with the exception that illegitimate violence is more likely to be punished in media presentations; 3. the fact that violent criminals tend to be versatile - they commit nonviolent crimes as well - is inconsistent with explanations that emphasize proviolence socialization (from the media or other sources). I conclude that exposure to television violence probably does have a small effect on violent behavior for some viewers, possibly because the media directs viewer's attention to novel forms of violent behavior that they would not otherwise consider.
Article
The relationship of reciprocity, sex, and race to friendship proximity in adolescent friendships was studied. Intelligence, personality, physical attractiveness, popularity, and proximity were measured for 136 junior high school students. Subjects were classified as either having reciprocated or nonreciprocated friendships. Reciprocated adolescents were perceived as more attractive, had higher social status, and were more committed to their best friend than nonreciprocated adolescents. More black than white students were in the nonreciprocated group. White students had more in-school contact and black students more out-of-school contact with their friends.
Article
Survey, correlational, randomized control, and covariance structure modeling investigations indicate that the media are a significant factor in the development and maintenance of eating and shape-related disorders. One specific individual difference variable, internalization of societal pressures regarding prevailing standards of attractiveness, appears to moderate or even mediate the media's effects on women's body satisfaction and eating dysfunction. Problematic media messages inherent in existing media portrayals of eating disorders are apparent, leading researchers to pinpoint intervention strategies that might counteract such viewpoints. Social activism and social marketing approaches are suggested as methods for fighting negative media messages. The media itself is one potential vehicle for communicating productive, accurate, and deglamorized messages about eating and shape-related disorders.
Article
Increasing evidence suggest that imitative behavior may have a role in suicide among teenagers. We studied the variation in the numbers of suicides and attempted suicides by teenagers in the greater New York area two weeks before and two weeks after four fictional films were broadcast on television in the fall and winter of 1984-1985. The mean number of attempts in the two-week periods after the broadcasts (22) was significantly greater than the mean number of attempts before the broadcasts (14; P less than 0.05), and a significant excess in completed suicides, when compared with the number predicted, was found after three of the broadcasts (P less than 0.05). We conclude that the results are consistent with the hypothesis that some teenage suicides are imitative and that alternative explanations for the findings, such as increased referrals to hospitals or increased sensitivity to adolescent suicidal behavior on the part of medical examiners or hospital personnel, are unlikely to account for the increase in attempted and completed suicides.
Article
The literature on the effect of exposure to media violence (including exposure to violent pornography) on aggressive behavior is critically reviewed. Evidence and theoretical arguments regarding short-term and long-term effects are discussed. Three points are emphasized: 1. Exposure to violence in laboratory and field experiments is as likely to affect nonaggressive antisocial behavior as it does aggressive behavior. The pattern is consistent with a sponsor effect rather than a modeling effect: an experimenter who shows violent films creates a permissive atmosphere; 2. the message that is learned from the media about when it is legitimate to use violence is not much different from the message learned from other sources, with the exception that illegitimate violence is more likely to be punished in media presentations; 3. the fact that violent criminals tend to be versatile—they commit nonviolent crimes as well—is inconsistent with explanations that emphasize proviolence socialization (from the media or ot...
Article
A total of 126 participants were asked to select, from a series of photographs, the dentist which they perceived as: most caring, most competent, and which they would wish to have as their own dentist. White European male dentists were most likely to be chosen as the respondents' general dental practitioner. Men were generally perceived as more competent than women. Women were more likely to be chosen as the most caring dentists. It is concluded that, in the absence of other information, sex and ethnicity of the dentist exert an influence on patients' perceptions of general dental practitioners.
Article
The relationship of managerial experience to gender and attractiveness biases was examined in decisions involving suitability for hire and probable organizational progression within a typical financial institution. Each of 112 managers evaluated 4 equivalent résumé-data sheets, to which different candidate photographs were attached. The photographs were varied using a 2 X 2 (Gender X Attractiveness) design wherein each photograph depicted a woman or a man who was either highly attractive or slightly below average in attractiveness. For both ratings and rankings of candidates, clear evidence of attractiveness and gender biases were present. The extent of the bias was generally smaller for the most experienced managers, although less attractive female applicants were routinely at a disadvantage regardless of managerial experience. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
The effect of forced postponement of a hiring decision until after specific qualifications had been evaluated was examined as a procedure to reduce sex and physical attractiveness discrimination. Ninety six male and 148 female undergraduates evaluated the qualifications of an attractive, average, or unattractive male or female applicant. Ratings of specific qualifications preceded or followed an overall and hiring decision rating. Results indicated that the order variable influenced ratings of specific qualifications but not the overall or hiring decision. Sex of subject and attractiveness did affect the hiring decision with male and attractive applicants being preferred.