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Perception of Smile and Esthetic among Dental and Non- Dental Student

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DOI: 10.21276/aimdr.2018.4.2.DE13

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 DOI: 10.21276/aimdr.2018.4.2.DE13

Original Article ISSN (O):2395-2822; ISSN (P):2395-2814

Section: Dentistry
Perception of Smile and Esthetic among Dental and Non-
Dental Student.
Abdullmajeed Khalaf Alharthi1, Roshan Noor Mohamed2, Durgesh Nagesh Bailoor3, Mohamed
Wael Bassuoni4, Wasim Abdulaziz Shaikh5, Yousef Al-Thomali6
1
6th Year Dental Student, Faculty of Dentistry, Taif University, Taif, Saudi Arabia.
2
Assistant Professor, Preventive Dental Sciences (Pediatric Dentistry Division), Faculty of Dentistry, Taif University, Taif, Saudi Arabia.
3
Associate Professor, Basic Diagnostic Sciences (Radiology Division), Faculty of Dentistry, Taif University, Taif, Saudi Arabia.
4
Assistant Professor, Preventive Dental Sciences (Community Dentistry Division), Faculty of Dentistry, Taif University, Taif, Saudi Arabia.
5
Associate Professor, Basis Medical Sciences (Physiology Division), Faculty of Dentistry, Taif University, Taif, Saudi Arabia.
6
Head of The Department, Preventive Dental Sciences, Faculty Of Dentistry, Taif University, Taif, Saudi Arabia.

Received: January 2018

Accepted: February 2018
Copyright: © the author(s), publisher. Annals of International Medical and Dental Research (AIMDR) is an
Official Publication of “Society for Health Care & Research Development”. It is an open-access article
distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits
unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is
properly cited.

ABSTRACT
Background: To assess the self perception of one's own smile and its influence on their behavior and also their ability
to rate different types of smiles from most attractive to least attractive on a visual analogue scale by dental and non
dental students. Methods: This study was carried out by using structured questionnaire and booklet of visual analogue
scale distributed to 276 students in Taif University that included Dental, Medical and Pharmacy students. Results:
Medical (66%), Pharmacy (60%) and dental students (49%) agreed for confidence in their own smile. Observing smiles
of others in photographs was significantly higher for dental students 60%, compared to medical 58% and pharmacy
41% students. 56% of both dental and medical students agreed that they recognized the minor defects in their own
smile whereas for pharmacy students 40% agreed for the same [p<0.01]. Conclusion: This survey showed that the
dental and medical students were able assess their own smile and also other's smile better than pharmacy students.
Dental students were able to detect minor defects in smile photographs better than medical and pharmacy students.

Keywords: Smile Perception, Aesthetics, Visual analogue scale, Dental.

INTRODUCTION Perception of smile and aesthetic differ from

person to person based on multiple factors as, age,
People pay more attention to their beauty and they gender, educational level, and economic status,[7]
are more concerned about their appearance than also it is differ between the dentist and patients.[8-10]
their health,[1] and they provide more care to their The self perception of one's own smile and its
face. impact of their behavior is an important factor in
The face was reported to be determinant factor in understanding the influence of esthetic smile on
perception of esthetic especially the mouth and the their performance in day to day activities including
eyes, which are the most important area the persons both social and academic nature. The perception of
focus on during social interaction.[2-3] esthetics as tested by viewing various levels of
The mouth considered the communication center of esthetic smiles in the form of colored photographs
the face,[4] therefore the people give more care to may help in understanding the ability of a person in
their mouth and smile, and this is one of the most rating the attractiveness of smile as per his
important factors for patients to seek dental understanding of ideal and altered smiles.
treatment,[5] to increase their attractive appearance The present research is conducted with the aim to
and self-confidence. The attractive individuals gain assess the self perception of one's own smile and its
good verdicts, and achievement than do influence on their behavior and also their ability to
unattractive individuals according to some rate different types of smiles from most attractive
researchers.[6] to least attractive on a visual analogue scale by
dental and non dental students.
Name & Address of Corresponding Author
Dr. Roshan Noor Mohamed,
Assistant Professor, MATERIALS AND METHODS
Preventive Dental Sciences
(Pediatric Dentistry Division), The present research was approved by the
Faculty Of Dentistry,
Taif University, Taif, Saudi Arabia
Institutional Review Board, Faculty of Dentistry,

Annals of International Medical and Dental Research, Vol (4), Issue (2) Page 59
 Alharthi et al; Smile and Esthetic among Dental and Non-Dental Student

Section: Dentistry
Taif University. The study involved using of groups with 7%, 16% and 10% for Dental, Medical
questionnaire and visual analogue scale (VAS) in a and Pharmacy students respectively.
pretested format that was distributed to total of 275 There was statistically significant response for the
students of Taif University which included 75 question which enquired whether students believed
dental, 100 medical and 100 pharmacy students. that someone has a better smile then themselves
[p<0.01] [Table 1]
Questionnaire Regarding the question which enquired if their eyes
The questionnaire comprised of three printed pages are drawn towards the smile when they see a
with a catalogue that included the sets of the picture of a person there was statistically
colored smile photographs. The questionnaire significant agree response with 60%, 58% and
included 15 items covering different aspects 41% of dental, medical and pharmacy students
perception of smile. The Items in the questionnaire respectively [p<0.01] [Table 1].
is summarized in [Table 1]. The reliability of the 56% of both dental and medical students agreed
questionnaire was carried out using Cronbach's that they recognized the minor defects in their own
Alpha for all the questions by testing on 10 smile whereas for pharmacy students 40% agreed
participants. The correlation coefficients were high for the same [p<0.01] [Table 1].
and ranged from 0.83 to 0.91. The percentage of student wishing their teeth to be
Visual analogue scale was used as tool to assess more whiter was highest for medical student with
smile and dental esthetic perception. The 76% and least for dental students (58%) [p<0.01]
photographs of different manipulated smiles were [Table 1].
presented in the catalogue [Figure 1] and evaluated
by the study participants using the rating starting Conversely, 38 of pharmacy students were satisfied
from 1 that indicating to the least attractive smile with their gum appearance when compared to 42
and ending at 10 indicating to the most attractive and 46% of dental and medical students
smile. respectively.
The color photographs displayed anterior teeth and
lips with the smile. The nose, chin and cheeks were For visual analogue scale (VAS) Cronbach’s alpha
not displayed in an attempt to avoid their coefficient was measured for determination of the
confounding influence in smile perception of the scale reliability and it was 0.85. So it is preferable
participants. The photographs included eight with good internal consistency.
images starting with ideal smile and others The VAS ratings given by the dental, medical and
obtained by alteration of ideal smile using adobe pharmacy students for different smile photographs
photoshop software to display common is summarized in [Table 2,3 and 4] respectively.
discrepancies of anterior esthetics in shade, shape,
length of crown, size, midline shift, spacing and lip Out of 276 participants 40% of dental student gave
line [Figure 1]. high rated (8 out of 10) to ideal smile, and 21.8%,
26% of pharmacy and medical students,
Statistical Analysis respectively rated ideal smile as it the most
Data analysis was undertaken using the Statistical attractive picture.
Package for Social Science (version 20.0; IBM). Altered crown shape picture get 7 marks from
The mean and standard deviation (SD) of each 26.7% of dental student, 3 to 8 marks from 15% of
group were calculated. Comparison between the medical students and 7 marks from 16% of
groups was performed using the Kruskal-Wallis pharmacy students .
ANOVA and Man-Whitney U test with the
significance level of less than P< 0.05. Altered crown shade was rated by18.7% of dental
students as it low attractive, 20.8% of medical
RESULTS student as it moderately attractive and 20% of
pharmacy student as it not attractive .
Total number of participant was 276 students. 75 22.7% of dental and medical students with 18% of
dental, 100 pharmacy and 101 medical student with pharmacy students gave moderate rated (4 to 6 out
100 percent response rate. of 10) to picture of reduced maxillary laterals size.
The percentage of agree response for each of the Altered crown length was rated by 33.33% of
item in the questionnaire and statistical test results dental students and 22% of pharmacy student as it
is summarized in [Table 1]. Regarding self moderately attractive and 19.8% of medical student
confidence about their own smile, Medical (66%) gave it the highest rated (10 out of 10).
and Pharmacy (60%) students agreed more than
that of dental students (49%), although results were Mid line shift get moderate rated (4 to 6 out of 10)
not statistically significant. Covering the smile with by 34.7%, 21.8%, 16% of dental, medical and
hands showed less percentage for all the three pharmacy students, respectively.

Annals of International Medical and Dental Research, Vol (4), Issue (2) Page 60
 Alharthi et al; Smile and Esthetic among Dental and Non-Dental Student

Section: Dentistry
Table 1: Perception of smile and esthetic among dental and non dental student: percentage of agree response.
Questions Type of students Kruskal-Wallis Man-Whitney
Dental Medical Pharmacy ANOVA, p U test
number number number (%) value
(%) (%)
Are you self-confident about smiling? 49 66 60 0.20 NA
Do you ever put your hand over your mouth 7 16 10 0.04 M>D
when you smile?
Do you photograph better from one side of 21 29 32 0.37
your face?
Is there someone you believe has a better 63 75 50 0.0001 M > P, M > D
smile than you?
Do you look at magazines and wish had a 46 44 48 0.06
smile as pretty as the model's smile?
When you see a picture of person, are your 60 41 58 0.0001 D > M, P > M
eyes drawn to his\her smile?
When you look at your smile in mirror, do 56 56 40 0.0001 M > P, D > P
you see any defects in your teeth or gums?
Do you wish your teeth were whiter? 58 76 60 0.008 M > D, P > D
Are you satisfied with the way your gum 42 46 38 0.02 M>P
look?
Do you show too many or too few teeth 14 45 42 0.0001 M > D, P > D
when you smile?
Do you show too much or too little gum 18 20 30 0.04 P > D1
when you smile?
Are your teeth too long or too short? 13 28 30 0.08 NA
Are your teeth too wider or too narrow? 23 22 40 0.04 P > M,
Are your teeth too square or too round? 11 26 18 0.19 NA
Do you like the way your teeth shaped? 49 55 50 0.29 NA
NA – Not applicable, D – Dental, M – Medical, P – Pharmacy, ANOVA – Analysis of variance.

Table 2: Response of Dental students regarding their opinion to different smile pictures.
Picture Visual analogue scale scores
Type Dental student [n(%)]
VAS rating 1 2 3 4 5 6 7 8 9 10
Picture A 2 2 7 7 30 8 19
0 0 0
(2.7) (2.7) (9.3) (9.3 (40) (10.7) (25.3)
Picture B 2 3 8 8 8 20 15 11
0 0
(2.7) (4) (10.7) (10.7) (10.7) (26.7) (20) (14.7)
Picture C 4 13 14 10 11 11 8 4
0 0
(5.3) (17.3) (18.7) (13.3) (14.7) (14.7) (10.7) (5.3)
Picture D 3 8 14 17 11 7 7 8
0 0
(4) (10.7) (18.7) (22.7) (14.7) (9.3) (9.3) (10.7)
Picture E 2 4 3 17 25 10 4 6 4
0
(2.7) (5.3) (4) (22.7) (33.3) (13.3) (5.3) (8) (5.3)
Picture F 2 10 11 26 20 3 1 2
0 0
(2.7) (13.3) (14.7) (34.7) (26.7) (4) (1.3) (2.7)
Picture G 29 10 15 16 1 2 2
0 0 0
(38.7) (13.3) (20) (21.3) (1.3) (2.7) (2.7)
Picture H 4 7 14 5 6 5 12 5 8 10
(5.3) (9.3) (18.7) (6.7) (8) (6.7) (16) (6.7) (10.7) (13.3)

Table 3: Response of Medical students regarding their opinion to different smile pictures.
Picture Visual analogue scale scores
Type Medical students [n(%)]
VAS rating 1 2 3 4 5 6 7 8 9 10
Picture A 3 5 6 10 14 14 8 19 22
0
(2.9) (4.9) (5.9) (9.9) (13.9) (13.9) (7.9) (18.8) (21.8)
Picture B 3 1 16 5 14 15 13 16 6 12
(2.9) (0.9) (15.8) (4.9) (13.9) (14.9) (12.9) (15.8) (5.9) (11.9)
Picture C 6 10 14 20 21 5 12 6 4 3
(5.9) (9.9) (13.9) (19.8) (20.8) (4.9) (11.9) (5.9) (3.9) (2.9)
Picture D 3 9 7 17 8 17 16 11 8 5
(2.9) (12) (9.3) (22.7) (10.7) (22.7) (21.3) (14.7) (10.7) (4.9)
Picture E 4 15 18 11 9 4 13 20
7(6.93%) 0
(3.9) (14.9) (17.8) (10.8) (8.9) (3.9) (12.9) (19.8)
Picture F 14 14 14 6 22 6 14 2 6 3
(13.9) (13.9) (13.9) (5.9) (21.8) (5.9) (13.9) (1.9) (5.9) (2.9)
Picture G 50 19 6 10 2 6 4 4
0 0
(49.5) (18.8) (5.9) (9.9) (1.9) (5.9) (3.9) (3.9)
Picture H 3 4 10 14 7 2 15 3 15 28
(2.9) (3.9) (9.9) (13.9) (6.9) (1.9) (14.9) (2.9) (14.9) (27.7)

Annals of International Medical and Dental Research, Vol (4), Issue (2) Page 61
 Alharthi et al; Smile and Esthetic among Dental and Non-Dental Student

Section: Dentistry
Table 4: Response of Pharmacy students regarding their opinion to different smile pictures.
Picture Visual analogue scale scores
Type Pharmacy students [n(%)]
VAS rating 1 2 3 4 5 6 7 8 9 10
Picture A 8 6 8 10 6 10 14 12 26
0
(8) (6) (8) (10) (6) (10) (14) (12) (26)
Picture B 6 8 14 6 12 16 14 14 10
0
(6) (8) (14) (6) (12) (16) (14) (14) (10)
Picture C 20 16 12 6 10 10 12 8 4 2
(20) (16) (12) (6) (10) (10) (12) (8) (4) (2)
Picture D 2 2 4 18 12 16 10 14 8 14
(2) (2) (4) (18) (12) (16) (10) (14) (8) (14)
Picture E 2 2 6 10 22 8 20 18 4 8
(2) (2) (6) (10) (22) (8) (20) (18) (4) (8)
Picture F 2 2 15 16 15 16 10 14 6 4
(2) (2) (15) (16) (15) (16) (10) (14) (6) (4)
Picture G 36 16 14 8 6 2 6 6 6
0
(36) (16) (14) (8) (6) (2) (6) (6) (6)
Picture H 4 8 8 10 16 4 12 12 8 18
(4) (8) (8) (10) (16) (4) (12) (12) (8) (18)

The wish to having whiter teeth was revealed for

most students which supports that an increase in the
tooth whitening demand as an option for smile
improving.[14,10]
In our study, the level of satisfaction was low in
term of gingival display, crown with and length,
number of teeth showed during smiling and whiter
teeth appearance were considerably lower among
dental student in comparison to non dental student.
One can be expected that the knowledge of the
physiological process of color and shape change,
normal characteristics of dental structures and the
natural tooth appearance by dental students may
increase the level of esthetic assessment and reduce
the request for tooth whitening. At most, dental
students more aware due to their understanding of
the natural appearance of the teeth. In a previous
Figure 1: Different smiles for Visual analogue scale study, Carlsson et al.[15] revealed a higher
rating preference for teeth to be whiter by non-dental than
dental student.
DISCUSSION & CONCLUSION Visual analogue scales have been widely used in
dental aesthetics assessment and it is suitable for
Aesthetics has become more important factor than discriminating the levels of self-satisfaction.
health and function nowadays.[1] Dental students showed broad-mindedness to the
Perception of the smile and aesthetic vary between seven pictures of altered dental smiles as they
the people depending on their age, gender, assessed them significantly lower than the picture
socioeconomic status, level of education, of ideal smile.
occupation.[11,12] Therefore, trying to screen the Dental students indicated in those results as they
esthetic-perception is a challenge for a given were sensitive to aesthetic factors influencing the
population, and the results comparison, which smile more than non dental students. Similar to that
rarely present similarities. results obtained in studies that assessed the
Our study showed that 63% of dental, 75% of perception of dental professionals and
medical and 50% of pharmacy students believed laypeople.[16,17]
that someone has a better smile; conversely, 49%, The higher rating indicates that dental students
66% and 60% of dental, medical and pharmacy have enough knowledge about dental factors that
students, respectively, they are confident about might affect the smile and to their theoretical and
their smile. clinical background in relation to dental esthetics.
16% of medical, 7% of dental and 10% of Regarding the results, the image that showed
pharmacy students have already covering the smile alternation in dental shade was rated as it low to
with the hands which is approximately near to the moderately attractive, controversy Grosofsky et al
result has been found in Gabrielle de Carli et al study revealed that alternation in teeth shade did
study.[13] not affect the ratings of smile attractiveness.[18]

Annals of International Medical and Dental Research, Vol (4), Issue (2) Page 62
 Alharthi et al; Smile and Esthetic among Dental and Non-Dental Student

Section: Dentistry
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