Dentists Take Dimmer View of Patients' Smiles

MONDAY, Dec. 17 (HealthDay News) -- People tend to be much happier with the condition of their teeth and smiles than their dentists are, Norwegian researchers report.

Patients also view eyes and teeth as the most important aspects of facial attractiveness, and younger people under 50 are most at ease with the appearance of their teeth, the study found.

"Patients had much higher opinions of their smiles than dentists assessing their smiles," said study author Dr. Oystein Fardal, a periodontist in private practice in Egersund, Norway.

Yet despite the inclination towards more favorable assessments, patients did not usually rank their pearly whites as being the best that they could be.

"They only gave themselves scores of six out 10," he noted. "This could mean that they are content, but realize that they do not compare with the 'perfect smiles' of Julia Roberts, Angelina Jolie, etcetera."

Fardal and co-author Jannike Jornung, a graduate student in the department of orthodontics in Sweden's Sahlgrenska Academy at Goteborg University, published their findings in the December issue of the Journal of the American Dental Association.

To gauge patient and dentist perceptions, the researchers first interviewed 78 patients at a general dental practice in a small rural Norwegian community during September of 2004.

The patients were between the ages of 22 and 84 and, at the time, none were seeking any kind of aesthetic dental care. Nearly two-thirds were women.

Written questionnaires were completed, in which patients assessed on a scale of one to 100 the shape of their lips; the appearance of the soft tissue (gingiva) surrounding their teeth; the shade, shape and alignment of their teeth; and the overall state of their smile.

Patients were also asked to indicate if they thought they had crooked teeth and/or receding gums.

No photographs or mirrors were provided, as patients were asked to grade themselves from memory.

In addition, all the men and women also ranked various facial features according to how important they believed they were to overall attractiveness. Features included hair and hairline, eyes and eyebrows, nose, skin, ears, lips, teeth, chin and the shape of the head.

Digital photos were then taken of the smiles of the first 40 patients, and both the attending dentist and Fardal independently arrived at aesthetic scores based on assessments of tooth shade, spacing, crowding, inflamed tissue and overall appearance.

At no time had Fardal been involved in the dental care of any of the patients.

The authors found that on a scale of 100, average patient satisfaction with the state of their smile came to just over 59 -- a figure that rose significantly among patients under the age of 50.

By contrast, the two dentists' assessments taken together registered at about 40 on the scale.

Specifically, patients were most satisfied with the state of their soft tissue (gingiva) when they smiled. They were least satisfied with the color of their teeth, which they generally described as being too dark.

Skin condition followed teeth and eyes as the most important features contributing to a person's facial attractiveness. Female patients said that teeth and hair were more important to them than did the men, while the men said head shape was more critical.

Fardal and Jernung suggested that dentists should remember that their opinion of the aesthetics of a patient's smile may not match that of the patient.

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