Are ratings of dentofacial attractiveness influenced by dentofacial midline discrepancies?

To assess the attractiveness of dentofacial midline discrepancies during smiling, and to determine if the ratings were influenced by the gender of the judges.

Twenty non-dental undergraduate students (10 males, mean age: 33.5 years; 10 females, mean age: 31.2 years) and 20 orthodontists (10 males, mean age: 36.6 years; 10 females, mean age: 34.3 years) assessed frontal photographs of the same smiling adult female with coincident midlines, and images of the same person with the upper dental midline shifted 2 mm and 4 mm to the right and left of the facial midline. The judges scored the attractiveness of the smile using 5-point scale.

Both the students and the orthodontists considered that the images were less attractive as the dentofacial midline discrepancy increased. More orthodontists than undergraduate students, and more female orthodontists than male orthodontists, considered a 4 mm discrepancy between the dental and facial midlines as unattractive.

Dental to facial midline discrepancies reduce dentofacial attractiveness. Discrepancies of 2 mm or more are likely to be noticed by both orthodontists and non-dental university students. Orthodontic treatment objectives should include correction of the dental midline discrepancies to within 2 mm of the facial midline.