Recognition of patient-reported impairment in oral aesthetics

The objectives of this study were to investigate the degree of effective recognition by professionals of patient-estimated oral aesthetic impairment and the most reliable aspects in such recognition. Participants consisted of 95 patients with partial dentition in need of prosthodontic replacements. The oral aesthetics was professionally evaluated using the Prosthetic Esthetic Index (PEI), compiling 13 aesthetic aspects and an overall evaluation. The patient-reported impairment was evaluated using the Oral Health Impact Profile Aesthetic (OHIP-Aes) and the Oral Esthetic Scale (OES). Background variables were as follows: gender, age, work situation, education level, marital status, number and location of teeth, wearing a removable dental prosthesis (RDP) and smile line. A significant correlation was found between the overall professional evaluation and the OHIP-Aes score (R = 0·43, P < 0·05), the OES score (R = 0·46, P < 0·05) and the overall patient evaluation (0·35, P < 0·05). Correlations of the 13 specific aspects of the PEI with the patient-reported evaluations were generally small to moderate: the aspect 'discoloration of the teeth' showed the highest correlation. The multivariate analyses showed that up to 57% of the patient-reported impairment could be explained by the professionally evaluated oral aesthetic in combination with background variables. Discoloration of the teeth was the greatest explanatory variable, but also dental arch symmetry, and position and colour of the teeth were significant aspects. A high percentage of the patient-reported aesthetic impairment can be recognised by the professionals. The most reliable aspect is discoloration of the teeth, but also dental arch symmetry, and the position and colour of the teeth are important for recognising the aesthetic impairment.