Smile microesthetics as perceived by dental professionals and laypersons

To evaluate and compare the perception of different dental professionals and laypersons toward altered gingival characteristics (microesthetics) and to identify those characteristics that are most negatively and positively rated.

A smiling photograph of a female dental student was selected and digitally manipulated to create changes in different microesthetic parameters. These altered images were rated by the following five groups: 120 orthodontists, 45 periodontists, 49 prosthodontists, 130 general dentists, and 172 laypersons. Smile esthetics scores were calculated, and comparisons between groups were performed using the univariate general linear model.

The presence of black triangles between the upper incisors was the most negatively rated, and the ideal smile was the most positively rated. Significant differences were detected in the rating scores among the different study groups (P < .05). Orthodontists, prosthodontists, and general dentists scored the presence of a black triangle in the smile as the least attractive, whereas periodontists and laypersons perceived the inflamed gingiva and pigmented gingiva as the least attractive, respectively. Dental specialists tended to give the altered smile images lower scores than the laypersons.

The ideal smile and that with black triangles between the upper incisors were rated as the most and the least attractive smiles, respectively. Orthodontists, prosthodontists, and general dentists scored the presence of black triangles in the smile as the least attractive, whereas periodontists and laypersons perceived the inflamed gingiva and pigmented gingiva as the least attractive smiles, respectively. Dental specialists tended to give the altered smile images lower scores than the laypersons.