The perception of smile attractiveness to altered vertical position of maxillary anteriors by various groups

There is a gap in research about the differences in smile attractiveness. The problem the study addresses is how the vertical canine and incisor position affect smile attractiveness. The aim of this study was to assess the perception of the smile attractiveness between Saudi laypersons, orthodontists, non-orthodontist, and various dental students levels, and to determine how the canine and incisor vertical positions affect the attractiveness of smile. The study is a cross-sectional survey and was conducted at King Abdulaziz University, Jeddah, Saudi Arabia. Six groups of subjects participated in the study: Orthodontic residents (n = 31), prosthodontic, restorative, periodontics specialties residents specialties residents (n = 30), interns (n = 31), fifth year students (n = 41), 6th year students (n = 39), and laypeople (n = 39). Participants were asked to rate the attractiveness of a smile of a female subject photographed using a Minolta DiMage 7i digital camera. The image had been manipulated to produce 2 sets of images; 1 to modify the incisors and 1 to change the canines. The subjects were asked to choose the most and least attractive picture. For the best incisor positions, only the laypeople and prosthodontics liked the original picture, the rest liked +0.5 mm which accentuate the smile curve and make it follow the lower lip line. For the worst incisor position, all groups did not prefer the minus 1.5 reversed smile. For the best canine vertical position, all groups preferred the original position where canine was at the level of the incisal plane. For the worst canine position, they all disliked the minus 1.5 reversed smile. Results confirmed past findings that orthodontists are in general more critical about smile attractiveness than laypersons, but just like other dental specialists. The findings can be used in the esthetic dentistry field, but further research on the study population based on other dental design parameters remain necessary.