Influence of Gender and Skin Color on the Perception of Tooth Shades in a Moroccan Subpopulation

Introduction and aim Dental esthetics is a key component of modern dentistry, with tooth shade playing a major role in smile harmony. This study aimed to evaluate the influence of skin color and gender on the perception of tooth shades within a Moroccan population. Methods In this cross-sectional study, 300 non-dental participants were recruited using a convenience sampling method. Participants evaluated 48 digitally modified smile photographs of one male and one female model. Six tooth shades (BL1-A1) were combined with four Fitzpatrick skin types (II-V) using spectrophotometric calibration based on the CIE L*a*b* color space. Participants selected the most esthetically pleasing shade for each skin type. Associations between shade preference and demographic variables were analyzed using Pearson's chi-square tests, with Monte Carlo permutation (B = 100,000 simulations) applied when more than 20% of expected cell counts were below five. Effect sizes were assessed using Cramer's V coefficient. Results Lighter shades (BL1-BL3) were predominantly selected across all skin types and demographic subgroups. No statistically significant association was observed for gender, age, or professional status (p > 0.05). Education level showed statistically significant but weak associations (Cramer's V = 0.19-0.21). Overall, lighter shades accounted for 69-92% of selections. Conclusion In this Moroccan sample, lighter tooth shades were predominantly preferred across all skin types and observer subgroups. These findings suggest a general tendency toward higher-value (brighter) tooth shades in esthetic perception, although no causal inference can be made. Individualized shade selection remains essential in clinical practice.