title: An assessment of teenagers' perceptions of dental fluorosis using digital simulation and web-based testing.
abstract: OBJECTIVE
  To develop a new model to establish teenagers' perceptions of the aesthetic impact of fluorosis, in the context of overall facial appearance. This web-based model was used to compare different degrees of fluorosis at any one distance, while also comparing the same level of fluorosis at different 'distances'.
  
  
  METHODS
  A 14-year-old subject was used as the model face. Different degrees of fluorosis were 'built-up' on this subject's teeth using digital simulation. A web-based questionnaire showed 30 photographs, displaying four levels of fluorosis, in addition to fluorosis-free, at five different 'distances'. The closest images were shown with and without retractors, while the more distant pictures showed more of the subject's face. Teenage pupils (n = 217) were then asked to grade the acceptability of the appearances and indicate if they would wish treatment for each such appearance.
  
  
  RESULTS
  At any one distance, acceptability fell as fluorosis level increased. When the same degree of fluorosis was compared at different distances, acceptability improved as the teeth were viewed from further away. Pictures taken without retractors had higher acceptability than those taken with retractors in place.
  
  
  CONCLUSIONS
  Teenagers can discriminate between various degrees of fluorosis. However, more distant viewing of fluorosed teeth, within the overall context of the face, improves acceptability of the appearance.
authors: Dental Public Health Unit, University of Glasgow Dental School, Glasgow, UK.
authors: Maura
authors: M
authors: Edwards
authors: Lorna M D
authors: LM
authors: Macpherson
authors: David R
authors: DR
authors: Simmons
authors: W
authors: W
authors: Harper Gilmour
authors: Kenneth W
authors: KW
authors: Stephen
mesh_terms: D000293:Adolescent; D000704:Analysis of Variance; D003198:Computer Simulation; D004955:Esthetics, Dental / Q000523:psychology* / Q000706:statistics & numerical data; D005260:Female; D009050:Fluorosis, Dental / Q000523:psychology*; D006801:Humans; D020407:Internet; D008297:Male; D008960:Models, Psychological; D010465:Perception; D023861:Photography, Dental; D000297:Psychology, Adolescent; D015203:Reproducibility of Results; D018709:Statistics, Nonparametric