title: Perceptions of dental professionals and laypersons to altered dental esthetics: asymmetric and symmetric situations.
abstract: BACKGROUND
  Previous studies evaluated the perception of laypersons to symmetric alteration of anterior dental esthetics. However, no studies have evaluated the perception of asymmetric esthetic alterations. This investigation will determine whether asymmetric and symmetric anterior dental discrepancies are detectable by dental professionals and laypersons.
  
  
  METHODS
  Seven images of women's smiles were intentionally altered with a software-imaging program. The alterations involved crown length, crown width, midline diastema, papilla height, and gingiva-to-lip relationship of the maxillary anterior teeth. These altered images were rated by groups of general dentists, orthodontists, and laypersons using a visual analog scale. Statistical analysis of the responses resulted in the establishment of threshold levels of attractiveness for each group.
  
  
  RESULTS
  Orthodontists were more critical than dentists and laypeople when evaluating asymmetric crown length discrepancies. All 3 groups could identify a unilateral crown width discrepancy of 2.0 mm. A small midline diastema was not rated as unattractive by any group. Unilateral reduction of papillary height was generally rated less attractive than bilateral alteration. Orthodontists and laypeople rated a 3-mm distance from gingiva to lip as unattractive.
  
  
  CONCLUSIONS
  Asymmetric alterations make teeth more unattractive to not only dental professionals but also the lay public.
authors.affiliation: Department of Orthodontics, University of Washington, Seattle 98195, USA.
authors.forename: Vincent O
authors.initials: VO
authors.lastname: Kokich
authors.forename: Vincent G
authors.initials: VG
authors.lastname: Kokich
authors.forename: H Asuman
authors.initials: HA
authors.lastname: Kiyak
mesh_terms: D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D001291:Attitude of Health Personnel; D003198:Computer Simulation; D003815:Dentists / Q000523:psychology; D003970:Diastema; D004955:Esthetics, Dental / Q000523:psychology*; D005260:Female; D005881:Gingiva / Q000033:anatomy & histology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009811:Odontometry; D009970:Orthodontics; D010465:Perception; D011639:Public Opinion; D012904:Smiling; D011795:Surveys and Questionnaires; D019228:Tooth Crown / Q000033:anatomy & histology