title: Periodontal health, quality of life, and smiling patterns--an exploration.
abstract: BACKGROUND
  This study explored whether periodontal health/disease affects psychosocial outcomes in smiling patterns of particular subjects and their smile-related quality of life.
  
  
  METHODS
  We collected data from 21 regularly scheduled patients in a periodontal graduate student clinic (four males and 17 females; average age: 50.38 years; age range: 24 to 82 years). The subjects were videotaped while watching a funny television (TV) program. Two independent raters rated each videotape at 31 predetermined time points to assess four aspects of the objective smiling patterns of the subjects. In addition, the subjects responded to a questionnaire to assess their smile-related quality of life. Provider ratings and chart review data were used to assess the clinically assessed oral health status of the subjects.
  
  
  RESULTS
  The smile-related quality of life of the subjects correlated significantly with indicators of the periodontal health of the subjects, such as the number of mobile teeth (r = 0.681; P =0.000), missing teeth (r = 0.784; P = 0.001), and gingival recession in the esthetic zone (r = 0.718; P = 0.001). Periodontal health and smiling patterns also were correlated. The more teeth with probing depths between 4 and 6 mm the subjects had, the less widely they opened their mouths when they smiled (r = -0.468; P = 0.032); the more hypermobile teeth the subjects had, the less open their smiles were (r = -0.442; P = 0.045) and the more likely they were to cover their mouths when they smiled (r = 0.517; P = 0.017); and the more sites of gingival recession in the esthetic zone the subjects had, the fewer teeth they showed when they smiled (r = -0.491; P = 0.028).
  
  
  CONCLUSIONS
  The periodontal health of the subjects affects their smiling patterns and their smile-related quality of life. Poor periodontal health may prevent adults from expressing positive emotions which, in turn, can impact their self-concept as well as their social interactions.
authors.affiliation: School of Dentistry, University of Michigan, Ann Arbor, MI 48109-1078, USA.
authors.forename: Ruchir R
authors.initials: RR
authors.lastname: Patel
authors.forename: Philip S
authors.initials: PS
authors.lastname: Richards
authors.forename: Marita R
authors.initials: MR
authors.lastname: Inglehart
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D008875:Middle Aged; D010510:Periodontal Diseases / Q000523:psychology*; D011788:Quality of Life; D012647:Self-Assessment; D012904:Smiling / Q000523:psychology*; D013690:Television; D014743:Videotape Recording