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Orthodontics - April 30, 2014 - Vol. 28 - No. 5

You can use this article as an objective basis to advise your patients that they will not be seen as any less attractive by others as a result of wearing braces.

Article Reviewed: Impact of Metal and Ceramic Fixed Orthodontic Appliances on Judgments of Beauty and Other Face-Related Attributes. Fonseca LM, de Araújo TM, et al: Am J Orthod Dentofacial Orthop; 2014;145 (February): 203-206.

Background: Patients are sometimes reluctant to pursue orthodontic treatment because they feel that wearing braces will result in them being seen as less attractive. Is there a basis for this concern?

Objective: To investigate how people who wear fixed orthodontic appliances see themselves and how they are seen by others in social settings.

Participants: 60 adults (21 men, 39 women; ages 18 to 47 years) whose maxillary dentition was complete with both dental arches either aligned or having mild crowding.

Methods: 3 smile photographs were taken for each subject: one with metal braces and an 0.018" stainless steel maxillary archwire, a second with ceramic braces and a maxillary 0.018" stainless steel archwire, and a third acted as a control with no braces in place. The subjects rated each of their 3 photographs on an analog scale ranging from 0 to 10 from not beautiful at all to very beautiful. Additionally, the same 180 photographs (3 each of the 60 subjects) were rated by 15 adult raters who were lay people not currently undergoing orthodontic treatment.

Results: The subjects saw themselves as more beautiful when not wearing a fixed orthodontic appliance, followed by wearing an esthetic fixed orthodontic appliance, and finally a metal fixed orthodontic appliance. However, for the raters there was no statistically significant difference found between any of the 3 photographs.

Conclusions: Wearing an orthodontic appliance has no bearing on interpersonal esthetic judgments.

Reviewer's Comments: There is no doubt that there are people who do not pursue orthodontic treatment because they feel that wearing braces will make them look less attractive. I suspect that many orthodontists tell their patients that they understand the concern about looking less attractive wearing braces; however, people looking at them will not. Now you have a study to provide a basis for that statement, and I would suggest that you might even want to keep a copy of this article in your office.(Reviewer–John S. Casko, DDS, MS, PhD).

© 2014, Oakstone Publishing, LLC

Dr. Powell is currently accepting new patients and taking  appointments in April for West Wieuca.  To make an appointment for your child,  please call 770-934-5900.

Dr. Wesley Powell graduated from the McCallie School in Chattanooga, Tennessee. He then attended Southern Methodist University in Dallas, Texas, where he earned a degree in Anthropology. He attended Columbia University School of Dentistry and Oral Surgery in New York, New York for his dental training. Dr. Powell then completed a three-year residency program in Pediatric Dentistry while earning a Masters Degree in Clinical Dentistry at the University of Alabama at Birmingham.

Upon completion of his residency, Dr. Powell practiced for two years in suburban Washington, D.C. at a pediatric/orthodontic practice before relocating to Atlanta. While there, he was on staff at Arlington Hospital.

Dr. Powell is a member of the American Academy of Pediatric Dentistry, Southeastern Society of Pediatric Dentistry, American Dental Association, Virginia Dental Association, Georgia Dental Association and the Better Business Bureau. Dr. Powell served as the Atlanta representative for Crest, Proctor and Gamble for Children’s Dental awareness month speaking to inner city children and also appeared on local television to promote dental health. He is currently a member of Gnathos, a continuing education organization that deals solely with the orthodontic treatment and clinical modification of growth and development of growing children and teens, Atlanta Dental Coordinator for the charitable organization Team Smile and the Atlanta Falcons.  This organization teams with a local professional sports team to provide free dental care and screenings to children in many NFL/NBA cities including some colleges (including UGA!) around the country.

Dr. Powell resides in Buckhead. He has one son, Pearson, and two Jack Russells Sophie & Cowboy. He enjoys golf, travel, snow skiing, the outdoors and fishing. He is active in the community with numerous foundations and community service organizations including the National Black Arts Festival, Camp Sunshine, and Lanier Partners of North Georgia. Dr. Powell is a member of Peachtree Presbyterian Church and has participated with helping with pre-school children.

The greater the space and the more mesially located the lateral spacing was, the more unattractive the smile.

Background: Facial esthetics and the attractiveness of a smile are of great interest to clinicians. Previous research has described the negative impact of having a maxillary midline diastema on perceived esthetics.

Objective: To evaluate the perception of smile esthetics among laypeople and orthodontists as affected by the presence of diastemas in the maxillary lateral incisors using an oblique smile analysis.

Methods: The study used 2 standardized oblique smiling photos from 2 female subjects. One subject had been treated with extractions and one without extractions, and both were considered to have attractive smiles. The photographs were digitally altered to create interproximal spaces in the lateral incisor. Space were generated in 0.5mm increments and were located in the mesial, distal, or both surfaces. The final images were randomly assembled and given to 120 judges for evaluation. Sixty of the judges were orthodontists and 60 were laypersons. The judges were asked to assess the attractiveness of the images on a visual analog scale.

Results: the judges rated the images without lateral spacing as the most attractive smiles. both groups rated the presence of diastemas as unattractive. they found that the greater the space and the more mesially located the lateral spacing was, the more unattractive was the smile rating.

Conclusions: This study suggested that spacing in the upper lateral incisor area is a factor in smile attractiveness. The larger and the more mesially located a lateral diastema, the more unattractive was the smile assessment.

Reviewer's Comments: This was an interesting article in that the focus was on the esthetics of lateral spacing rather than the more commonly studied midline diastema. Both laypersons' and orthodontists' perceptions of the lateral spacing were quite similar; the larger the space and the closer to the maxillary midline the less attractive the smile. For the layperson group, a 0.5mm space distal to the lateral was not rated as unattractive. thus, if it is not necessary to leave some space in the maxillary anterior arch, this study supports leaving the space distal to the laterals. There were no differences found between the extraction smile photos and the non extraction smile photos. (Reviewer-John S. Kanyusik, DDS, MSD)

2014 Oakstone Publishing, LLC

Orthodontics - March 30, 2014 - Vol. 28 - No. 4
Laypersons are not aware of asymmetries of the maxillary canine gingival contours until they reach 1.5 mm.
Article Reviewed: Influence of Maxillary Canine Gingival Margin Asymmetries on the Perception of Smile Esthetics Among Orthodontists and Laypersons. Correa BD, Bittencourt MAV, Machado AW: Am J Orthod Dentofacial Orthop; 2014;145 (January): 55-63.

Background: Both facial and dental asymmetries have a negative effect on esthetics. Are orthodontists and laypeople equally perceptive in identifying asymmetries of the maxillary canine gingival contours?

Objective: To determine the perceptions of smile esthetics among orthodontists and laypersons with respect to asymmetry in the maxillary canines' gingival margins using facial and close-up smile analyses.

Participants: Fifty laypersons and 50 orthodontists evaluated altered maxillary gingival contour asymmetry.

Methods: Smile photographs of 2 male and 2 female adults had the maxillary gingival contours altered digitally ranging from symmetric to discrepancies of 0.5, 1.0, 1.5, 2.0, and 2.5 mm of asymmetry. Full-face and close-up views of the smiles of 4 patients were rated by both the orthodontists and the laypersons using a 100-mm visual analog scale ranging from very attractive to very unattractive.

Results: For both the orthodontists and the laypersons, the most attractive smiles were the symmetric maxillary canine gingival contours. Orthodontists perceived asymmetric alterations of >0.5 mm whereas laypersons required >1.5 mm. For both groups, asymmetries of 2.0 and 2.5 mm received the lowest scores. There was no difference between full face and close-up assessments of the smile.

Conclusions: Orthodontists are more perceptive than laypersons in evaluating asymmetric maxillary canine gingival contours.

Reviewer's Comments: It is not surprising to me that orthodontists could detect smaller amounts of asymmetry than laypersons. The practical application of these findings is that laypersons are not likely to notice canine marginal discrepancies of 1.5 mm or less, and discrepancies of 2.0 and 2.5 mm are found to be unattractive by both laypersons and orthodontists.(Reviewer–John S. Casko, DDS, MS, PhD).

© 2014, Oakstone Publishing, LLC