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JADA Specialty Scan - Cosmetic/Esthetic
Cosmetic/Esthetic - A Quarterly Newsletter on Dental SpecialtiesJADA

Smile perception among children and adolescentsThe template calls for the image at 225 by 175 but adjustments can be made within reason

Correcting poor smile esthetics, even in children, may be fundamental in preventing teasing and improving social interactions, according to a report published online May 19 in Angle Orthodontist.

It’s well recognized that physical attractiveness influences the perception of a person’s social skills. There’s also evidence that others’ perceptions can influence behavior and result in long-term developmental changes. However, scientists at the University of Turin in Italy found little research regarding the perceptions of children and adolescents. In conducting their own research, the scientists aimed to evaluate children’s and adolescents’ thresholds of acceptance of various smile anomalies and the impact on social perception.

To do so, they searched all peer-reviewed articles in the literature reporting such data to identify relevant studies involving at least 10 observers younger than 18 years. Key search words and phrases included “children,” “adolescents,” “smile esthetics perception,” and “smile esthetics evaluation.” Of 1,667 identified articles, they deemed 5 studies to be eligible for the systematic review. The mean age of the evaluated participants in these studies ranged from 8 to 16 years, and the sample size among the selected studies ranged from 121 to 840 children and adolescents.

Although the heterogeneity of analyzed categories among reviewed studies made it impossible for the scientists to assess the extent of the influence of smile esthetics, they did find that the smile was important among overall esthetics for adolescents, as well as for children younger than 10 years. For example, 1 of the analyzed studies found a significant preference for smiles with aligned teeth compared with altered smiles regarding perceived attractiveness, desirability as a friend, and less aggressive tendency. Another study investigating the influence on social perception in a sample of evaluators showed that children with well-aligned teeth conveyed significantly stronger characteristics of honesty, personal happiness, and intelligence compared with those with crowding and proclinated maxillary incisors.

Another study showed significant differences in the perception of athletic performance, confidence, popularity, and leadership ability between those with ideal and nonideal smiles. Teasing associated with malocclusion and unfavorable self-perceptions related to participants teeth was reported in other research.

However, 1 study didn’t report significant changes between ideal and crooked smiles. This finding indicated that evaluators found the whole face predominant over single dental features, said the authors.

None of the studies included in the review analyzed perception of smile anomalies in either a quantitative or qualitative way. Therefore, no threshold for acceptance of smile esthetic anomalies emerged, revealing a need for such studies, the authors said.

Read the original article.


Consulting Editor: Luiz Meirelles DDS, MS, PhD
Director, Professional Products and Standards
ADA Science Institute

Simplified technique for early-stage dental erosion treatment

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Patients who have dental erosion that they can’t see are often reluctant to pursue early dental treatment. In fact, patients usually don’t accept full-mouth rehabilitation at all unless dental erosion has affected the appearance of their smiles.

“Consequently, while intercepting initial cases of dental erosion should become a more ideal approach, it is difficult for clinicians to convince patients that early dental treatment is necessary, and that it will be more favorable if not postponed,” reported authors in the spring issue of International Journal of Esthetic Dentistry. “In addition, since there is no literature to support the premise that exposed dentin is pathology, not every clinician considers an early intervention appropriate. This division within the dental community confuses patients who seek a second opinion.”

The authors said that to maximize tooth preservation for these patients a simplified therapy at a reduced cost with a low number of dental appointments should be advocated, and they proposed just such an approach. The technique—a modification of the classic 3-step technique—was described in the treatment of a patient who had been bulimic. Using computer-aided design/computer-aided manufacturing monolithic restorations allowed the patient to complete therapy in 5 visits with low clinical and laboratory costs, according to the authors. No anesthesia or tooth preparation was required. Authors reported that the patient was very satisfied at the end of the treatment.

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The template calls for the image at 160 by 160 but adjustments can be made

view buttonWhat’s behind those IPS e.max lips?
Today, when it matters most, dental professionals around the world enthusiastically make it IPS e.max. That’s because Ivoclar Vivadent is committed to making the best esthetic, high-strength options for every day dentistry. Patients are delighted with the superior esthetic quality of their restorations and appreciate the care provided by their dentist and dental laboratory.

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Patient expectation and professional opinion

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It is well known that patients’ expectations of dental esthetics may differ from professional opinions. Yet scientists at Jordan University of Science and Technology found little information on the topic among Jordanian patients. Aiming to improve esthetics, they conducted a study evaluating factors that affected patients’ satisfaction with their dental appearances and attitudes toward treatments.

Scientists analyzed the self-reported data of 450 patients (66.2% male and 33.8% female) of the associated dental teaching center who answered a questionnaire about the appearance of their front teeth, esthetic treatment previously received, and desired treatment for improving esthetics.

Among results, scientists found that only 58% of the patients were satisfied with the color of their front teeth. In the discussion, the scientists speculated that patients may prefer white and shiny teeth, rather than a natural appearance and that patients might tend to rate the shade of their teeth as darker than professionals do or the actual shade. They advised that clinicians may wish to take this into consideration when selecting tooth shades. Scientists also found that patients’ general satisfaction with their dental appearances was highly correlated with having previously received whitening procedures. Indeed, whitening was the most desired treatment influenced by satisfaction with dental appearance, a finding consistent with previous research.

However, the treatments with the most significant effects on satisfaction were esthetic restorations and orthodontia. Authors deduced this may be related to their finding that factors that significantly affected general satisfaction with esthetics were tooth color and crowding. Tooth crowding was significantly correlated with general dissatisfaction.

Authors called for future studies both to determine how the dental profession and society might address the increased demand for esthetic dental treatment, as well as to identify factors that can affect esthetic perception, such as emotions, personality, and social and psychological backgrounds.

The full report is published in the January issue of The Journal of Contemporary Dental Practice.

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Technique uses visible light-polymerized resin to make interim RPDs

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There are many situations that call for an interim removable partial denture (RPD). They include treatment to restore esthetics, reestablish or maintain occlusal relationships, condition damaged mucosa under an existing RPD, or prepare a patient for a definitive RPD. Designed to enhance esthetics, stabilization, or function for a limited period, an RPD is typically replaced by a permanent prosthesis.

In an article published online June 3 in Journal of Prosthodontics, a team of scientists described a technique using a visible-light–polymerized (VLP) resin as the base material to make an interim RPD. They reported that VLP resin can be predictably fabricated in any dental setting that has a visible light-curing unit. The lead author of the report used the presented technique for more than 10 years with what authors described as “excellent” results. “If there is sufficient bulk to the base material, an interim RPD fabricated in this manner has demonstrated serviceability for up to 2 years,” they said.

“The primary advantages of a VLP resin are its ease of handling and fabrication, tissue biocompatibility and less laboratory time required,” the authors said in noting previous research. “The primary disadvantages are brittleness and low-impact resistance.” Among other references to the evidence, they noted that recent studies show that when an acrylate bonding agent is used, higher shear bond strength was achieved to the VLP resin.

The report provides details about each of the 10 steps required to perform the technique.

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Enjoy great delivery with the Adhese Universal VivaPen

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Adhese Universal is a single-component, light-cured universal dental adhesive for direct and indirect bonding procedures. Adhese Universal is compatible with all etching techniques: self-etch, selective enamel-etch, and total-etch. It is available in the unique VivaPen delivery form.

Learn More.

Smiles look their best with cosmetic treatment

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Summer is when people are at their most social. Help your patients put their best smiles forward by giving them clear options for cosmetic treatment with help from the trusted ADA brochure, Improving Your Smile.

This brochure is an essential tool for helping patients visualize more beautiful smiles. It includes a smile quiz and gives an overview of the many different cosmetic treatments available to dentists and their patients: tooth-colored fillings, whitening, veneers, braces, enamel shaping, and crowns. Before-and-after photos show just how attractive a smile improvement can be.

The 6-panel brochure is sold in packs of 50; a personalized version is also available. To order, call 1-800-947-4746 or go to Readers who use the code 16406E before July 15 can save 15% on all ADA Catalog products.


The template calls for the image at 160 by 160 but adjustments can be made

view buttonPacking a one-two punch
Dr. David Rice of igniteDDS explains how to pack a great one-two punch for ultimate esthetics with IPS e.max and Variolink Esthetic.

Watch Video.


Editorial and Advertising Policies

Any statements of opinion or fact are those of the authors and do not necessarily reflect the views of the American Dental Association. Neither the ADA nor any of its subsidiaries have any financial interest in any products mentioned in this publication. Any reference to a product or service, whether in advertisements or otherwise, is not intended as an endorsement or as approval by the ADA or any of its affiliated organizations unless accompanied by an authorized statement that such approval or endorsement has been granted.

All matters pertaining to advertising should be addressed to the advertising sales manager, Sales and Marketing Department, American Dental Association, Publishing Division, 211 E. Chicago Ave., Chicago, Ill 60611, 1-312-440-2740, fax 1-312-440-2550. All advertising appearing in ADA publications must comply with official published standards of the American Dental Association, a copy of which is available on request.