|Year : 2020 | Volume
| Issue : 3 | Page : 189-193
Dental esthetics and its effect on psychological well-being in a university hospital in Riyadh, KSA
Yasmine Tarek Ahmed1, Abdulrahman Al Saffan2, Atheer Saleh Al Malky3, Haila Ahmed Al Nughaimshi3, Reem Jasir Al Herbisch3, Reema Ebrahim Al Yahya3, Sultana Mohammed Al Zain3
1 MSc Restorative and Aesthetics Dentistry, Restorative Department Dentistry, Riyadh Elm University, Riyadh, Saudi Aarabia
2 MSc Community Dentistry, Preventive Department Dentistry, Riyadh Elm University, Riyadh, Saudi Aarabia
3 Dental Intern, Riyadh Elm University, Riyadh, Saudi Aarabia
|Date of Submission||05-Feb-2020|
|Date of Decision||31-May-2020|
|Date of Acceptance||14-Aug-2020|
|Date of Web Publication||12-Nov-2020|
Dr. Yasmine Tarek Ahmed
Department of Restorative and Esthetics, Riyadh Elm University, Riyadh
Source of Support: None, Conflict of Interest: None
Background: The importance of dental esthetics among young adults is significantly increasing, affecting their self-confidence and self-image, especially with the major role being played by the media.
Objective: The objective of this study was to assess the impact of dental esthetics on the psychological well-being of adult patients attending a university hospital in Saudi Arabia.
Materials and Methods: A total of 613 patients attending university hospitals participated in this study by answering the online and printed version of the questionnaires. A Psychosocial Impact of dental aesthetics questionnaire was used in self-assessment for satisfaction with dental esthetics, and a self-perceived dental treatment needs. Collected data were analyzed using descriptive statistics and Chi-square tests.
Results: The participants reported smile satisfaction with satisfied (52.4%) and highly satisfied (22.8%), while only 24.8% reported dissatisfaction. Tooth color was the most common cause of dissatisfaction (49.3%).
Conclusions: The majority of the participants were satisfied with their smiles, however, a large percentage are still in need of further esthetic dental treatments as their smiles have a major impact on their social and psychological well-being. Hence, more public awareness programs should be directed to educate our community to make better choices of cosmetic dental procedures.
Keywords: Dental esthetics, malocclusion, psychological well-being, quality of life, self-perception, social impact
|How to cite this article:|
Ahmed YT, Al Saffan A, Al Malky AS, Al Nughaimshi HA, Al Herbisch RJ, Al Yahya RE, Al Zain SM. Dental esthetics and its effect on psychological well-being in a university hospital in Riyadh, KSA. Saudi J Oral Sci 2020;7:189-93
|How to cite this URL:|
Ahmed YT, Al Saffan A, Al Malky AS, Al Nughaimshi HA, Al Herbisch RJ, Al Yahya RE, Al Zain SM. Dental esthetics and its effect on psychological well-being in a university hospital in Riyadh, KSA. Saudi J Oral Sci [serial online] 2020 [cited 2021 Jan 17];7:189-93. Available from: https://www.saudijos.org/text.asp?2020/7/3/189/300592
| Introduction|| |
Oral health is a multifactorial state; according to the American Dental Association, it includes function, structure, esthetic, physiologic, and psychosocial aspects affecting an individual's quality of life. Recently, social media platforms and its influencers play a major role in shaping communities' perception of beauty and facial esthetics. Promoting a variety of methods to increase physical attractiveness and grow self-esteem and prestige, therefore, dental esthetics became a major concern to adults affecting their self-confidence. The psychological impact of dental esthetics is a significant component of oral health-related quality of life (OHRQoL). Moreover, adolescents' and young adults' self-esteem remained significantly influenced by the self-perceived psychosocial impacts of dental esthetics., Patients are passionately seeking esthetic dental treatments and the majority would visit a dental clinic because they viewed or read their page on social media sites. In a national study conducted in Qassim, the majority of the subjects (65.9%) would visit a dental clinic based on social media information on esthetics. Recently, adults are not only concerned with their tooth alignment and shape of their smile but also demanding whiter teeth.
This study aimed to assess the impact of dental esthetics on the psychological well-being of adult patients attending a university hospital in Riyadh.
| Materials and Methods|| |
This cross-sectional study was conducted at a university hospital, and the Psychosocial Impact of dental aesthetics questionnaire (PIDAQ) composed of 12 questions was used to collect the information. The English PIDAQ version was independently translated into Arabic by two lecturers at the university, native Arabic speakers, proficient in English, and one of them familiar with the OHRQoL instruments. To check the clarity of the items in an Arabic context, the questionnaire was administered to 20 subjects (patients). A few linguistic modifications were made according to their comments. The study was approved by the Institutional Review Board (IRB) of the university's research center (IRB) number FUGRP/2020/155/161/158. Quantitative convenience sampling size was calculated and carried out using online SurveyMonkey.com (Ryan and Chris Finley, 2009). A total of 613 patients (47.5% – males and 52.5% – females) aged 18–35 years participated in this study whether they have undergone dental treatment or not. All participants gave informed consent before their inclusion in the study. The questionnaires were self-administered and included a self-assessment of satisfaction with dental esthetics, a self-perceived dental treatment need, and self-reported malocclusion. Descriptive statistics of frequency distribution and percentages were calculated for the categorical variables (age, gender, and questionnaire items). Association between age, gender, and perceived dental esthetics on psychological well-being was assessed by applying the Chi-square test. A value of P < 0.05 was considered statistically significant. All the data were analyzed using the Statistical Package for the Social Sciences (SPSS) version 25 (Armonk, NY: USA).
| Results|| |
A total of 322 females (52.5%) and 291 males (47.5%) participated in the study. The majority of the participants were in the age range of 31–35 years (n = 176, 28.7%). More than half of the participants (n = 321, 52.4%) reported that they were satisfied with their smile, almost a quarter of the participants (n = 152, 24.8%) were not satisfied, and the remaining (n = 140, 22.8%) were highly satisfied [Table 1]. The majority (63.5%) of the participants reported that they do not hide their teeth when they smile, which shows high confidence, however, 36.5% of the participants reported that they hide their teeth when they smile [Figure 1]. Almost half (n = 302, 49.3%) of the participants reported that the tooth color was the main reason for their dissatisfaction with their smile, followed by tooth position and arrangement(n = 221, 36.1%). The lip shape (n = 114, 18.6%), gingival color/position (n = 118, 19.2%), and tooth size (n = 119, 19.4%) were the least causes of dissatisfaction[Table 2] and [Figure 2]. When the subjects were evaluated on the basis of various components of the questionnaire, a significantly high percentage of participants (n = 552, 90%) wished to have better-looking teeth.
|Table 1: Descriptive statistics for age. Gender and satisfaction with smile among study subjects|
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While more than half of the participants were comfortable with their teeth to display in the mirror, photographs, and videos (n = 375, 61.2%). More than one-fourth of the study subjects perceived notion about other people's views of smile (n = 176, 28.7%) and smile made conscious in the presence of opposite sex (n = 182, 29.7%), and nearly (n = 180, 29.4%) of the participants thought that the teeth were the reason behind their dissatisfaction with their looks [Table 3]. We have found that age significantly impacted participants' satisfaction with their smiles when displayed in the mirror, photographs and videos (P = 0.005). Similarly, the perceived notion about other people's views of smiles was found to differ significantly among different age groups (P = 0.033) and gender (P = 0.001). Similarly, responses to the questionnaire item if smiling makes you conscious in the presence of the opposite sex were also found to be significantly different between genders (P = 0.001). While other questionnaire responses did not differ significantly across various age groups and gender, as shown in [Table 4]. The relationship between perceived smile characteristics and age, gender, and smile satisfaction are shown in [Table 5]. The gender of the study participants showed a statistically significant difference with lip shape (P = 0.040) and gingival color and position (P = 0.041). While smile satisfaction was significantly related to tooth size (P = 0.000), tooth position (P = 0.000), and gingival color and position (P = 0.000).
|Table 3: perceived dental esthetics and psychology among study participants|
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|Table 4: Association between dental esthetics and age, and gender of study participants|
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|Table 5: Relationship between perceived smile characteristics and age, gender and smile satisfaction|
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| Discussion|| |
Dental appearance significantly impacts an individual's social, psychological, and career interactions. People with healthy dentitions are perceived to be more socially competent, show greater intellectual achievement, and have better psychological adjustment. With the constant evolution of cosmetic dentistry and minimally invasive procedures, and using what is now known as social media influencers/celebrities to promote different cosmetic dental procedures, public demand for improving dental appearance increased. The overall results of our study showed that the majority of the participants attending a university hospital are satisfied with their smile esthetics (52.4%) and 22% were highly satisfied, however, a significant portion of our sample (90%) were still seeking further improvements of their smile esthetics proving the major impact of social media on the public's perception of dental esthetics. Patients aged 31–35 years were more concerned with their looks, which is a valid concern in their stage of life for seeking job opportunities, looking for suitable partners, and showing more stability in their thought desires. When it comes to self-evaluated dental appearance satisfaction every participant in the society has a different opinion depending on the patient's culture, education, and socioeconomic status, we found a quarter of the participants dissatisfied with their smile (24.8%), and tooth color was the main cause of dissatisfaction (49.3%); as it is one of the major concerns about smile aesthetics in many cultures. However, our participants were satisfied with their dental appearance (52.4%) additionally satisfaction with dental esthetics was positively related to higher educational levels and increased with age with high levels of satisfaction among our participants aged 26–35 years old, however, teeth display in the mirror, photographs, and videos was higher in younger age groups (18–20) and (21–25) years old (P = 0.005) indicating high levels of confidence about their smile esthetics.,,,,
The present study has some limitations that may restrain the generalization of results. The study participants are chosen from a single university hospital; this may limit the study's representativeness and prevent the generalization of these findings to the general population, but it will reduce other interference factors to the research. This study only focused on the influence of PIDAQ. Various other factors might affect people's desire for esthetic treatment;,,,,,,,,,,,,,,,,,,,,,,,,, further study is needed with large samples from the general population to exactly point out the impact of dental esthetics on the psychological well-being of adults.
| Conclusions|| |
An individual's social and psychological well-being is dramatically affected by their dental esthetics. Nowadays, young adults seek perfection and pursue unnecessary esthetic dental treatments. Therefore, more public awareness programs should be directed to educate our community about natural smile esthetics to help them make better choices when it comes to cosmetic dental procedures.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Gavric A, Mirceta D, Jakobovic M, Pavlic A, Zrinski MT, Spalj S. Craniodentofacial characteristics, dental esthetics-related quality of life, and self-esteem. Am J Orthod Dentofacial Orthop 2015;147:711-8.
Bucci R, Rongo R, Amato A, Martina S, D'Antò V, Valletta R. The psychological impact of dental aesthetics in patients with juvenile idiopathic arthritis compared with healthy peers: A cross-sectional study. Dent J (Basel) 2019;7:98.
Bilal T. Self perception and satisfaction with dental esthetics in dental students of Qassim region of Saudi Arabia. Pak Oral Dental J 2016;36(3).
Azodo C, Ogbomo A. Self-Evaluated Dental Appearance Satisfaction among Young Adults. Ann Med Health Sci Res 2014;4:603-7.
] [Full text]
Afroz S, Rathi S, Rajput G, Rahman SA. Dental esthetics and its impact on psycho-social well-being and dental self confidence: A campus based survey of north Indian university students. Journal of Indian Prosthodont Soc 2013;13:455-60.
Akarslan ZZ, Sadik B, Erten H, Karabulut E. Dental esthetic satisfaction, received and desired dental treatments for improvement of esthetics. Indian J Dent Res 2009;20:195-200.
] [Full text]
Heerey EA, Gilder TS. The subjective value of a smile alters social behavior. Journal Plos one 2019;14:e0225284.
Ali DA. Patient satisfaction in dental healthcare centers. Eur J Dent 2016;10:309-14.
] [Full text]
Armalaite J, Jarutiene M, Vasiliauskas A, Sidlauskas A, Svalkauskiene V, Sidlauskas M, et al
. Smile aesthetics as perceived by dental students: A cross-sectional study. BMC Oral Health 2018;18:225.
Baiju RM, Peter E, Varghese NO, Sivaram R, et al
. Oral health and quality of life: Current concepts. J Clin Diagn Res 2017;11:21-2.
Bennadi D, Reddy CV. Oral health related quality of life. J Int Soc Prev Community Dent 2013;3:1-6.
Biazevic MG, Rissotto RR, Michel-Crosato E, Mendes LA, Mendes MO. Relationship between oral health and its impact on quality of life among adolescents. Braz Oral Res 2008;22:36-42.
Bipeta R. Legal and ethical aspects of mental health care. Indian J Psychol Med 2019;41:108-12.
] [Full text]
Mokhtar HA, Abuljadayel LW, Al-Ali RM, Yousef M. The perception of smile attractiveness among Saudi population. Clin Cosmet Investig Dent 2015;7:17-23.
Carolina P, Silvia A, Paulo G, de Goes PSA. Self-esteem and oral health behavior in adolescents. Cienc Saude Coletiva 2019;24:4083-2.
Van der Geld P, Oosterveld P, Van Heck G, Kuijpers-Jagtman AM. Smile attractiveness. Self-perception and influence on personality. Angle Orthod 2007;77:759-65.
Samorodnitzky-Naveh GR, Geiger SB, Levin L. Patients' satisfaction with dental esthetics. J Am Dent Assoc 2007;138:805-8.
Singh VP, Sharma A, Roy DK. Assessment of the self-perception of dental appearance, its comparison with orthodontist's assessment and demand for treatment in eastern Nepalese patients. Adv Med 2014;2014:547625.
Sudhakar N, Vishwanath A. Smile esthetics – A literature review. IOSR J Dent Med Sci 2014;13:32-6.
Klages U, Bruckner A, Zentner A. Dental aesthetics, self-awareness, and oral health-related quality of life in young adults. Eur J Orthod 2004;26:507-14.
Klages U, Claus N, Wehrbein H, Zentner A, et al
. Development of a questionnaire for assessment of the psychosocial impact of dental aesthetics in young adults. Eur J Orthod 2006;28:103-1.
Venete A, Trillo-Lumbreras E, Prado-Gascó VJ, Bellot-Arcís C, Almerich-Silla JM, Montiel-Company JM. Relationship between the psychosocial impact of dental aesthetics and perfectionism and self-esteem. J Clin Exp Dent 2017;9:e1453-e1458.
Paula DF Jr., Santos NC, da Silva ET, Nunes MF, Leles CR. et al
. Psychosocial impact of dental esthetics on quality of life in adolescents. Angle Orthod 2009;79:1188-3.
Mafla AC, Luna EG, Sánchez NR, Barrera DA, Muñoz GM. Dental aesthetics and self-esteem in adolescents. Colombia Médica 2011;42:482-9.
Gupta T, Sadana G, Rai HK. Effect of esthetic defects in anterior teeth on the emotional and social well-being of children: A survey. Int J Clin Ped Dent 2019;12:229-2.
Hass NC, Weston TD, Lim SL. Be happy not sad for your youth: The effect of emotional expression on age perception. PLoS One 2016;11:e0152093.
Janghu D, Dua VS, Mangla R, Khanna MS. Smile esthetics. Indian J Oral Sci 2015;6:1017. DOI: 10.4103/0976-6944.171074. [Full text]
Kaur P, Singh S, Mathur A, Makkar DK, Aggarwal VP, Batra M, et al
. Impact of dental disorders and its influence on self esteem levels among adolescents. J Clin Diagn Res 2017;11:ZC05-8.
Klages U, Erbe C, Sandru SD, Brüllman D, Wehrbein H. Psychosocial impact of dental aesthetics in adolescence: Validity and reliability of a questionnaire across age-groups. Qual Life Res 2015;24:379-90.
Al Taki A, Khalesi M, Shagmani M, Yahia I, Al Kaddah F. Perceptions of altered smile esthetics: A comparative evaluation in orthodontists, dentists, and laypersons. Int J Dent 2016;2016:11. Article ID 7815274.
Thiyagarajan A, Kumar D. Dental esthetics: Perception from future dental professionals”. Acta Scientific Dental Sciences 2018;2:03-5.
Al Awdah AS, Ali BB, Al Twaim S, Al Habdan AA. The Power of Social Media on Esthetic Dental Treatment Choices in Arabian Gulf Region. International Journal of Dentistry and Oral Health 2019;4:2378-0
CAVALCANTI, Sabrina Maciel, VALENTIM, Selva Maria Goncalves, ROSETTI, Elizabeth Pimentel, et al
. Aesthetic perception of gingival smiles. Revista de Oddontologia da UNESP 2018;47:45-0.
[Figure 1], [Figure 2]
[Table 1], [Table 2], [Table 3], [Table 4], [Table 5]