Perceptions of patients' smiles - A comparison of patients' and dentists' opinions

Background. Little information has been published regarding the difference between how patients perceive their own smiles and how dentists view them. Methodology. The authors interviewed 78 consecutively seen patients in a general dental practice in Norway about esthetic features of their faces. The patients were not actively seeking esthetic treatment. Patients rated themselves using a 100-point visual analog scale (VAS), and then two dentists (the patients'regular dentist and an independent periodontist), working with photographs of the patients, used the same VAS in rating the patients' smiles. Results. The average age of the patients was 51.2 years (range, 22-84 years). There were 50 women (average age, 51.5 years; range, 22-84 years) and 28 men (average age, 52 years; range, 30-78 years). Patients' satisfaction with their own smiles reached an average of 59.1 (standard deviation [SD], 21.1; range, 5-100) on the VAS. The dentists' scores (38.6 and 40.7) were significantly lower than the patients' scores. The authors observed poor correlation between the periodontist's scores of dentogingival features and the patients' scores. Patients were most satisfied with the gingiva when smiling and least satisfied with tooth shade. Patients younger than 50 years were most satisfied with their smiles. Patients rated teeth and eyes as the most important features in an attractive face. Women gave teeth and hair significantly higher scores and head shape lower scores than did men. Conclusion. Patients' opinions of their own smiles were significantly higher than the two clinicians' assessments of their smiles. Dentists should be aware that patients who seek esthetic services may have different perceptions of their smiles than may patients who do not express such desires.