Objective: This study explored the variables that determine self-perception of smile attractiveness in an adolescent sample population.
Methods: An analytical cross-sectional study conducted among 398 adolescents (184 males and 214 females) patients at a dental outpatient clinic in Lagos State, Nigeria between March and December 2019. The subjects were clinically assessed using the Dental Aesthetic Index. Photographs of their frontal posed smiles and intraoral frontal view with teeth in centric occlusion were taken for rating on a visual analog scale (VAS) for self-perception of smile attractiveness and dental aesthetics attractiveness, and objective smile analysis. Data were analyzed with ANOVA and Tukey's post-hoc tests to compare variables among groups based on their self-perceived smile attractiveness. Regression analysis was done with smile attractiveness as a dependent variable to determine predictors of smile attractiveness.
Results: Participants' mean age was 14.17 years (SD + 2.74). Respondents who perceived their smile as unattractive significantly had more severe malocclusion (p = 0.034) and significantly perceived their dental aesthetics as unattractive (p < 0.01) compared to those who perceived their smile to be very attractive. Regression model showed a significant effect of self-perceived dental aesthetics attractiveness and buccal corridor ratio (p < 0.05) on smile attractiveness. The strongest predictor of self-perceived smile attractiveness was self-perceived dental aesthetics attractiveness.
Conclusion: Self-perception of dental aesthetics attractiveness is a strong predictor of smile attractiveness and should therefore be assessed during orthodontic pre-treatment assessment since this can influence patients' satisfaction with treatment results.