Saudi Children's and Their Parents' Perception of a Digitally Modified Photograph Model of Different Smiles with Different Anterior Teeth Alignments and Dental Appearances.

Aim: Since there is a lack of data on dentofacial esthetic perception in Saudi Arabia, the present research was conducted to study children's and their parent's perceptions of smiles with different dental alignments and dental appearances. In addition, we aimed to determine whether facial attractiveness or dental esthetic dominates the overall esthetic perception. Finally, we aimed to investigate the influence of gender on the judgment of a dental smile.

Materials And Methods: Six digitally altered photographs and two dynamic videos of smiling faces of boys and girls with different dental alignments and appearances were shown to 183 children and their parents in malls in Saudi Arabia's Qassim Province. Following the parent's acceptance of the interview, the child was interviewed first, followed by the parent. Their responses were measured using a smile perception questionnaire (SPQ) for children aged 8-10 years. Data were analyzed using the Kruskal-Wallis one-way analysis of variance (ANOVA) and the Wilcoxon signed-rank test.

Results: The results demonstrated that whole-face smiles of both boys and girls with different poor dentofacial esthetics had a significantly lower rating score than lower third-face smiles scores among children and their parents ( ≤ 0.05). Except for a few views, there were no significant differences between children's and their parents' dentofacial esthetic judgments. Moreover, the answers to the smile perception questionnaire 8-10 for the smiling face dynamic videos of boys and girls were not significantly different.

Conclusion: Children agreed with their parents in judging the smiles of different dentofacial esthetic perceptions. Overall, esthetics was more influenced by facial esthetics than dental esthetics. Background attractiveness and sexual characteristics do not affect smile perception.

Clinical Significance: The smile is considered one of the major determinants of how the overall esthetic of children will appear. Thus, the comprehensive diagnosis involving the analysis of malocclusion and poor dental appearance psychological effect can be used for patient care improvement. Consequently, dental treatment to improve the dental smile will enhance the children's quality of life and social interaction.