The Effect of Canine Characteristics and Symmetry on Perceived Smile Attractiveness When Canine Teeth Are Substituted for Lateral Incisors

Abstract

Objectives

To determine the effect of canine tooth characteristics and symmetry on perceived smile attractiveness when maxillary canine teeth are substituted for missing lateral incisors.

Design

Prospective, cross-sectional study.

Setting

Non-clinical study undertaken from Leeds Dental Institute, UK.

Participants and methods

A composite full-face image of a smiling female was used to display various dentitions; a control image with an ‘ideal’ smile, plus six further images substituting the maxillary lateral incisors with canine teeth either unilaterally or bilaterally with varying size, shape, colour and gingival margin level. The seven images were shown to orthodontists (n = 30), dentists (n = 30) and lay people (n = 30) who were asked to rate smile attractiveness using a visual analogue scale.

Results

Dental professionals rated smiles with canine substitution for lateral incisor agenesis to be significantly less attractive than an ideal smile unless the substituted canine teeth approximated the lateral incisor in terms of size, shape, colour and gingival margin. Lay people did not find smiles where canine teeth were substituted for lateral incisors significantly more or less attractive than an ideal smile regardless of the canine tooth characteristics. Dental professionals were significantly more perceptive than lay people to the deviation from ideal smile aesthetics due to canine substitution. Smiles with unilateral canine substitution were not found to be significantly less attractive than bilateral canine substitution by all groups.

Conclusions

Canine characteristics and observer status will affect how canine substitution for lateral incisor agenesis is viewed in terms of aesthetic outcome.