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Influence of Malocclusions In Development of New Relationships - JPDA

Influence of Malocclusions In Development of New Relationships

 

Muhammad Azeem1                       BDS, FCPS
Muhammad Ansar Bilal2              BDS
Muhammad Ayaz3                         BDS
Arfan Ul Haq4                                 MDS, FCPS, MCPS, BDS

ABSTRACT:

OBJECTIVE: For young adults, dental attractiveness is a key factor that influences social relationships. The objective of present study was to find out the influence of malocclusion in development of new relationships.

METHODOLOGY: In this cross sectional study, photographs of 6 willing young adults (3 boys, 3 girls) were used. Of these, photographs of 2 adults (1 boy, 1 girl) were manipulated (Photoshop, CS3, Adobe System) to produce photographs of different types of orthodontic conditions. A total of 90 evaluator age 20 to 25 years were asked to evaluate these photographs on a questionnaire based on Visual Analog Scale. Data was analyzed using SPSS software (version 21.0).

RESULTS: All malocclusions interfered negatively in development of new social relationships among adults, with inadequate incisal show at smile, being the type of malocclusion that led to the highest level of rejection (P =0.001).

CONCLUSION: All malocclusions interfered negatively in development of new social relationships among adults, with some having more influence than others.

KEY WORDS: Malocclusion; Dental esthetics; Occlusion.

HOW TO CITE: Azeem M, Bilal MA, Ayaz M, Ul Haq A. Influence of Malocclusions In Development of New Relationships. J Pak Dent Assoc 2017;26(4):146-50. DOI: https://doi.org/10.25301/JPDA.264.146

Received: 20 September, 2017, Accepted: 08 November, 2017

INTRODUCTION

Contemporary diagnostic tripod consists of macroesthetics (the face), miniesthetics (the smile), and microesthetics (tooth and gingival shape and form).1-4 In general, the goal of orthodontics is to uplift the patient’s life by enhancing dentofacial functioning and aesthetics.5
From this perspective, the role of orthodontics is analogous to that of several other medical specialties, such as orthopaedics and plastic surgery, in which the patient’s problems often do not result from disease but rather from distortions. Contemporary orthodontics goal is to establish emotional and physical wellness.5 Dentofacial distortions create a disability that can influence physical and mental health. Appropriate treatment can be important for the patient’s well-being.

As per Dion et al.,6 “What is beautiful is good.” The relationship between physical attractiveness and social relationships is already proven.7-9 Adults are especially inclined to start conversations with physically attractive people.10 Many factors related to malocclusion have been reported to affect the perceptions of facial esthetics, namely anterior tooth alignment, tooth shape and position, lip thickness, symmetric gingival or tooth contour, lip profile, overjet, and so on.11-17
Studies have demonstrated that perceptions of facial esthetics influence psychological development.18-19 A teacher’s perceptions of a student’s attractiveness can influence the teacher’s expectations and evaluation of the student.20 Young adults with healthy smiles are considered more attractive, perceived as being more intelligent, and regarded as those with the best social skills.21 However, past research has not shown a possible influence of malocclusion in young adults on the development of new social relationships.22 Therefore, objective of present study was to find out the influence of malocclusion in development of new social relationships among adults.

METHODOLOGY

This cross-sectional study was conducted at Department of Orthodontics, de’Montmorency College of Dentistry and Faisalabad Medial University, from 1-1-2017 to 15-8-2017. Institutional ethical board approval (2015/3074-B) was obtained. A total of 90 young adult patients acting as evaluators, were randomly selected from orthodontic outdoor department and were asked to score the various manipulated full face smiling photographs.

Inclusion criteria of evaluator were: 20 to 25 years of age, irrespective of gender, willing to participate in the study, no history of orthodontic treatment, not student of any medical or dental courses, and having no eye sight issues.

Inclusion criteria of participants’ whose photographs were used and manipulated: 20 to 25 years of age, irrespective of gender, willing to participate in the study, agreed to the manipulation of their smile, gave consent to publish such manipulated photographs, having normal harmonious smile and no previous history of orthodontic treatment. Extraoral full face smiling photographs of six willing young adults were used and included three pictures of boys and three pictures of girls. The pictures of two subjects (1 boy and 1 girl) were manipulated to produce five types of orthodontic conditions: diastema, anterior open bite, crowding, excessive gingival display on smile, inadequate incisal show. The pictures were manipulated using software (Photoshop, CS3, Adobe System) and changes were made at dentition level only to produce malocclusions, so that the face remained unaltered.

This resulted in production of twelve photographs i.e. two normal non-malocclusion photographs (1 boy and 1 girl), ten manipulated malocclusion photographs (5 of boy and 5 of girl). Five manipulated photographs of one willing boy are shown as an example in Figure I.

Figure I: Manipulated smile photographs

Photographs were divided into six group’s i.e. normal non malocclusion, diastema, anterior open bite, crowding, excessive gingival display on smile, and inadequate incisal show photograph group. Since there were six groups of pictures, initially selected 90 evaluators were asked to score each group of photograph.

Before scoring smile, each photograph was accompanied by 5 questions. Questions were: (1) Person with this type of smile attracts you? (2) Would you like to talk with a person with this type of smile? (3) Would you dinner with a person with this type of smile? (4) Would you start a friendship with a person with this type of smile? (5) Would you like to meet with a person with this type of smile, again? After answering these questions, the evaluators were asked to grade smile using a visual analog scale 0-10, 0 for complete disagreement and 10 for complete agreement. At the time of data analysis, only answers directed to the opposite gender were taken in to account.

Data was analyzed using SPSS software (version 21.0). Since data was not normally distributed, scores per photographs were evaluated by means of the Kruskal-Wallis test. Between the groups comparison was made by MannWhitney test. The level of significance was etermined at p < 0.05.

RESULTS

The mean age of the evaluators was 22.2 ± 1.1 years, with 55% being males. (Table I).

Table I: Age and gender distribution
Figure II: Mean scores as per type of malocclusion, in boys.
Figure III: Mean scores as per type of malocclusion, in girls.

In Tables II and III, the answers of boys and girls, respectively, are tabulated with regard to the interest in development of new relationships according to the type of orthodontic conditions. Significant differences were found in the frequencies of replies to all questions asked. (p = 0.001) For both males and females, all smile type had a negative influence in development of new relationships among adults, when compared with the harmonious smile. (Figure II & III)

Inadequate incisal show was the malocclusion that most negatively interfered in the development of new relationships. (Figure II & III)

Gummy smile was the malocclusion that least negatively interfered in the development of new relationships. (Figure II & III)
For boys, inadequate incisal show followed by crowding, was found out to be the orthodontic conditions that most negatively interfered in the development of new relationships. Similarly for girls, inadequate incisal show followed by crowding, was found out to be the orthodontic conditions  that most negatively interfered in the development of new relationships. (Figure II & III)

Table II. Development of new relationships (Replies of boys)
Table III. Development of new relationships (Replies of girls)

DISCUSSION

In today’s world, dental micoesthetics and miniesthetics is highly graded, pointing orthodontists to focus on all aspects of micoesthetics and miniesthetics while treating orthodontic patients.1-3 According to Palomares et al.,23 the eyes are on top followed by smile that draws most attention at a first interaction. Ideal arrangement of teeth is must for attractive smile and this ideal arrangement of the teeth when smiling has an impact on social relations.24-25 In 1985, Shaw concluded that kids with an optimal smile were judged to be more beautiful, desirable as friends, more intelligent, and less likely to behave in an aggressive manner than kids with malocclusions.24

This study was designed to to find out the influence of malocclusion in development of new relationships among adults. To conceive this research, the methodology part was adopted from study ‘Do dental esthetics have any influence on finding a job?’ by Pithon et al,14 with certain modifications. Modifications includes: Questions adopted together with photographs, 6 surveys were applied instead of 2 and separate investigation of influence of each malocclusion perceivable in a front smiling view.22

With regard to malocclusions, the result was that all smile type had a negative influence, which is in agreement with results of previous studies.26-29 For specific types of malocclusions, inadequate incisal show was the malocclusion that most negatively interfered in the development of new relationships; this result may be due to the fact that inadequate incisal show indicates characteristics of aging.30 Gummy smile was the malocclusion that least negatively interfered in the development of new relationships; this result may be explained by the fact that the gingival smile gives women a younger looking appearance.31
The limitation of this study is small sample size; we suggest conducting another multi-centric study of evaluators with larger group size. Because of subjective nature of VAS scores which affects scoring, further studies are suggested to using objective criteria.

CONCLUSION

  • It is concluded that all malocclusions interfered negatively in development of new relationships among adults, with some having more influence than others.
  • Inadequate incisal show was the malocclusion that most negatively interfered in the development of new relationships.
  • Gummy smile was the malocclusion that least negatively interfered in the development of new relationships.

CONFLICT OF INTEREST

None declared

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