Perceptions of Gingival Esthetics: Comparing Dentists, Dental Students and Laypersons

Aim: As smile is a key component of facial expression and esthetic perception is inherently subjective, an appearance deemed esthetic by dentists may not align with patients' expectations, potentially affecting treatment outcomes. This study aimed to compare the esthetic perceptions of dentists, dental students, and laypersons based on different dentogingival conditions.
Material & Methods: An ideal smile photograph of a female subject was obtained under standardized conditions using a DSLR camera. Eight different gingival scenarios were digitally created on the photograph: alterations in gingival margin position, interdental papilla loss, changes in zenith position, gingival contour irregularities, gingival recession, gingival pigmentation, gingival inflammation, and gummy smile variations. Participants ranked the scenarios from most to least esthetic using the Q-sort methodology.
Results: The study was conducted with 150 participants (dentists (n=50), dental students (n=50) and layperson (n=50)) aged between 19 and 59 years. The ideal control image receives the highest esthetic score across all groups. Gingival inflammation and gingival pigmentation are evaluated as the least gingival condition by all participants. No significant differences are observed among the groups regarding changes in gingival margin position or gingival contour (p > 0.05). Gingival recession scenarios are rated significantly more negatively by dentists compared with laypersons (p = 0.004). Gingival inflammation is also perceived significantly more negatively by dental students than by laypersons (p = 0.004).
Conclusion: Dentogingival variations significantly influence esthetic perception, with notable differences observed between dentists, dental students, and laypersons. Understanding these perceptual differences may help clinicians improve treatment planning and patient satisfaction.