SMILE AESTHETICS PERCEPTION ACROSS POPULATIONS: A NARRATIVE REVIEW OF CULTURAL AND PSYCHOLOGICAL INFLUENCES
DOI:
https://doi.org/10.31435/ijitss.3(51).2026.5935Keywords:
Smile Aesthetics, Facial Attractiveness, Aesthetic Perception, Social Perception, Cultural Differences, Cross-Cultural Perception, Psychological Factors, Self-Perception, First Impression, Quality of LifeAbstract
Objectives: The aim of this narrative review was to synthesize the determinants of smile aesthetics perception across different populations, with special emphasis on cultural, psychological, social, and individual influences.
Methods: A narrative literature review was conducted using full-text scientific publications retrieved from the PubMed, Scopus, and Google Scholar databases. Studies published between 1981 and 2026 concerning topics like smile aesthetics, facial attractiveness, aesthetic perception, cultural differences, psychological factors, and social perception were analyzed and organized into thematic categories.
Key Findings: The reviewed literature demonstrated that smile aesthetics perception is influenced not only by objective anatomical parameters but also by observer-related factors. Although tooth symmetry, proportions, smile line curvature, and gingival display remain important determinants of attractiveness, their perception is strongly modulated by cultural background, education, personality traits, self-esteem, and previous experiences. Major differences were observed between dental professionals and laypersons, as well as among populations representing different cultural and ethnic backgrounds. Social media also increasingly shaped expectations regarding the “ideal smile” and contributed to growing interest in cosmetic dental procedures.
Conclusions: Smile aesthetics perception is a complex phenomenon resulting from interactions between biological, psychological, social, and cultural factors. Contemporary aesthetic dentistry should adopt individualized and culturally adapted approaches that integrate objective anatomical analysis with patients’ subjective expectations and psychosocial context.
References
Rossini, G., Parrini, S., Castroflorio, T., Fortini, A., Deregibus, A., & Debernardi, C. L. (2016). Children’s perceptions of smile esthetics and their influence on social judgment. The Angle Orthodontist, 86(6), 1050–1055. https://doi.org/10.2319/102715-722
Verdecchia, F., Bee, M., Lombardo, L., Sgarbanti, C., & Gracco, A. (2011). Influence of anterior tooth alignment on peer perception in 8- to 10-year-old children. European Journal of Orthodontics, 33(2), 155–160. https://doi.org/10.1093/ejo/cjq049
Shaw, W. C. (1981). The influence of children’s dentofacial appearance on their social attractiveness as judged by peers and lay adults. American Journal of Orthodontics, 79(4), 399–415. https://doi.org/10.1016/0002-9416(81)90382-1
Perillo, L., Esposito, M., Caprioglio, A., Attanasio, S., Santini, A. C., & Carotenuto, M. (2014). Orthodontic treatment need for adolescents in the Campania region: The malocclusion impact on self-concept. Patient Preference and Adherence, 8, 353–359. https://doi.org/10.2147/PPA.S58971
Seehra, J., Fleming, P. S., Newton, T., & DiBiase, A. T. (2011). Bullying in orthodontic patients and its relationship to malocclusion, self-esteem and oral health-related quality of life. Journal of Orthodontics, 38(4), 247–256. https://doi.org/10.1179/14653121141641
Willis, J., & Todorov, A. (2006). First impressions: Making up your mind after a 100-ms exposure to a face. Psychological Science, 17(7), 592–598. https://doi.org/10.1111/j.1467-9280.2006.01750.x
Zebrowitz, L. A. (2017). First impressions from faces. Current Directions in Psychological Science, 26(3), 237–242. https://doi.org/10.1177/0963721416683996
Gao, S., Li, Q., He, C., Yan, X., & Yin, Y. (2025). Words or appearance? The impact of verbal behaviour and facial attraction on first impression. Biological Psychology, 200, 109107. https://doi.org/10.1016/j.biopsycho.2025.109107
Akpasa, I. O., Yemitan, T. A., Ogunbanjo, B. O., & Oyapero, A. (2022). Impact of severity of malocclusion and self-perceived smile and dental aesthetics on self-esteem among adolescents. Journal of the World Federation of Orthodontists, 11(4), 120–124. https://doi.org/10.1016/j.ejwf.2022.05.001
Scarborough, L. (2011). Self-perception of smile aesthetics and self-esteem [Thesis or dissertation]. https://doi.org/10.25772/QA3Q-WF64
Machado, A. W. (2014). 10 commandments of smile esthetics. Dental Press Journal of Orthodontics, 19(4), 136–157. https://doi.org/10.1590/2176-9451.19.4.136-157.sar
Rodrigues, C. de D. T., Magnani, R., Machado, M. S. C., & Oliveira, O. B., Jr. (2009). The perception of smile attractiveness. The Angle Orthodontist, 79(4), 634–639. https://doi.org/10.2319/030508-131.1
McLeod, C., Fields, H. W., Hechter, F., Wiltshire, W., Rody, W., & Christensen, J. (2011). Esthetics and smile characteristics evaluated by laypersons. The Angle Orthodontist, 81(2), 198–205. https://doi.org/10.2319/060510-309.1
Sadrhaghighi, A. H., Zarghami, A., Sadrhaghighi, S., Mohammadi, A., & Eskandarinezhad, M. (2017). Esthetic preferences of laypersons of different cultures and races with regard to smile attractiveness. Indian Journal of Dental Research, 28(2), 156–161. https://doi.org/10.4103/0970-9290.207795
Kokich, V. O., Kiyak, H. A., & Shapiro, P. A. (1999). Comparing the perception of dentists and lay people to altered dental esthetics. Journal of Esthetic Dentistry, 11(6), 311–324. https://doi.org/10.1111/j.1708-8240.1999.tb00414.x
Al-Saleh, S. A., Al-Shammery, D. A., Al-Shehri, N. A., & Al-Madi, E. M. (2019). Awareness of dental esthetic standards among dental students and professionals. Clinical, Cosmetic and Investigational Dentistry, 11, 373–382. https://doi.org/10.2147/CCIDE.S224400
Piscoche-Rodríguez, C. D., Zambrano de la Peña, L. S., Guerrero, M. E., Wahjuningrum, D. A., Wahjudianto, N., & Saragih, K. N. (2025). The relationship between self-perception of smile aesthetics and personality traits of university students: A cross-sectional study. Heliyon, 11(3), e42115. https://doi.org/10.1016/j.heliyon.2025.e42115
Mazur, M., Jedliński, M., Westland, S., Piroli, M., Luperini, M., Ndokaj, A., Janiszewska-Olszowska, J., & Nardi, G. M. (2024). Tooth colour and facial attractiveness: Study protocol for self-perception with a gender-based approach. Journal of Personalized Medicine, 14(4), 374. https://doi.org/10.3390/jpm14040374
Samman, M., Tashkandi, A., Alsharif, M., Ashi, H., & Bahanan, L. (2024). User insights into fake snap-on veneers: Perceptions and experiences. Clinical, Cosmetic and Investigational Dentistry, 16, 419–429. https://doi.org/10.2147/CCIDE.S489013
Abbasi, M. S., Lal, A., Das, G., Salman, F., Akram, A., Ahmed, A. R., Maqsood, A., & Ahmed, N. (2022). Impact of social media on aesthetic dentistry: General practitioners’ perspectives. Healthcare, 10(10), 2055. https://doi.org/10.3390/healthcare10102055
Ruiz, M., Kabani, F., & Cotter, J. (2022). A review of the effects of oral health media hype on clients’ perception of treatment. Canadian Journal of Dental Hygiene, 56(1), 31–38.
Melo, M., Ata-Ali, J., Ata-Ali, F., Bulsei, M., Grella, P., Cobo, T., & Martínez-González, J. M. (2020). Evaluation of the maxillary midline, curve of the upper lip, smile line and tooth shape: A prospective study of 140 Caucasian patients. BMC Oral Health, 20, 42. https://doi.org/10.1186/s12903-020-1031-y
Tikku, T., Khanna, R., Maurya, R. P., & Ahmad, N. (2012). Role of buccal corridor in smile esthetics and its correlation with underlying skeletal and dental structures. Indian Journal of Dental Research, 23(2), 187. https://doi.org/10.4103/0970-9290.100424
Fermeiro, M., Costa, L. G., Manso, M. C., Herrero-Climent, M., Gil, J., Brizuela-Velasco, A., & Ribeiro, P. (2025). Influence of incisal embrasures on smile aesthetics. Journal of Clinical and Experimental Dentistry, 17(9), e1129–e1138. https://doi.org/10.4317/jced.62981
Chaves, P. R. B., Karam, A. M., & Machado, A. W. (2021). Does the presence of maxillary midline diastema influence the perception of dentofacial esthetics in video analysis? The Angle Orthodontist, 91(1), 54–60. https://doi.org/10.2319/032020-200.1
Sabri, N. A. B. M., Ridzwan, S. B. B., Soo, S. Y., Wong, L., & Tew, I. M. (2023). Smile attractiveness and treatment needs of maxillary midline diastema with various widths: Perception among laypersons, dental students, and dentists in Malaysia. International Journal of Dentistry, 2023, 9977868. https://doi.org/10.1155/2023/9977868
Geevarghese, A., Baskaradoss, J. K., Alsalem, M., Aldahash, A., Alfayez, W., Alduhaimi, T., Alehaideb, A., & Alsammahi, O. (2019). Perception of general dentists and laypersons towards altered smile aesthetics. Journal of Orthodontic Science, 8, 14. https://doi.org/10.4103/jos.JOS_103_18
Talic, N., AlOmar, S., & AlMaidhan, A. (2013). Perception of Saudi dentists and lay people to altered smile esthetics. The Saudi Dental Journal, 25(1), 13–21. https://doi.org/10.1016/j.sdentj.2012.09.001
Rabe, A. H., Tabchi, Y., Zaoui, F., Faouzi, A. M., & Bahoum, A. (2023). Perception of smile aesthetics between orthodontists and Moroccan patients. Indian Journal of Dental Research, 34(2), 178. https://doi.org/10.4103/ijdr.ijdr_179_22
Mora, M. G., Serna, M. E. V., & Ledesma, A. F. (2015). Perception of smile aesthetics by dental specialists and patients. Revista Mexicana de Ortodoncia, 3(1), e13–e21. https://doi.org/10.1016/j.rmo.2016.03.006
Reddy, H., Singla, R., Singla, N., Natarajan, M., & Singhal, D. K. (2024). Esthetic preferences of orthodontists, general dentists, and laypersons for Indian facial profiles: A cross-sectional study. F1000Research, 12, 953. https://doi.org/10.12688/f1000research.138742.2
Romsics, L., Segatto, A., Boa, K., Becsei, R., Rózsa, N., Szántó, I., Nemes, J., & Segatto, E. (2020). Dentofacial mini- and microesthetics as perceived by dental students: A cross-sectional multi-site study. PLoS ONE, 15(3), e0230182. https://doi.org/10.1371/journal.pone.0230182
Althagafi, N. (2021). Esthetic smile perception among dental students at different educational levels. Clinical, Cosmetic and Investigational Dentistry, 13, 163–172. https://doi.org/10.2147/CCIDE.S304216
Armalaite, J., Jarutiene, M., Vasiliauskas, A., Sidlauskas, A., Svalkauskiene, V., Sidlauskas, M., & Skarbalius, G. (2018). Smile aesthetics as perceived by dental students: A cross-sectional study. BMC Oral Health, 18(1), 225. https://doi.org/10.1186/s12903-018-0673-5
Bolas-Colvee, B., Tarazona, B., Paredes-Gallardo, V., & Arias-De Luxan, S. (2018). Relationship between perception of smile esthetics and orthodontic treatment in Spanish patients. PLoS ONE, 13(8), e0201102. https://doi.org/10.1371/journal.pone.0201102
Al-Bitar, Z., Attari, N., Abu Arqub, S., & Al-Omiri, M. (2025). Analyzing how personality factors influence the perception of smile aesthetics across diverse dental educational backgrounds and lay audiences. Progress in Orthodontics, 26, 52. https://doi.org/10.1186/s40510-025-00599-7
Spyropoulou, G.-A. C., Pavlidis, L., Herrmann, S., Tsimponis, A., Foroglou, P., Delimpaltas, A., Demiri, E., & Cohen, M. (2020). Can cosmetics’ advertisements be an indicator of different perceptions of beauty amongst countries? Aesthetic Plastic Surgery, 44(5), 1871–1878. https://doi.org/10.1007/s00266-020-01679-1
Samizadeh, S., & Wu, W. (2018). Ideals of facial beauty amongst the Chinese population: Results from a large national survey. Aesthetic Plastic Surgery, 42(6), 1540–1550. https://doi.org/10.1007/s00266-018-1188-9
Xu, T.-M., Korn, E. L., Liu, Y., Oh, H. S., Lee, K. H., Boyd, R. L., & Baumrind, S. (2008). Facial attractiveness: Ranking of end-of-treatment facial photographs by pairs of Chinese and US orthodontists. American Journal of Orthodontics and Dentofacial Orthopedics, 134(1), 74–84. https://doi.org/10.1016/j.ajodo.2006.08.023
Mui, P. H. C., Gan, Y., Goudbeek, M. B., & Swerts, M. G. J. (2020). Contextualising smiles: Is perception of smile genuineness influenced by situation and culture? Perception, 49(3), 357–366. https://doi.org/10.1177/0301006620904510
Najarzadegan, F., & Eslamipour, F. (2024). Laypersons’ perception of smile esthetics from different backgrounds. Dental Research Journal, 21, 30.
Ahiaku, S., & Millar, B. J. (2022). Maxillary midline diastemas in West African smiles. International Dental Journal, 73(2), 167–177. https://doi.org/10.1016/j.identj.2022.06.020
Pizzo Reis, P. M., Lima, P., Pimentel Garcia, F. C., & Faber, J. (2020). Effect of maxillary median diastema on the esthetics of a smile. American Journal of Orthodontics and Dentofacial Orthopedics, 158(4), e37–e42. https://doi.org/10.1016/j.ajodo.2020.07.028
Razakova, N., Priede, D., & Artykova, S. (2025). Cross-cultural analysis of smile characteristics, perception, and satisfaction among Latvian and Uzbek young adults: A comparative study. Clinical, Cosmetic and Investigational Dentistry, 17, 641–650. https://doi.org/10.2147/CCIDE.S558771
Liang, L.-Z., Hu, W.-J., Zhang, Y.-L., & Chung, K.-H. (2013). Analysis of dynamic smile and upper lip curvature in young Chinese. International Journal of Oral Science, 5(1), 49–53. https://doi.org/10.1038/ijos.2013.17
Kowalski, J., La Rosa, G. R. M., Cibella, F., Urso, S., Polosa, R., Stefano, A. D., Gangi, D., Pacino, S. A., Pedullà, E., Generali, L., Consolo, U., Checchi, V., Gospodaru, S., Bordeniuc, G., Fala, V., Magrin, G. L., Górska, R., Amaliya, A., Chapple, I., . . . Kim, B. I. (2026). The SMILE study cohort: Baseline comparison of oral health and dental aesthetics among smokers in Italy, Poland, Moldova, and Indonesia. Journal of Dentistry, 166, 106229. https://doi.org/10.1016/j.jdent.2025.106229
Dobreva, D., Gkantidis, N., Halazonetis, D., Verna, C., & Kanavakis, G. (2022). Smile reproducibility and its relationship to self-perceived smile attractiveness. Biology, 11(5), 719. https://doi.org/10.3390/biology11050719
Mannaa, A. I. (2023). Knowledge and attitude toward esthetic dentistry and smile perception. Cureus, 15(9), e46043. https://doi.org/10.7759/cureus.46043
Tin-Oo, M. M., Saddki, N., & Hassan, N. (2011). Factors influencing patient satisfaction with dental appearance and treatments they desire to improve aesthetics. BMC Oral Health, 11, 6. https://doi.org/10.1186/1472-6831-11-6
Vallittu, P. K., Vallittu, A. S. J., & Lassila, V. P. (1996). Dental aesthetics—A survey of attitudes in different groups of patients. Journal of Dentistry, 24(5), 335–338. https://doi.org/10.1016/0300-5712(95)00079-8
Feldmann, I. (2014). Satisfaction with orthodontic treatment outcome. The Angle Orthodontist, 84(4), 581–587. https://doi.org/10.2319/093013-710.1
Kragt, L., Dhamo, B., Wolvius, E. B., & Ongkosuwito, E. M. (2016). The impact of malocclusions on oral health-related quality of life in children—A systematic review and meta-analysis. Clinical Oral Investigations, 20(8), 1881–1894. https://doi.org/10.1007/s00784-015-1681-3
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