Comparison between orthodontist, general dentist, and layperson in the perception of pink esthetics on smile: A cross-sectional study

Smile designing has become an essential part of dental training and a beautiful smile not only adds to the esthetics of the face but also conveys emotions and augments the self-esteem of an individual. A beautiful smile is achieved by well-balanced pink and white esthetics. This study was designed to evaluate the difference in perceptions of orthodontists, general dentists, and laypersons to alterations in gingival characteristics on smile. Smile images were modified intentionally to obtain the desired variations in gingival features such as color and contour of free gingival margins, inflammation, pigmentation, gingival margins with or without recession, zenith, and interdental papilla. A total of 51 images were rated by orthodontists, general dentists, and laypersons using Q sort methodology. Variations in the position of free gingival margin with recession was most negatively ranked gingival factor by orthodontists, general dentists, and laypersons followed by variations in the position of interdental papilla. Position of free gingival margin without a recession, color changes due to pigmentation, and inflammation were moderately ranked. Control images and altered gingival zenith images were most positively ranked. Bilateral changes were perceived more readily compared to unilateral in factors such as a black triangle, zenith position, pigmentation, inflammation, and recession. Orthodontists seem to be less tolerant in their evaluations in comparison to general dentists and laypersons. The findings of this study point toward a crucial fact that smile designing should focus on parameters that are perceived readily by the public in general.