Date of Award

2017

Document Type

Thesis - MUSC Only

Degree Name

Master of Science (MS)

Department

Orthodontics

College

College of Dental Medicine

First Advisor

Jing Zhou

Second Advisor

Ricky Harrell

Third Advisor

Roland Fulcher

Abstract

Objective: Gingival display is one of the numerous factors of smile esthetics that compound into an assessment of smile attractiveness. Verifying a patient’s concerns about esthetics such as gingival display may change the treatment strategy. Many studies have investigated laypeople’s perceptions of gingival display, but none have investigated if perception may be altered through education by the clinician. This study aims to determine if a layperson can independently identify excessive gingival display and to ascertain whether education regarding gingival display implores the patient to identify it. The null hypothesis is that there will be no significant difference of the layperson’s perception of gingival display prior to and following education about it. The intention is to determine if educating a patient about a topic, particularly esthetic attributes and specifically gingival display, alters their perception of that topic. Materials and Methods: An intraoral frontal smiling photograph of a patient with excess gingival display was edited to decrease the amount of gingival display in 0.5 mm increments for a total of 10 photographs. 73 laypeople – 37 in the experimental group and 36 in the control group – rated the randomized photographs on a VAS scale from 0-100 and then ranked them from least to most attractive. The experimental group viewed a PowerPoint presentation about the etiology, appearance, and treatments of gingival display. The control group did not view the PowerPoint and instead was asked to take a break. Both groups subsequently re-rated and re-ranked the same photographs in a different, random order. Results: Only one photograph’s ratings changed statistically significantly between the groups, and there was no major statistical significance in how the rankings changed between the groups for each photograph. The experimental group ranked the photographs with more gingival display lower and those with minimal gingival display higher than the control group. However, when the experimental group’s rankings were evaluated independently, only two photographs were ranked significantly different the second time. These findings indicate that perception of the experimental group was not significantly impacted by the informative presentation. Of the two additional variables investigated, prior orthodontic experience did seem to influence the perception of attractiveness while education level did not. Conclusions: Though the results of this study indicate that the perception of the experimental group was not significantly altered with education, treatment objectives should not be universal. Rather, the treatment plan should be individualized to incorporate patient and provider goals within the parameters of generally acceptable esthetics. Even if educating the patient will not necessarily alter their perception, it is still the moral obligation of the clinician to do so.

Rights

All rights reserved. Copyright is held by the author.

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