377 - Perception of Smile Esthetics in Preschool Children

Perception of Smile Esthetics in Preschool Children, Gollub R, Piscitelli T, Rasmussen L, Hajishengallis E, Magee L, Ratnani, P (University of Pennsylvania and Children’s Hospital of Philadelphia, Philadelphia, PA)

Purpose: To determine if children under the age of six are cognizant of changes in their appearance as it relates to smile esthetics.

Methods: A photo survey was given to parents and children less than six years of age with and without a history of unesthetic dental treatments such as extraction of anterior teeth, silver diamine fluoride (SDF) or stainless steel crown (SSC) placement. 23 children (16 with healthy teeth and 7 with treated teeth) and 21 parents took their respective photo surveys. The survey consisted of five photographs depicting the same mouth modified with healthy, decayed, missing, anterior teeth treated with SDF or posterior teeth restored with SSCs. Parents of children who received unesthetic dental treatment were asked to complete an additional survey asking about the social experiences with their child such as receiving comments from other parents or children as well as their feelings towards treatment outcomes. For the children, answer choices were in the form of very happy, neutral, and very sad faces.

Results: The treatments for which children in both groups felt worse were SDF (70%) and caries (80%). In children with healthy teeth the conditions that bothered them most were caries (84.62%), followed by SDF (64.23%), and SSCs (50%). In children with treated teeth the condition that bothered them most was SDF (83.33%) followed by caries (50%). Only 25% of children in both groups rated missing teeth as being awful. The treatment for which parents of children with and without treated teeth felt worse was SDF (91.3%), followed by caries (84.33%), SSCs (78.57%), and then missing teeth (54.22%). In children with healthy teeth the condition that bothered their parents most was SDF (100%), followed by SSCs (80%), and caries (80%). There was no significant correlation between the parents’ and children’s responses. Our study indicates that children are cognizant about smile esthetics as it relates to dental treatments. For the additional survey the parents of children with treated teeth completed, responses for appearance of their child’s teeth increased from 66.67% to 83.33% following unesthetic dental treatment. 66.67% of parents reported that they or another family member has felt guilty about the child needing dental treatment. None of the parents reported that their child or any family members have been dissatisfied with the dental treatment. The majority of parents say they would have been interested in reading educational material or receiving coping documents when the treatment was completed.

Discussion: This was a pilot study with many limitations. So far, a small number of child and parent dyads have been included in the study; more subjects are needed to show statistical significance and true effects of smile esthetics in children less than six years of age. All children and parents surveyed so far are of low socioeconomic status; data across other socioeconomic statuses are needed to determine applicability among all children. Esthetics differ with culture, so additional studies are needed to account for this effect. The study included children and parents of children who have already received treatment. Although the parents of these children were asked how they felt before the treatment, it would be of interest to survey both children and parents before any treatment is rendered.

Conclusions: Children's appearance, including facial and dental esthetics, may affect social acceptance and thus the psychological and social well-being of the child. As self-awareness starts developing from infancy, it is important that pediatric dentists and parents consider esthetics in their dental treatment decisions.