Perception of Smile Attractiveness Based on Gingival Display and Smile Arc Among Dentists, Dental Students, and Laypersons

ABSTRACT Objective: Smile attractiveness is a multifactorial construct influenced by variables such as tooth alignment, gingival display, and smile arc curvature. Despite growing global research on smile aesthetics, there is limited data from South Asia, particularly Pakistan, that evaluates these features across diverse demographic groups. Methods: A cross-sectional analytical study was conducted among 810 participants in Pakistan, stratified into dentists (n=186), dental students (n=366), and laypersons (n=258). Participants rated digitally modified images depicting varied smile arcs (consonant, reverse, flat) and gingival displays (normal, high, low) using a Visual Analog Scale (VAS). Data were analyzed using two-way ANOVA, Tukey’s HSD, and Chi-square tests to evaluate group differences and demographic associations. Results: Consonant arcs with normal gingival display received the highest attractiveness ratings across all groups, while reverse arcs with high gingival display were rated lowest. The two-way ANOVA indicated significant effects of participant group (p < 0.001) and smile type (p < 0.001) on attractiveness ratings, with an interaction effect (p = 0.005). Chi-square tests revealed significant associations between group, gender, and age distributions. Conclusion: This study provides valuable insights into smile aesthetic perceptions in Pakistan, highlighting the influence of clinical training on aesthetic sensitivity. These findings can guide treatment planning in esthetic dentistry, though future research incorporating cross-cultural analyses and dynamic smile assessments is recommended. Keywords: aesthetics; arch; dental; human; smile