Smile beyond Borders: Gender, Academic Level, and Contextual Cross‐Cultural Smile Self‐Perception among Preclinical and Clinical Dental Students

OBJECTIVES: Understanding esthetic self-perception among dental students provides insights into how future practitioners view their own smiles and the role of gender and sociocultural context. Incorporating this awareness into dental education may strengthen communication, empathy, and patient-centered care in clinical practice. The objectives of this study were to assess esthetic self-perception among dental students and interns, with emphasis on gender differences, and to contextualize the findings through comparison with published international studies using the same assessment tool. METHODS: A cross-sectional survey was conducted among 207 participants using a structured Smile Satisfaction Index questionnaire. Responses were recorded as "yes" or "no," and scoring was conducted across all items. Esthetic self-perception scores were dichotomized using the median split approach, where scores equal to or below the median were categorized as "high esthetic self-perception," while scores above the median were categorized as "low esthetic self-perception." Descriptive statistics (mean and standard deviation for age, frequencies and percentages for gender and academic level) were calculated, and chi-square tests were applied to assess associations, with significance set at p ≤ 0.05. Cross-cultural perspectives were explored through comparison of the present findings with results from previously published studies conducted in different cultural settings using the same instrument. RESULTS: The mean satisfaction score was 5.64 (median 6). Overall, 63.3% of students reported high esthetic self-perception. Gender differences were significant: females were more likely to conceal their smiles (37.4% vs. 21.2%, p = 0.031), perceive others' smiles as more attractive (83.2% vs. 63.5%, p = 0.003), desire smiles similar to magazine models (52.3% vs. 21.2%, p ≤ 0.001), and report dental or gingival defects (61.3% vs. 40.4%, p ≤ 0.001). Comparison with international cohorts revealed both similarities and differences, suggesting the influence of sociocultural context on smile self-perception. CONCLUSION: The majority of students reported high esthetic self-perception. Female students, however, expressed greater concerns about their smiles, reflecting gender-related differences in self-evaluation. Contextual cross-cultural comparisons with international studies further highlight the influence of sociocultural norms on smile perception, underscoring the importance of integrating gender and cultural awareness into dental education to enhance students' understanding of esthetic self-perception.