Factors influencing social confidence in relation to dental appearance among university students in Bangladesh

Dental appearance may have a significant impact on individuals' self-image and confidence when interacting with others in different social contexts. Hence, the relationship between several psychosocial factors and social confidence among university students in Bangladesh was examined in this study. A total of 534 undergraduate and postgraduate students from one public and two private universities in Sylhet, Bangladesh, were selected through convenience sampling. This cross-sectional study used a structured questionnaire to collect data. Three dimensions related to dental appearance and social confidence were assessed: dissatisfaction with dental appearance, confidence while smiling or speaking, and confidence in social situations. The data were analyzed using descriptive statistics, Chi-square tests, one-way ANOVA, and multinomial logistic regression. Associations were reported as adjusted odds ratios (AORs) with 95% confidence intervals (CIs), and statistical significance was set at p < 0.05. In the adjusted multinomial logistic regression model, STEM students were more likely to have moderate levels of feeling bad about dental appearance (AOR = 2.189, p = 0.032); however, very poor and fair gum health were associated with high levels of feeling bad about dental appearance (AOR = 2.765, p = 0.008; AOR = 1.905, p = 0.007). Reporting no tooth discoloration, no teeth misalignment, not considering orthodontic treatment, and disagreeing with social media comparison were associated with high levels of feeling bad about dental appearance (AORs = 0.258 - 0.476). Additionally, tooth discoloration, orthodontic treatment consideration, social media comparison, and concern about bad breath were associated with confidence-related outcomes (AORs = 0.178-0.430). In the ANOVA, orthodontic treatment consideration and social media comparison were associated with all four outcomes (p < 0.001). However, concern about bad breath was associated only with confidence-related outcomes (p < 0.01). The findings suggest that students' social confidence is influenced by both self-perceived dental appearance and others' social evaluation. Addressing both the psychosocial factors and perceived oral conditions may help improve the social well-being of the students.