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The Ohio State University College of Dentistry  

    Dr. Stephen Rosenstiel (left) and Dr. Henry Fields

  2. A typical "buccal corridor"

Ohio State Researchers Pursue the Perfect Smile: Findings Published in JADA

November, 2008

College of Dentistry professors Stephen Rosenstiel and Henry Fields have conducted a research study that was recently featured in the prestigious Journal of the American Dental Association (JADA). A premier, peer-reviewed publication that presents the best and most significant research in dentistry, JADA’s articles feature research that has a significant impact on the practice of clinical dentistry, such as the esthetic smile research conducted by Drs. Rosenstiel and Fields.

Dr. Fields, a former president of the Ohio Dental Association (ODA) and the current chairman of the College of Dentistry’s Division of Orthodontics, partnered with Dr. Rosenstiel, the chairman of the Division of Restorative and Prosthetic Dentistry at OSU, to conduct a groundbreaking study in esthetic smile research.

Working with Ohio State orthodontics residents A.J. Ker and Richard Chan, and Professor Emeritus Mike Beck, Drs. Rosenstiel and Fields surveyed 243 individuals from Columbus (Ohio), Boston (Massachusetts), and Seattle (Washington), using an innovative survey method that allowed participants to view images of various smiles, and to manipulate those images on a laptop screen to create what they considered  the “perfect” smile.

The results of the survey were published in a JADA article titled, "Esthetic and Smile Characteristics from the Layperson's Perspective: A Computer-Based Survey Study." Commenting on this research, Fields said, “Dentists have always known that crooked, crowded, and protruding teeth are esthetically undesirable, but we’ve learned from this study that the general population is more tolerant of certain flaws than we expected -- and they’re slightly less tolerant of others.”

Rosenstiel agreed with that statement. “There are a lot of factors to consider in creating an attractive smile,” he said, “but we wanted to better quantify what it means to create the truly perfect or most esthetically pleasing smile -- and we wanted to be highly specific about this.”

Although esthetic smile research has been done for many decades, what is new about this research is that Fields and Rosenstiel have studied the factors that make up the perfect smile, and they can pinpoint right down to the millimeter what survey participants considered attractive or unattractive in an array of smile characteristics.

Some of the esthetic preferences expressed by certain groups of survey respondents surprised Rosenstiel and Fields. For instance, the Seattle, Washington, participants were more accepting of a broad smile than those who were surveyed in Boston and Columbus.

When asked about this variation in smile preference, Rosenstiel said, “That finding was statistically insignificant, so we didn’t focus on it, but we think the ‘Hollywood’ effect might account for that preference.” He added, “When you see popular Hollywood celebrities -- like Julia Roberts, for example -- you notice that her smile is very broad, and that almost all of her teeth are visible when she smiles. And yet that smile is often described as being beautiful.”

Other preferences expressed by survey respondents included a small amount of “buccal corridor,” which is the dark space that’s visible at the edges of the mouth when people smile. Survey participants preferred smiles with very little buccal corridor, and their ratings showed that the amount they were willing to tolerate in an esthetically pleasing smile was minimal.

Asked about the significance of this research and its impact on patients and dentists, Fields and Rosenstiel agreed that these findings will help clinicians to refine their treatment methods so their patients can get a smile they consider to be truly beautiful.

Fields said in closing, “When you examine people’s smiles as minutely as we’ve done in this study, you can make them overly sensitive about the way they look -- but if we apply this research in a smart way, it can help us determine which treatments will give our patients the closest approximation of a perfect smile.”