Smiling Dimples – Use of a Visual Treatment Objective for Assessment of Preference by Professionals and Laypersons

Abstract Background: The perception that cheek dimples enhance facial aesthetics has resulted in a demand for surgically created dimples. However, dimples may not suit all faces, thus precluding the need for dimple simulators to help patients in decision-making. This study aimed to evaluate and compare the preference for smiling dimples by dental professionals and laypersons using a visual treatment objective (VTO). Methods: Standardized facial smiling photographs (N=36) where gender and facial type were equally represented were digitally modified such that each face had a smile with no smiling dimples, unilateral, and bilateral dimples. Faces were ranked twice by laypeople and professionals for preference of smiling dimples Results: 62.5% of the observers preferred faces with no smiling dimples over faces with a unilateral dimple The odds ratio (OR) was 0.599 (p<0.001), indicating there is a clear preference for faces with no smiling dimples over faces with a unilateral smiling dimple.53.7% of the observers preferred faces with no smiling dimples over faces with bilateral dimples, but there was no clear preference (OR 0.858, p = 0.065), and 52.4% of the observers preferred faces with bilateral smiling dimples over faces with a unilateral dimple (OR 1.103, p = 0.152), but this finding was not significant. The facial type or gender of the scored faces did not affect the dimple preferences. Conclusions: A face without cheek dimples is preferred over a face with bilateral and unilateral cheek dimples by both professionals and laypersons. Facial type and gender play no role in the dimple preference of observers. The use of VTO can help patients visualize the outcome prior to dimpleplasty and make choices accordingly.