Background. The authors conducted a study to determine whether variations in skin color would influence perceptions of smile attractiveness for a given tooth shade value.
Methods. Using a photograph of a woman smiling, the authors altered skin color to consist of four tones (fair, fair/medium, medium/dark and dark) and altered tooth shade value (brightness) to range from 00 (brightest) to 05 (darkest). Two groups of judges (70 dentists, 70 laypeople) completed a questionnaire and rated the images for smile attractiveness.
Results. For most tooth shade values (00, 01, 03, 04, 05), multiple mixed linear regression showed that variation in skin color influenced respondents’ perceptions of smile attractiveness (P < .001). For images corresponding to tooth shade values 01, 02, 03, 04 and 05, men provided lower ratings than did women (P < .05). Attractiveness ratings increased with the age of participants (P < .05). Dentists rated images higher than did laypeople (P < .05).
Conclusion. Variation in skin color for most tooth shade values influenced dentists’ and laypeople’s perceived smile attractiveness.
Clinical Implications. Dentists and laypeople did not perceive the brightest tooth shade to be the most attractive, and they did not perceive all skin colors to be equally attractive with bright white teeth. Respondents perceived dark skin with bright white teeth and fair skin with dark teeth as relatively unattractive.
