Can smile influence the lower anterior vertical facial height on frontal view in an adult Asian female subject? A cross-sectional study

Abstract

Smile is a universal phenomenon, the effect of which is not discovered on the lower anterior facial height (LAFH). The objective of this study was to determine the influence of smile on different LAFH in frontal view as assessed by different panels of raters using visual analog scale (VAS) in a female subject. The frontal photographs (at rest and on smile) were taken at natural head position of a female subject aged 28 years old after taking informed consent. LAFH of the photographs was modified using a Photoshop software (Adobe Systems, San Jose, Calif.). Sixty raters equally divided into orthodontic residents, general dentists, and laypersons were given a VAS to make subjective assessments of facial attractiveness of the modified photographs. Comparison of raters’ scores was done using Kruskal–Wallis and Mann–Whitney U-tests. Wilcoxon Signed-Rank test was used to compare the esthetic scores of the subject at rest and with smile. The mean age of the all raters was comparable (early adulthood). All raters preferred normal or slightly shorter LAFH in both postures, that is, at smile and rest. Similarly, all raters disliked long face modifications. On comparing smile and rest photographs at various LAFH, we found less VAS scores for smile. Gender of raters played no role in difference of VAS scores. All the panels of rater found normal LAFH to be the most attractive; however, the panels disliked long face modifications on both smile and at rest. Smile had no positive influence on the VAS scores as assumed so the effect of “Smiloflage” must be investigated further to understand it properly.