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Aesthetic dentistry: Changing public perceptions

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Sir, midline diastema is a form of malocclusion and its prevalence reduces with growth (it is present in approximately 98% of 6-year-olds, 49% of 11-year-olds and 7% of 12–18-year-olds).1 Treatment options for permanent diastemas include fixed orthodontic therapy and restorative dentistry.2

People undergo corrective treatments since diastema can impair speech3 and cause problems for neighbouring teeth but usually the need for treatment is mainly attributed to aesthetic and psychological reasons, rather than functional ones. Facial aesthetic perception differs among individuals and is often influenced by their own experiences, and the influence from society and culture.2

Society’s view of diastema is fairly negative for lay people. Furthermore, dental professionals consider the high smile and diastemas to be the least aesthetic.4 This universal negative outlook on diastema makes the individual self-conscious especially as they reach the adolescent years where quality of life is influenced by facial aesthetics through their social interactions. Studies have shown that the correction of midline diastema improves the quality of life among young people by nearly 50%.2

The fashion industry shapes society’s views on modern standards of beauty. Models are a colossal part of changing these standards. Kate Moss singlehandedly changed the accepted beauty standards by allowing a new breed of ‘heroin chic’ models, who were shorter and skinnier, to replace the Amazonian models of the supermodel era of Naomi Campbell and Eva Evangelista.

Lara Stone, Georgia May Jagger and Vanessa Paradis are all extremely successful models with diastema: their defining feature.

If those at the forefront of the fashion industry, the models, relay an image which makes diastema appear as an aspect of beauty which is unique and desirable, perceptions of the malocclusion will consequently change. People may be more accepting of their diastema because it is no longer regarded as a flaw but rather as something that is aesthetically pleasing and accepted as ‘cool’ for the younger generation who look up to them as role models.

I believe it is important for dental professionals to highlight the advantages of not having corrective treatments when going through treatment plans and to encourage patients to see the beauty in their condition and not treat it as a deformity that necessarily needs correction. It may also be helpful to bring patients’ attention to the examples in the fashion industry, helping the individuals with diastema to see their deformity as the ‘norm’. This in turn will transform the public’s perception of diastema, consequently changing the psychological and social problems that people with uncorrected diastema face.


  1. 1

    Campbell A, Kindelan J . Maxillary midline diastema: a case report involving a combined orthodontic/maxillofacial approach. J Orthod 2006; 33: 22–27

  2. 2

    Nagalakshmi S, Sathish R, Priya K, Dhayanithi D . Changes in quality of life during orthodontic correction of midline diastema. J Pharm Bioallied Sci 2014; 6(Suppl 1): 162–164.

  3. 3

    Kumar L N S, Nagmode P, Tambe V, Gonmode S, Mukram Ali F . Midline diastema: treatment options. J Evolution Med Dent Sci 2012; 1: 1262–1267.

  4. 4

    Cracel-Nogueira F, Pinho T . Assessment of the perception of smile esthetics by laypersons, dental students and dental practitioners. Int Orthod 2013; 11: 432–444.

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Anari, S. Aesthetic dentistry: Changing public perceptions.
Br Dent J 223, 390 (2017). https://doi.org/10.1038/sj.bdj.2017.791

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