Perception about tooth colour and appearance among patients seen in a tertiary hospital, South-West, Nigeria.

INTRODUCTION: patients´ satisfaction with their dental appearance and tooth colour is often influenced by certain factors which need to be addressed periodically among different populations. METHODS: a self-administered questionnaire consisting of sociodemographic data, questions on patients´ satisfaction with tooth colour, perceived malalignment of teeth, non-aesthetic anterior tooth-coloured restoration and presence of tooth fracture were distributed. Data collected was analysed using Statistical Package for Social Sciences (IBM, SPSS version 20). Chi square was used to test the statistical differences at a significance of p> 0.05. RESULTS: a total of 410 patients (M=147, F=263) participated in the study. About 73% had tertiary education while 36.3% were within the modified ISCO-08 Group 2. The respondents that were satisfied with the general dental appearance and tooth shade were 66.3% and 63.5% respectively. More males (65.1%) than females (62.7%) were satisfied with tooth colour while more females (69.1%) were satisfied with dental appearance. The older age group were more satisfied with dental appearance and tooth colour. Awareness of tooth whitening (Over 80%) and the desire to undergo tooth whitening was more among the post-secondary individuals. More of dental patients (73.1%) than medical (59.2%) were satisfied with teeth appearance (p=0.003). CONCLUSION: patients are increasingly aware of their dental appearance/tooth colour and the need to improve it with tooth bleaching and/or orthodontic treatment. Female were more dissatisfied with their tooth colour but more satisfied with their dental appearance than the male. Older people were more satisfied with their dental appearance and tooth colour compared to younger age group.

Information on teeth whitening from employees at establishments in New York City.

Teeth whitening (bleaching) is a popular cosmetic procedure in the United States and the potential side-effects are well-documented. Establishments offering whitening procedures in New York City were found online and 148 were successfully contacted to inquire about the benefits, side effects, and eligibility criteria of their whitening procedures. Most had no eligibility criteria and the only stated benefit was brighter teeth. Representatives from 25 businesses stated that there were no side effects. About half of the establishments used UV light and employees at these businesses were more likely to state that there were side effects. While limited in its cross-sectional design, this study demonstrates a lack of effective communication by employees regarding the side effects of teeth whitening. Future public health research on this topic would complement existing biological and clinical research.

The effects of at-home whitening on patients' oral health, psychology, and aesthetic perception.

BACKGROUND: The aesthetic self-perception and psychosocial impact of whitening is poorly explored in the literature; it is even less clear whether the effect of whitening may influence the psychology or social relations of patients. Therefore, the aim of this trial is to evaluate the impact of an at-home whitening procedure on patients' quality of life. Also, this study's secondary objective is the adaptation and validation of the Spanish version of the OES questionnaire (OES-SP). METHODS: Fifty eight patients underwent whitening with 10% carbamide peroxide (CP) gel for 1 h daily for 3 weeks. For these participants, the OHIP-Esthetics, PIDAQ, and OES surveys were applied before, one week after, and one month after the whitening procedure. Oral health-related quality of life was measured using the OHIP-Esthetics survey and the psychosocial impact using the PIDAQ survey. The orofacial aesthetics was measured by OES and validated for the Spanish Chilean context. The treatment efficacy (ΔE and ΔSGU) and data from the OHIP-Esthetics PIDAQ and OES surveys were compared using the Wilcoxon Signed-Rank test. RESULTS: The whitening procedure was effective (ΔE = 5.9 ± 1.8). The OHIP-Esthetics results were significant when comparing the initial baseline survey prior to the treatment and one week after whitening (p < 0.001) and when comparing the baseline and one-month results (p < 0.001). The overall score on the PIDAQ, after one week post-whitening, was separated into factors and all factors were statistically significant (p < 0.03); the factors for the one-month results were also all statistically significant (p < 0.001), except the social impact factor. The OES questionnaire had statistically significantly increased scores both one week and one month post-treatment (p < 0.0001). The reliability, validity, and responsiveness of the OES-SP were satisfactory. CONCLUSION: The at-home whitening procedure with carbamide peroxide 10% had a positive effect on patients' oral health-related quality of life, psychology, and aesthetic perception after one month post-whitening. The Chilean Spanish version of the OES showed satisfactory psychometric characteristics to evaluate dental whitening. TRIAL REGISTRATION: NCT02605239 . Date that the study was retrospectively registered: 11-11-2015.

Avaliação do impacto do clareamento dental na qualidade de vida de pacientes adultos / Evaluation of the impact of dental bleaching on the quality of life of adult patients / Evaluación del impacto del blanqueamiento dental en la calidad de vida de pacientes adultos

Objetivo: este trabalho teve como objetivo avaliar o impacto do clareamento dental profissional na qualidade de vida de pacientes. Método: foram selecionados 40 pacientes em tratamento de clareamento dental de consultório com peróxido de hidrogênio a 35%, e que atenderam a critérios específicos de inclusão e exclusão. Para determinar o impacto do clareamento dental na qualidade de vida dos pacientes, foi aplicado o questionário OHIP-14, contendo 14 perguntas divididas em 7 domínios avaliando os aspectos: limitação funcional, dor física, desconforto psicológico, incapacidade física, incapacidade psicológica, incapacidade social e desvantagem social, antes do inicio e 30 dias após finalizado o clareamento dental. Resultados: os escore total do Ohip-14 e dos domínios foram comparados nos dois momentos (antes e após o clareamento), por meio do teste de Wilcoxon, que não mostrou diferencia significante (p<0.05%), para todos os domínios, com exceção do domínio desconforto psicológico no qual foi observado uma diminuição de impacto após o procedimento clareador. Conclusão: o OHIP 14 mostrou que o procedimento clareador favorece a estética dos indivíduos, melhorando sua qualidade de vida e, diminuindo assim, o estresse frente aos impactos psicológicos em sociedade.(AU)

Objective: this study aimed to evaluate the impact of professional tooth bleaching on patients' quality of life. Methods: a total of 40 patients were selected in the treatment of office tooth bleaching with 35% hydrogen peroxide, which met specific inclusion and exclusion criteria. To determine the impact of dental bleaching on patients' quality of life, the OHIP-14 questionnaire was used, containing 14 questions divided into 7 domains assessing aspects: functional limitation, physical pain, psychological discomfort, physical incapacity, psychological incapacity, social incapacity and social disadvantage, before the beginning and 30 days after dental bleaching was completed. Results: the total Ohip-14 score and domains were compared at both time points (before and after bleaching) using the Wilcoxon test, which showed no significant difference (p <0.05%) for all domains, except for the psychological discomfort domain in which a reduction in impact was observed after the bleaching procedure. Conclusion: OHIP-14 showed that the bleaching procedure favors the aesthetics of individuals, improving their quality of life, thus reducing the stress on the psychological impacts on society.(AU)

Objetivo: este trabajo tuvo como objetivo evaluar el impacto del blanqueamiento dental profesional en la calidad de vida de pacientes. Métodos: se seleccionaron 40 pacientes en tratamiento de blanqueamiento dental de consultorio con peróxido de hidrógeno al 35%, y que atendieron a criterios específicos de inclusión y exclusión. Para determinar el impacto del blanqueamiento dental en la calidad de vida de los pacientes, se aplicó el cuestionario OHIP-14, conteniendo 14 preguntas divididas en 7 áreas evaluando los aspectos: limitación funcional, dolor físico, incomodidad psicológica, incapacidad física, incapacidad psicológica, incapacidad social y desventaja social, antes del inicio y 30 días después de finalizado el blanqueamiento dental. Resultados: los puntajes totales del Ohip-14 y de los dominios fueron comparados en los dos momentos (antes y después del blanqueamiento), por medio de la prueba de Wilcoxon, que no mostró diferencia significante (p <0.05%), para todos los dominios, excepción del dominio de incomodidad psicológica donde se observó una disminución de impacto después del procedimiento blanqueador. Conclusión: el OHIP-14 mostró que el procedimiento blanqueador, favorece la estética de los individuos mejorando, su calidad de vida disminuyendo así el estrés frente a los impactos psicológicos en sociedad.(AU)

Changes in Quality of Life Induced by Tooth Whitening are Moderated by Perfectionism: A Randomized, Double-Blind, Placebo-Controlled Trial.

PURPOSE: To explore the influence of perfectionism on the short-term changes in satisfaction with smile esthetics and quality of life (QoL) induced by tooth whitening. MATERIALS AND METHODS: A total of 60 subjects were analyzed: 30 in the active group, in which the subject's anterior teeth were whitened with a photoactivated gel, and 30 in the placebo group. The Smile Esthetics-Related Quality of Life and Multidimensional Perfectionism Scale questionnaires were administered to all participants. RESULTS: The active group demonstrated an increase in dental self-confidence and a decrease in dissatisfaction with color (P < .05). The amount of color change did not correlate linearly with change in dissatisfaction or with QoL. In subjects with higher perfectionism, increasing the color change led to more decrease in dental self-consciousness. CONCLUSION: Perfectionism moderates perception of smile esthetics.

Investigation of the perceptual thresholds of tooth whiteness.

OBJECTIVE: To investigate the tooth whiteness perceptibility thresholds of the average observer to changes in the CIELAB values and an optimised whiteness Index for dentistry (WIO) based on psychophysical studies. METHODS: A psychophysical experiment based on visual assessments of digital images of teeth on a calibrated display with a group of observers (n=32) has been conducted to determine the perceptual thresholds in tooth whiteness. Digital simulations of a tooth that is identical in shape to the left incisor in the image of teeth were superimposed on to images. The colour of the simulated tooth was varied and observers were asked to respond whether there was a difference in whiteness between the left incisor and the simulated tooth. Thresholds for detection of differences in whiteness were independently determined in four conditions: ΔL*, Δa*, Δb* and a blue optical whitening direction. Raw data were fitted using a non-parametric approach and thresholds of CIELAB and WIO for each conditions were calculated. RESULTS: Estimates of the threshold of the four conditions of ΔL*, Δa*, Δb* and a blue covarine optical tooth whitening direction were 1.14, 3.24, 1.11 and 1.51 respectively, with the corresponding WIO thresholds of 2.77, 6.52, 3.09 and 1.99 respectively. CONCLUSIONS: The thresholds for tooth whiteness perception in CIELAB space and WIO space were determined. The findings demonstrate that for a whitening treatment with a blue covarine optical technology, a colour change of about 2 WIO units would be noticeable. CLINICAL SIGNIFICANCE: This study gives a better understanding of the tooth whiteness perception threshold, and will help clinicians identify perceivable differences in tooth colour during matching and whitening procedures.

Effectiveness and Impact of the Walking Bleach Technique on Esthetic Self-perception and Psychosocial Factors: A Randomized Double-blind Clinical Trial.

OBJECTIVE: This trial evaluates the impact of psychosocial and esthetic self-perceptions of patients undergoing nonvital tooth bleaching using the walking bleach technique. We also assessed the clinical effectiveness of bleaching tooth discoloration. METHODS: Fifty volunteers with nonvital tooth discoloration were enrolled. Teeth were randomized into two groups: 35% hydrogen peroxide (n=25) and 37% carbamide peroxide (n=25). Intracoronal bleaching was performed over four sessions using the walking bleach technique. Tooth color was evaluated at each session to measure total color variation. The shade guide was arranged from highest (B1) to lowest (C4) values to assess the color and calculate the color change in the number of shade guide units. Subjective and objective assessments were compared with the tooth counterpart. Esthetic self-perception and psychosocial factors were assessed before and after treatment. RESULTS: Color change was 15.48<5.17 for hydrogen peroxide and 14.02<4.85 for carbamide peroxide. There was no significant difference at any time point (p>0.05) except at sessions 3 and 4 (p<0.05). Overall, whitened teeth values were similar to those of counterpart teeth (p>0.05). There was a decrease in Oral Health Impact Profile and Psychosocial Impact of Dental Esthetics questionnaire scores after treatment compared with baseline (p<0.05). CONCLUSION: The walking bleach technique was highly effective on nonvital teeth and had a positive effect on self-esthetic perception and psychological impact for the patients.

Tooth colour and whiteness: A review.

OBJECTIVES: To review current knowledge concerning the application of colour science on tooth colour and whiteness description, measurement, distribution and its psychological impact. DATA SOURCES: "Scopus" databases were searched electronically with the principal keywords tooth, teeth, colour, white, whiteness. Language was restricted to English and original studies and reviews were included. Conference papers and abstracts were excluded. CONCLUSIONS: The appearance and colour of teeth are a common concern for patients across many populations and are associated with an increased desire for treatments that improve dental aesthetics, including tooth whitening. The application of colour science in dentistry has allowed the precise description of tooth colour and whiteness. Coupled with the advances in instrumental tooth colour measurement, such as spectrophotometers, colorimeters, spectroradiometers and digital imaging systems, these parameters are quantifiable in a reproducible and robust manner. These principles have been applied to the tooth colour distribution in many study populations, indicating, in general, differences in tooth colour for subject age and gender, but not for ethnicity. Psychophysical studies on tooth colour and whiteness via third party assessment of images indicate that whitened teeth lead to judgements that are more positive on personality traits such as social competence and appeal, intellectual ability and relationship satisfaction.

Longevity, Esthetic Perception, and Psychosocial Impact of Teeth Bleaching by Low (6%) Hydrogen Peroxide Concentration for In-office Treatment: A Randomized Clinical Trial.

OBJECTIVE: The aim was to evaluate the color longevity after nine months of in-office bleaching with gel (6% hydrogen peroxide), to compare this to a control concentration of 35% in a split-mouth study model, and to assess the dental confidence and psychosocial impact on patients. METHODS AND MATERIALS: Twenty-seven patients were assessed at the nine-month recall. The bleaching procedure with 6% or 35% hydrogen peroxide gel was performed randomly in the upper hemi-arch of each patient. The color was measured at baseline and at one week, one month, and nine months after the procedure, using the Vita Easyshade spectrophotometer, the Vita classical shade guide organized by value, and Vita Bleach Guide 3DMaster. Moreover, two surveys, OHIP-Esthetics and PIDAQ, were used to assess the esthetic self-perception and psychosocial impact of the bleaching procedure. During the nine-month recall, the color was assessed before and after dental prophylaxis. RESULTS: Twenty-seven patients participated in the nine-month recall. There was a significant difference in ΔE between the two groups at all times assessed (p<0.011). The ΔL, Δa, and Δb showed a difference between the two groups at all times assessed (p<0.038), except for ΔL from the baseline vs nine-month after prophylaxis value (p>0.20). There was no significant difference in ΔSGU at all times (p>0.05). There was a significant difference in OHIP-Esthetics and PIDAQ sums compared with baseline scores (p<0.03). CONCLUSION: The two compounds remained effective at nine months, with a slight rebound of color, and maintained their objective color difference but not the subjective color difference. Patients were satisfied with the bleaching procedure, and this had a positive impact on esthetic perception and a positive psychosocial impact at the nine-month recall.

Is personality relevant in the choice of bleaching?

OBJECTIVES: The purpose was to administer the NEO-FFI personality test to patients who did and did not want to have their teeth bleached and before and after bleaching to the participants who accepted the treatment. The research question is to correlate styles and personality factors with bleaching. MATERIALS AND METHODS: There were 128 patients eligible for bleaching; 58 accepted (AB) while 70 refused (RB). The test was administered to both groups (AB-RB). The group AB was administered before and 1 week after the end of the bleaching. For each personality domain comparison, the Mann-Whitney test was used. For the group AB, the results for each domain before and after bleaching were compared using the Wilcoxon test. RESULTS: There was a significant difference between the groups (AB-RB) in the extraversion factor (p = 0.01). There was no significant difference between any of the personality items before and after bleaching (p > 0.1). The comparison between groups by sex revealed significant differences in extraversion and neuroticism factors. Males who AB scored higher in extraversion than males who RB (p < 0.05). Females scored higher in neuroticism than males who AB (p < 0.05). CONCLUSIONS: There were personality differences between people who decided to bleach compared with those who did not want the bleaching, which was mainly in the extroversion factor. This stereotypes the patients, who could be described as more sociable, extroverted, and concerned about esthetics and cleanliness. The bleaching protocol, however, cannot modify any of the personality factors. CLINICAL SIGNIFICANCE: It is important to understand a patient's behavior to meet their needs and to determine the type of patients who would like to have their teeth bleached.

Perception of dental esthetics: influence of restoration type, symmetry, and color in four different countries.

In this study, the influence of restoration type, symmetry, and color on the perception of dental appearance was evaluated. An esthetic questionnaire was completed by 29 patients before and after esthetic rehabilitation. In addition, 94 dentists from four countries (Germany, the United Kingdom [UK], China, and Switzerland) evaluated the influence of the above factors using before-and-after rehabilitation pictures. The most invasive treatment was recommended by Chinese dentists, while German, Swiss, and UK dentists recommended comparable treatment options. As for restorative symmetry, restoration type, and color, significant differences could be found among and within the dentists of the four countries (P ± .05).

Treatment responses to tooth whitening in twins.

The aim of this study was to determine heritability estimates of treatment responses to a 10% hydrogen peroxide strip-based whitening system in twins. Eighty-five twin pairs were randomly assigned to 10% hydrogen peroxide whitening strips or placebo strips without peroxide. Both twins (monozygotic or dizygotic) received the same treatment. Maxillary teeth were treated for 30 minutes twice daily for 7 days. Efficacy was measured objectively as L* (light-dark), a* (red-green), and b* (yellow-blue) color change from digital images at baseline (∆) and day 8. Heritability estimates for tooth whitening treatment responses for changes from day 8 to baseline were obtained using variance-component methodologies. Whitening treatment responses were highly heritable (h(2) = 71.0) for ∆b* and ∆a*(p < .0001), but not for ∆L* (h(2) = 27.0), which was essentially modulated by environmental factors. This study has demonstrated that both genetic and environmental factors significantly contributed to seven-day whitening treatment responses achieved with 10% hydrogen peroxide strips.

Changes in oral health related quality of life after dental bleaching in a double-blind randomized clinical trial.

OBJECTIVES: This study aimed to assess changes in oral health-related quality of life (OHRQoL) in individuals enroled in a double-blind randomized clinical trial conducted to evaluate the efficacy and safety of two carbamide peroxide concentrations used in at-home vital bleaching in the city of Pelotas, Southern Brazil. METHODS: Ninety-two volunteers with a shade mean of C1 or darker for the six maxillary anterior teeth were randomized into two balanced groups (n=46) according to bleaching agent concentration: 10% or 16% carbamide peroxide. The patients were instructed to use the whitening agent in a tray for 2h once a day for three weeks. To assess changes in OHRQoL, participants completed the oral impact on daily performance (OIDP) at the start and one week after the completion of treatment. Because there was no difference with regard to whitening effect or tooth sensitivity during or after treatment the two groups were merged for the analyses of the current article. Before-and-after changes in OIDP scores were assessed by chi-square and McNemar tests (p<0.05). RESULTS: Mean pre- and post-treatment OIDP scores varied from 0.42 to 0.60. When the frequency of impacts for different activities were compared, there was an increase in difficulty in cleaning teeth (p=0.02) and a significant reduction in smiling and showing teeth with embarrassment (p=0.03). Regarding the symptoms and main oral conditions that generated impact, there was higher number of participants reporting pain (p=0.05) after treatment. In opposite, significant decrease was observed in individuals reporting being unhappy with their appearance (p=0.03). On the contrary, it was showed a decrease in impacts resulting from dental colour was observed after bleaching (p=0.03). CONCLUSION: Quality of life is complex and encompasses different domains. Although positive impact of the dental bleaching was detected, with patients showing more their teeth without embarrassment, difficult in dental hygiene and pain resulting from the treatment were also reported, and this can negatively impact daily performances. Dentists must consider these aspects when performing aesthetics procedures.

Vital tooth whitening effects on oral health-related quality of life in older adults.

PURPOSE: The purpose of this study was to determine if vital tooth whitening affects oral health-related quality of life (OHRQOL) in adults age 50 years and older, and if tooth whitening causes increased participation in social activities. METHODS: Using a 2 group, single blind, randomized, pre-test, multiple post-test design, 62 participants were enrolled. The experimental group used a whitening product twice daily for 3 weeks. The control group used no whitening products. The Oral Health Impact Profile (OHIP) served as the pre- and post-test measure. The OHIP measures OHRQOL on 7 subscales: functional factors, psychological disabilities, psychological discomforts, physical disabilities, social disabilities, handicaps and physical pain. Additional questions measured the subjects' social activities at baseline, 3 weeks and 3 months. Data from 53 participants, who completed the study, were analyzed using paired t-tests and ANOVA at p=0.05. RESULTS: Statistical significance was observed for the OHIP physical pain subscale (p=0.0029) and the handicap subscale (p=0.05). Pre- to post-test means of the physical pain subscale increased in the experimental group (4.84 to 7.10), suggesting a lower OHRQOL, most likely related to tooth sensitivity experienced by the experimental group. Means from pre- to post-test of the handicap subscale (1.96 to 1.19) reveal that the experimental group reported an improved OHRQOL and felt they were more willing to work. Repeated measures ANOVA and Tukey's post-hoc tests revealed that the experimental group reported significantly less (p=0.04) social activities at the 3 month post-test (3.92 to 3.45). No statistically significant between-group differences were observed in the overall OHIP score for functional factors, psychological disabilities, psychological discomforts, physical disabilities and social disabilities. CONCLUSION: Results indicate that vital tooth whitening does not improve overall OHRQOL in older adults.

Comparison of two at-home whitening products of similar peroxide concentration and different delivery methods.

PURPOSE: This study compared the whitening efficacy, side effects, and patients' preferences/perceptions of two whitening systems of similar peroxide concentration but different formulation and delivery methods. METHODS: The tooth color change of 24 participants was measured using a shade guide (BSG) and a spectrophotometer (ES). Color difference was calculated: ΔE* = [(ΔL*)(2) + (Δa*)(2) + (Δb*)(2)](1/2). One whitening treatment was randomly applied to the right or left maxillary anterior teeth and the other was applied to the contralateral teeth, at-home with 35% carbamide peroxide in a tray (TW) or with 14% hydrogen peroxide in strips (WS). The tooth color was evaluated at baseline, 15 and 30 days (15 days postwhitening). Participants rated their tooth and soft tissue sensitivity (1-10 scale) and completed a questionnaire on their preferences. Results were analyzed by repeated measurement regression analysis/Tukey and Mann-Whitney (p<0.05). RESULTS: At 15 days, the teeth treated with TW and WS presented ΔE* = 7 and 6, respectively (ΔBSG=3 for both), and at 30 days, they presented ΔE* = 7.5 and 6.5, respectively (ΔBSG=3 for both). There was no significant difference in tooth and soft tissue sensitivity between treatments. No participant reported tooth and gingival sensitivity at the postwhitening appointment. Of the participants, 83% preferred the TW over WS. CONCLUSION: Both ΔE* and ΔBSG showed no significant difference in tooth color change between TW and SW at either time point. By the end of the study no participants reported tooth and gingival sensitivity. Participants preferred TW over SW.

Patients' perspective on dental aesthetics in a South-Eastern European community.

OBJECTIVES: To assess the importance attributed to dental aesthetics by subjects from a Romanian community. In addition, the role played by dental color, the group-distributions based on the self-evaluation of dental color and the previous experience regarding whitening treatments are analysed. METHODS: A multiple-choice questionnaire was administered to 540 patients in dental offices in Cluj-Napoca, Romania; the subjects were also asked to self-evaluate their dental shade, using a set of images as a comparison. Answers to the questionnaires were statistically analysed using Microsoft Excel and SPSS 13.00 (Pearson's chi-square test, Fisher's exact test, Kendall's tau b). RESULTS: From the participants, 17.96% were motivated by aesthetic reasons to ask for treatment; most of the patients evaluated their smile as "acceptable" (38.51%) or "having some defects" (29.44%) and were self-included in groups of medium and dark shades (33.7% and 33.89%, respectively). Whilst 22.40% of the subjects considered the dental color as being the most evident defect of their dentition, 39.07% indicated a self-perception of "an abnormal dental shade". A strong correlation between darker self-assessed tooth color-groups and the self-perception of an abnormal tooth color was found (Chi square p≪0.001, Kendall's tau-c=0.44, with p≪0.001). Previous whitening treatments were reported by 8.88% of the subjects. CONCLUSIONS: Among patients who wanted to improve one of their oral functions, the majority requested changes in aesthetics. Dental shade is one of the aspects recognized as problematic by the participants, but nonetheless the percentage of patients who had previously benefited by whitening treatments was moderate.

Tooth bleaching and young adults in Nigeria: knowledge, experiences and intention.

OBJECTIVE: To assess the knowledge, experiences and intention to have tooth bleaching among young adults studying in a Nigerian University. MATERIALS AND METHODS: A cross-section of part-time undergraduate students of University of Benin, Benin City, Nigeria were studied in 2010 using a self-administered questionnaire. RESULTS: About three-quarters 289 (72.4%) of the respondents reported awareness of at least one cause of tooth discoloration. A total of 143 (35.8%) of the respondents have heard of tooth bleaching with main sources of information being friends/relatives, dentists and the internet. One-third 132 (33.1%) of the respondents correctly identified that the aim of tooth bleaching was to make the teeth whiter. The respondents that had correct knowledge about mechanism, duration and complications of tooth bleaching were 51 (12.8%), 25 (6.3%) and 35 (8.8%) respectively. The major perceived benefits of tooth bleaching reported by the respondents were self confidence boost 152 (38.1%) and improvement of one's beauty 107 (26.8%). Out of the 68 (17.0%) respondents that have attempted tooth bleaching, 36 (52.9%) used tooth whitening toothpaste. Out of the 151 (37.8%) respondents that expressed intention of having tooth bleaching procedure, 32 (21.2%) would pursue the course, no matter the cost. CONCLUSION: In the studied population, knowledge of tooth discoloration was high, awareness and experiences of tooth bleaching were low but significant number expressed intention of having tooth bleaching. It is important that dentists increase oral health information particularly tooth bleaching information accessibility to the young adult population to improve the knowledge and prevent adverse effects.

Factors influencing patient satisfaction with dental appearance and treatments they desire to improve aesthetics.

BACKGROUND: We assessed factors influencing patients' satisfaction with their dental appearance and the treatments they desired to improve dental aesthetics. METHODS: A cross-sectional study was performed out among 235 adult patients who visited the Hospital Universiti Sains Malaysia dental clinic. A structured, interviewer-guided questionnaire was used to identify patient satisfaction with their general dental appearance, cosmetic elements and desired treatments. RESULTS: The 235 patients consisted of 70 males (29.8%) and 165 females (70.2%), of mean age 31.5 years (SD 13.0). Of these patients, 124 (52.8%) were not satisfied with their general dental appearance. In addition, 132 patients (56.2%) were not happy with the color of their teeth, 76 (32.3%), regarded their teeth were poorly aligned, 62 (26.4%), as crowded and 56 (23.4%) protruded. Dissatisfaction with tooth color was significantly higher in female than in male patients (odds ratio [OR] of 1.99 (95% confidence interval [CI] 1.13-3.50). Tooth whitening was the treatment most desired by patients (48.1%). Results of multiple logistic regression analysis showed that patient dissatisfaction with general dental appearance was significantly associated with female gender (OR = 2.18; 95% CI: 1.18-4.03), unhappiness with tooth color (OR = 3.05; 95% CI: 1.74-5.34) and the opinion that their teeth protruded (OR = 2.91, 95% CI: 1.44-5.91). CONCLUSIONS: Most patients in this study were not satisfied with their dental appearance with a greater percentage of females expressing dissatisfaction than males. An age was not associated with satisfaction. Unhappiness with tooth color and feelings of having protruding teeth also had a significant negative influence on patient satisfaction with general dental appearance.