Using the Smile Index to comparatively analyze the self-perceived esthetics, orthodontic awareness and treatment need amongst dental students

• Author Details:   
• Uday Kumar Digumarthi
• Ram Prakash

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Introduction: Esthetic cognition is an interactive heuristic process molded by numerous personal and social influencing factors. The self-perceived need of orthodontic treatment and acceptance of a clinician’s judgement although related to orthodontic awareness is influenced by factors directly or indirectly related to self-perceived esthetics.

This study aimed to emphasize the importance of obtaining candid responses regarding orthodontic awareness, self-perceived esthetics, and the overall desire for treatment. Utilizing the SMILE Index, a verbally assigned assessment tool, the research seeks to provide clinicians with valuable treatment safety scores, ensuring a more personalized and effective approach to patient care.

Objectives: The main objective of this study was to elicit unbiased opinions from the adolescents without any form of coercion to ascertain the true willingness or reluctance towards orthodontic treatment using an index to categorize the safety score of handling such patients based on their responses.

Materials and Methods: A purposive sample of 122 dental students with normal growth and development were enrolled in this clinical screening study after obtaining their consent and with the clearance of the ethical clearance committee. During the assessment of malocclusion-related factors, students were also evaluated using the verbally assigned Simplified Malocclusion Index for Layperson Evaluation (SMILE Index, Digumarthi & Prakash, 2022), providing an accessible and structured approach to understanding orthodontic concerns to elicit candid responses related to the three evaluation parameters of orthodontic awareness, self-perceived esthetics and orthodontic treatment need. Details related to malocclusion and the responses to the SMILE Index were tabulated in Microsoft Excel and subsequently subjected to statistical analysis.

Results: A SMILE Index based analysis of those dental students with clinically ascertained malocclusion revealed that 66.66 % boys and 74.03 % displayed orthodontic awareness and 55.55% boys and 69.23% girls displayed self-perceived esthetics. 27.77% of the boys and 31.73% of the girls screened felt a need for orthodontic treatment Based on the SMILE index scores it was seen that the highest was with score V as in patients who are difficult to treat unless extensively counselled (47.54%) followed by Score III (20.49%) as in patients who are moderately safe and easy to handle.

Conclusion: The informed consent of an adolescent in reality requires appropriate information to be provided to condition the conviction of a decision made by the young patient. The SMILE Index helps analyze the patient’s willingness for treatment without any form of coercion or bias from either the parent/guardian or the clinician by eliciting appropriate only candid responses and analyzing these responses. The SMILE Index also highlights the degree of safety in taking up a case for treatment based on the score.