Dental aesthetic self-perception, smile satisfaction and associated factors among adults: A cross-sectional study

Introduction: Dental aesthetics self-perception can influence self-confidence and psychosocial well-being, but evidence from Pakistan remains limited. This study examined dental aesthetic self-perception, smile satisfaction, and associated factors among adults in Karachi, Pakistan. Methods: This cross-sectional study was conducted at Liaquat College of Medicine and Dentistry (LCMD) in Karachi from November 2, 2022, to March 21, 2023. Adults residing in Karachi were recruited through an online convenience sample, with the questionnaire link distributed by email and social media platforms. Results: Eight hundred fifty-four individuals participated in the study, comprising 276 males (32.3%) and 578 females (67.7%). Overall, 62.8% of participants were satisfied with their smile, whereas 318 (37.2%) expressed dissatisfaction. A total of 595 (69.7%) agreed that a smile can affect mental, emotional, and social well-being, and 665 (77.9%) believed that smiling alleviates stress. Most respondents (542, 63.4%) agreed that tooth color influences the attractiveness of a smile. Additionally, 335 (39.2%) reported always or sometimes avoiding smiling in photographs. Reported reasons included irregular tooth size or shape (25.4%), yellow or stained teeth (22.7%), misaligned teeth (16.1%), gaps between teeth (8.3%), and other reasons (20%). Gender analysis indicated that more females believed a smile influences their cognitive, emotional, and social well-being (p = 0.032) and the influence of tooth color on attractiveness of a smile (p = 0.034). Binary logistic regression found no significant associations between sociodemographic variables and smile satisfaction. Conclusion: Overall, 62.8% of participants were satisfied with their smiles, and the measured sociodemographic variables were not significantly associated with smile satisfaction. Most participants believed that smiling reduces stress, enhances personality, and reflects confidence. Further studies using probability-based sampling and formally validated instruments are needed to identify clinical, psychological, and contextual factors associated with smile satisfaction.