Dental Aesthetic and Self Confidence among Filipino Adolescents Alarcon, Glen Paula Ocampo, Rodelando

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1 Dental Aesthetic and Self Confidence among Filipino Adolescents Alarcon, Glen Paula Ocampo, Rodelando ABSTRACT This study investigates the dental appearance and self confidence of Filipino adolescents. Mixed method design was used to identify their real life conceptual understanding, multi-level perspectives and cultural influences. A purposive sample of 319 male and female Filipino adolescent respondents were administered the Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ). PIDAQ surveys the patient's dental confidence (five items), social impact (nine items), psychological impact (five items), aesthetic concerns (four items) and patients belief (six items). Paired sample T-test was used to determine the results of participants in the first to fourth category of the questionnaire. Interview responses revealed that the treatments they went through boosted their confidence and self esteem. While those who were undergoing their treatment said that with every visit to the dentist, they get better and better in terms of self confidence. Also others are more comfortable with speaking and less conscious and insecure. Some respondents became more sociable and got a lot of good compliments. Keywords: Dental Aesthetic, Self Confidence, Psychosocial Impact of Dental Aesthetic Questionnaire Everyone has their own opinion on what they think is attractive. What is attractive is usually influenced by the people they surround themselves with. The influence may come from their close friends, or through the people they look up to, can affect their perception of what is attractive. Thus, having their own standards, people tend to squirm at the sight of what they perceive is attractive to them. That s where the term beauty premium is coined. When people squirm at the presence of an attractive individual, they tend to just agree, they couldn t think straight (Rosenblat, 2008). Modern society made people conscious of what they look like, making the generation today focus more on what is popular this is because media influences the self-confidence of an individual's perception to a higher degree about what is attractive. They feature what are the most popular trends of the season. With that, people try to change their appearance based on the trends up to date, while judged by others who did them wrongly. Some people try so hard to turn into perfection that the society draws, by turning into cosmetic surgery. People who have money go under the needle to reform or fix a part of their body. (Sung, 2005) One of the things they look at the mirror is their face then their mouth (Van Der Geld, 2007). Not everyone is blessed with a perfect occlusion. They find dissatisfaction with their teeth or malocclusion. Many desire to whiten and have better alignment of their teeth. Self confidence is very important in every aspect in life, especially in becoming successful. There are a lot of factors which can alter one s self confidence. Someone with strong understanding and perception of one s ability cannot be put down easily. However, those who have low self confidence can be put down easily. Individuals comparing themselves to someone they perceive is better than them may decrease their self confidence. Some upgrade their material things like in gadgets, cars, clothes and etc. While others focus on their physical appearance like on their hair, nose, in makeup and dental aesthetics. A study on the association of dental caries and weight status was conducted to Filipino children to investigate the association between the variables. The results were that underweight 7

2 children were more associated with socioeconomic and demographic conditions. However, underweight and dental caries are public health issues that affect children in important phases of development. (Heinrich-Weltzien, Monse, Benzian, Heinrich & Kromeyer-Hauschild, 2012) Cultural belief, values and practices are often intertwined with the causes of diverse oral health. However, no adequate literature supports these cultural beliefs and practices. A research on different literatures throughout different ethnic groups was conducted by Butani, Weintraub & Barker. In the Philippines, very little published information about oral health beliefs or practices was available. A finding in which that parents (mostly the mother) fear dental treatment without anesthesia and personal negative experiences in the dental office prevented them from seeking care for their children. Among the people in poverty line, the cost is the most common reason for not seeking professional dental care. (Butani, Weintraub & Barker, 2008) Schools can provide health promotion in the most influential stages of children s lives. (Kwan, Petersen, Pine & Borutta, 2005) With that, schools are enabling children to develop lifelong sustainable attitudes and skills. A study by Kwan, Petersen, Pine & Borutta (2005) focused on the global need of the importance of promoting oral health in schools. They also talked about the effects of poor oral health. It can affect the children's quality of life, their performance at school and their success in the later year. Petersen, Bourgeois, Ogawa, Estupinan-Day & Ndiaye described the influence of major sociobehavioral risk factors in oral health. Due to poor living conditions, the major risk factors relate to unhealthy lifestyle. To find out if dental aesthetics is a factor for low self- confidence in Filipino adolescents. Studies have conducted series of interview and questionnaire that focus on what are the factors that they dislike in their dental appearance. To assess the psychosocial impact of dental aesthetics on the emotional state of an individual, the mean values of Dental Self-Confidence were compared. This study will focus on dental aesthetic and self confidence. Will there be a need to reform a person s dental appearance to build his self confidence. If an individual will perform better after a treatment has been done on them and will they gain more self confidence. How can someone cope with their inability to get the treatments they want for the betterment of their dental appearance. Dental Aesthetics Dental Aesthetic is having a sense of the beautiful of to the teeth. It is being concerned with appearance of your teeth. A study aimed to evaluate opinions of a group of professionals and a group of lay people, with or without cleft lip or palate, regarding the facial appearance of patients treated for orofacial clefting. The results showed that the lay people with a cleft rated facial aesthetics with significantly higher and had a low perceived need for further treatment then lay people without a cleft. While professionals rated facial aesthetics significantly lower and also had a lower perception of need for further treatment. (Foo, 2011) In Brazil, the daily life of school children was assessed to test the association between aesthetic impact due to malocclusion and biopsychosocial variables. Marques (2006) concluded that the aesthetic impact of malocclusion significantly affects the quality of life of school children. Self Confidence Self-Confidence is a feeling or belief in your powers and abilities. Those very feelings and beliefs about an individual can have a clear and direct impact on our outward actions. Agou (2008) examined the relationship between self esteem and oral health related quality of life. He found out that the impact of malocclusion on quality of life is substantial in children with low self esteem. In the oral health related quality of life, self esteem is an important factor. Students who had received orthodontic treatment had a higher self-confidence than those who had not undergone treatment. Those students who had great self perceived need for treatment were those who demonstrated a greater negative self evaluation of their own aesthetics. 8

3 Dissatisfaction with dental appearance is a strong predictor for low self confidence. Students with low self esteem were those who avoided smiling to hide their teeth, having being teased about the appearance of their teeth and believed that having straight teeth improved ones popularity and success in life. (Badran, 2010) Most patients in this study were not satisfied with their dental appearance with a greater percentage of females expressing dissatisfaction than males. Unhappiness with tooth color and feelings of having protruding teeth also had a significant negative influence on patient satisfaction with general dental appearance. (Tin-Oo, Saddki & Hassan, 2011) Synthesis When faced with someone attractive or someone who they re attracted to, some people squirm and loss focus. All of a sudden, their self confidence goes down. Individuals tend to compare themselves to someone who is successful and attractive. Cultural beliefs and socioeconomic and demographic conditions can affect a person s dental health. A cultural belief in the Philippines is when a parent has fears of going to the dentist. This fear is passed over to their offspring. Thus, there is little knowledge on dental health. For the people in the poverty line, the price of an appointment is the common reason for not seeking dental care. Aesthetic is an important issue today s society. It is used to define one s character, ability and worth. People want to look our best to feel better about ourselves. Not everyone is guaranteed a perfect set of occlusion. General appearance, tooth color and tooth alignment are the factors which individuals are mostly concerned with the dental aesthetic. Dental aesthetic is the appearance of one s occlusion, (Marques, 2006). Self Confidence is a feeling or belief in your powers and abilities. Those very feelings and beliefs about oneself can have a clear and direct impact on our outward actions. Students with low self esteem avoided smiling to hide their teeth. Children were teased because of their malocclusion. (Badran, 2010) Adolescents tend to be strongly concerned about their body image. Thus, plays an important role in psychological and social adjustment and educational success, (De Paula, Santos, Da Silva, Nunes, and Leles, 2009). Hence, the aim of this study was compare the effect of malocclusion, quality of life and self image on the psychosocial impact of dental aesthetics in a sample of adolescents. Does an individual who underwent treatment have higher self confidence than an individual who had not had a treatment? Is there a difference between an individual who had undergone a treatment and who had not? Is the person with treatment more proud of their teeth than the person who didn't have a treatment? Does the appearance of their dental occlusion affect their self confidence? Are they conscious with the appearance of their teeth? Does it matter in their future endeavors? Method Research Design The researcher used a mixed method research design. With this method, the researcher can focus on real life conceptual understanding, multi-level perspectives and cultural influences. A mixed method design integrates or combines qualitative and quantitative data to maximize the strengths and minimizing their weaknesses. According to Creswell (2015), mixed methods research provides strengths that offset the weaknesses of both qualitative and quantitative research. The researcher will connect the data by analyzing the dataset (quantitative survey) and analyzing the data from the qualitative questions. Participants and Sampling The researcher targeted 319 male and female Filipino adolescent respondents. The selected participants were those who have undergone treatments, such as cleaning, dental fillings 9

4 or braces, from their dentist and those who did not. Participants were asked if they have gone to the dentist. The sampling method of the research is the purposive sample method. This is a type of sampling that is characterized as the judgmental sample. It selects based on the knowledge of the population. The subjects are selected because their characteristics and/or knowledge are qualified. Instrument The material used in the study is the Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ). The Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ) is a tool which gives very valuable information on aspects of the oral health-related quality of life. This self rating instrument was designed to assess the psychosocial impact of dental aesthetics in adolescents. The version used in this study contained four items on demographic information regarding name, age and gender. Twenty-eight items were clustered into five main groups; groups I IV were based on the four factors of Klages et al. (2006) and group V included six questions on general beliefs regarding dental aesthetics. Group I focuses on dental self confidence, group II is about social impact, group III tackles psychological impact and group IV is aesthetic concerns. Sample questions included: I am proud of my teeth and I am satisfied with the appearance of my teeth. The questionnaire provided qualitative and quantitative questions. PIDAQ is a likert scale questionnaire with interview questions. Procedures The researcher printed out hard copies of the questionnaire. Then it is distributed to different groups of students that ranges from years old. The questionnaires were given out to high school and college students. Filipino adolescents around Muntinlupa City were chosen through purposive sampling. The researcher selected male and female adolescents students in the schools in Muntinlupa city by using the purposive sampling method. Then, asked them if they were willing to participate and answer the survey questionnaire. The researcher informed the target participants if they would participate in a survey. After the participants have approved the procedures, the scales were given to them and they were instructed to respond to each of the item as honestly as possible. Then, the researcher double checked the questionnaires that were given back by the participants. A total of 319 questionnaires came back. Lastly, the researcher then tallied all the results of the survey and analyzed the data that were gathered through the whole survey. Participation was voluntary. Respondents were told that they can refuse to finish answering the survey-questionnaire if they feel like doing so: however, none of them failed to finish the questionnaires. Confidentiality of the information gathered most especially of their names was assured to the participants. Data Analysis In analyzing the results of the study, the researcher used simple frequency count and percentages. The collected data for the first part of the questionnaire was analyzed by using paired sample t test. Paired sample t-test is a statistical technique that is used to compare two population means in the case of two samples that are correlated. It is a comparison of two different methods of measurement or two different treatments where the measurements/ treatments are applied to the same subjects. The researcher will also use the IOTN as the researcher's reference for measuring dental aesthetics. The researcher used the qualitative results to support and explain the quantitative results. Descriptive statistics was also used to describe the basic features of the data collected in a study. 10

5 Results Research Question No. 1: Is there a significant difference in self-confidence between respondents who underwent dental aesthetic treatment from respondents who did not? Table 1: frequency of people who didn't had treatments or had treatments As shown from above, 59.52% of the respondents undergone treatments in regards with their dental health. The 40.48% had not gone to a dentist for any kind of treatment to fix or improve their dental aesthetic. Table 2: Paired Samples Test: Dental self-confidence For the results for Group I: Dental Aesthetics, the P-value of all questions are greater than the alpha (P>.05). I conclude that the null hypothesis is accepted. There is a statistically significantly difference to show that answers of individuals who had undergone treatment are different. Research Question No. 2: Does the appearance of their dental occlusion affect their selfconfidence? Patient s Belief Another part of the questionnaire, the respondents were asked qualitative questions. This special part of the questionnaire asked the respondents who have had treatments what they felt or opinion after the treatment. Patient s belief is a part of the questionnaire that asked the respondents their opinion whether the appearance of the teeth have a significant effect on general appearance. The first question asked if the treatment affected their life in any way. The treatment they underwent greatly affected their life. They think now they look more presentable. Some had said that having braces made them more confident as a person. The treatment boosted their confidence and self esteem. While those who were undergoing their treatment said that with every visit to the dentist, they get better and better in terms of self confidence. There are those who are excited for the finished outcome of their treatment. Others said that they improvements occurred like eating better and smiling better. However, there are others who are more comfortable with speaking and less conscious and insecure. Some respondents became more sociable and got a lot of good compliments. While others were happy with the results, it is not the same with the rest. One respondent 11

6 said that it didn't affect his life. Some they found it hard to eat while going through the treatment. Another one said that it was costly. While another one said that it hurt so much that they claims that it gave a trauma. The second question was how they feel about having dental treatment done. Majority of the respondents were happy after they underwent with whatever treatment they underwent. Many were relieved, satisfied and happy. A lot felt more confident, comfortable, clean and good. However, some got hassled with the treatment because it was painful. Research Question No. 3: Are they conscious with the appearance of their teeth? General Appearance The third question a lot had answered that it does have a significant effect on general appearance. One has answered that he believes that teeth can highly affect a person s appearance and having nice teeth can boost your appearance. Another answered that yes because it shows how you care about your mouth hygiene. It promotes that you are neat and clean and that you take care of yourself. Another said that being confident in smiling is a good way to pass positivity. Also, people tend to have more confidence if they have straight and beautiful teeth. They smile often or even always. They are not afraid to show off their beautiful smile. One believes that having beautiful teeth is a sign of a person having good hygiene. It makes you look more presentable and self caring and conscious. Whether you have a good set of teeth may affect the person s confidence. It contributes to the general appearance of a person because it can be considered to be one of the great assets of a person. Another answered that even though it isn't obvious; they think that it has this subconscious effect. They are those who said that it does not promote dental health. Some had answered that it is not significant. Imperfections are not something to be ashamed but with society today, we are judged by appearance. While some had answered no, they still believe that somehow it is still significant. Dental Health The fourth question is if it can promote dental health. A lot had answered that it is a peg for how people take care of themselves. It shows that your teeth are healthy and you have well maintained oral hygiene. One answered that it can make other people conscious of what their teeth looks like and therefore making people feel like they also need to take care of their own teeth. Research Question No. 4: Does it matter in their future endeavors? Career The fifth question is if it can promote career. While a lot have answered yes, not all have supported their answers. A good number of respondents answered that they gained confidence with the straight and beautiful teeth. Yes, especially if you are a tourism student. It promotes good and proper appearance. It can attract attention if you have a beautiful smile. It can reflect on your hygiene and self grooming which can influence a job application or how your boss or colleagues view your health keeping habits. Since appearance is what they see first, it does affect the promotion of social success. Another participant answered with they are just being realistic and because employers opt for general appearance when it comes to accepting employees. It is very important when you aim for the entertainment industry. It makes you presentable which makes you worthy of a good career and presentable. They are those who answered that it does not because the main focus of a career 12

7 excluding modeling is skill and that does not correlate with teeth appearance. Our teeth do not define who we become in our chosen career. Your career is determined by your work ethics performance and your hard work. Unless the people who hire you are judgmental, then it matters. One answered that you need skill not beauty, but you need to look decent. A good personality is what matters. Having intelligence and presentation can promote your career. Social success The sixth question is it can promote social success. You can socialize better if you have confidence in your smile. Having straight and beautiful teeth, you can freely show your smile to others without bothering what they might think. One answered yes because that is how our society sees it these days but when is appearance not going to matter. It can bring you higher poise than others while you are speaking. It creates a better appearance which can possibly boost someone s social success. It makes people look somewhat attractive despite their discrepancy. A participant answers that unfortunately yes, it is in human nature to judge others based on their appearance. A better appearance can always be beneficial in any situation. Others have answered that it does not and it depends on the confidence of the person. What s important is the personality of a person. It is your confidence and attitude skills that are important. As long as you are confident and have a pleasing charming personality is equal to public relations skills. It s how you work and it depends upon your skills and determination in socializing and general appearance does not help completely at all. Conclusion and Recommendation Dental aesthetics has an effect on people's confidence. People will say that beauty is in the eye of the beholder or looks doesn t matter. However, whatever people will say, looks affect a person subconsciously. Knowing that you look good or presentable puts a person at ease. It lessens the stress of how a person will conduct themselves. Those who had undergone orthodontic treatment had a higher self confidence than those who had not undergone treatment. There is a statistically significantly difference to show that answers of individuals who had undergone treatment are different. As the study was completed, it has come to the interest of the researcher that it would be better if the questionnaire is translated into Tagalog. Like other studies, PIDAQ is translated into their language to test their reliability and validity. References Agou, S., Locker, D., Streiner, D., & Tompson, B. (2015). Impact of self-esteem on the oralhealth related quality of life of children with malocclusion. Sciencedirect.com. Retrieved October 2008, from Badran, S. (2010). The effect of malocclusion and self-perceived aesthetics on the self-esteem of a sample of Jordanian adolescents. The European Journal Of Orthodontics, 32(6), doi: /ejo/cjq014 Bernabé, E., & Flores, C. (2015). Orthodontic Treatment Need in Peruvian Young Adults Evaluated Through Dental Aesthetic Index. The Angle Orthodontist. Retrieved 6 September 2015, from [0417:OTNIPY]2.0.CO;2 Biazevic, M., Rissotto, R., Michel-Crosato, E., Mendes, L., & Mendes, M. (2008). Relationship between oral health and its impact on quality of life among adolescents. Braz. Oral Res., 22(1), doi: /s

8 Butani, Y., Weintraub, J., & Barker, J. (2008). Oral health-related cultural beliefs for four racial/ethnic groups: Assessment of the literature. BMC Oral Health, 8(1), 26. doi: / Creswell,. (2015). CHOOSING A MIXED METHODS DESIGN. Sage Pub. Retrieved 6 September2015,from Chapter_4.pdf De Paula, D., Santos, N., Da Silva, E., Nunes, M., and Leles, C. (2009). Psychosocial Impact Of Dental Esthetics On Quality Of Life In Adolescents. Angle.org. N.p., 2015.Web. 3 Sept Eduardo Bernabé, Georgios Tsakos, Cesar Messias de Oliveira, and Aubrey Sheiham (2008) Impacts on Daily Performances Attributed to Malocclusions Using the Condition-Specific Feature of the Oral Impacts on Daily Performances Index. The Angle Orthodontist: March 2008, Vol. 78, No. 2, pp Eva Josefsson, Rune Lindsten, Lillemor R.-M. HALLBERG(2010) A qualitative study of the influence of poor dental aesthetics on the lives of young adults. Acta Odontologica Scandinavica Vol. 68, Iss. 1, 2010 Filippin, A., & Paccagnella, M. (2015). Family background, self-confidence and economic outcomes. Sciencedirect.com. Retrieved 6 September 2015, from direct.com/science/article/pii/s Foo, P. (2011). Adelaide Research and Scholarship: Facial aesthetics and psychosocial outcome assessment following treatment of non-syndromic cleft patients.digital.library.adelaide. edu.au. Retrieved 30 August 2015, from handle/2440/65935 Hamamci, N., Basaran, G., & Uysal, E. (2009). Dental Aesthetic Index scores and perception of personal dental appearance among Turkish university students. The European Journal Of Orthodontics, 31(2), doi: /ejo/cjn083 Hatfield, E., Roberts, D., Schmidt, L.(1980) "The Impact of Sex and Physical Attractiveness on an Initial Social Encounter." Recherchers De Psychologie Sociale (1980): Web. < Heinrich-Weltzien, R., Monse, B., Benzian, H., Heinrich, J., & Kromeyer-Hauschild, K. (2012). Association of dental caries and weight status in 6- to 7-year-old Filipino children. Clin Oral Invest, 17(6), doi: /s Jiang, H., Petersen, P., Tai, B., & Bian, Z. (2015). Self-assessed dental health, oral health practices, and general health behaviors in Chinese urban adolescents. Acta Odontologica Scandinavica. Retrieved from ?journalCode=iode20#.VePRW_mqqko Klages U, Claus N, Wehrbein H, Zentner A. Development of a questionnaire for assessment of the psychosocial impact of dental aesthetics in young adults. European Journal of Orthodontics 2006;28: Kwan, S., Petersen, P., Pine, C., & Borutta, A. (2005). Health-promoting schools: an opportunity for oral health promotion. Bulletin Of The World Health Organization, 83(9), doi: /s Little, A. C., & Mannion, H. (2006, November). Viewing attractive or unattractive same-sex individuals changes self-rated attractiveness and face preferences in women. Retrieved from Little, A. C., Jones, B. C., & DeBruine, L. M. (2011, May). Facial attractiveness: evolutionary based research Philosophical Transactions of the Royal Society B: Biological Sciences. Retrieved from Marques, L., Ramos-Jorge, M., Paiva, S., & Pordeus, I. (2006). Malocclusion: Esthetic impact 14

9 and quality of life among Brazilian schoolchildren. American Journal Of Orthodontics And Dentofacial Orthopedics, 129(3), doi: /j.ajodo Onyeaso, C., & Begole, E. (2015). Relationship between index of complexity, outcome and need, dental aesthetic index, peer assessment rating index, and American Board of Orthodontics objective grading system. Sciencedirect.com. Retrieved 6 September 2015, from Olson, Ingrid R.; Marshuetz, Christy. (2005) Facial Attractiveness Is Appraised in a Glance. Emotion, Vol 5(4), Dec 2005, Patrick, H., Neighbors, C., & Knee, C. R.(2004) Appearance-Related Social Comparisons: The Role of Contingent Self- Esteem and Self- Perceptions of Attractiveness. Pers Soc Psychol Bull vol. 30 no Poonacha, K., Deshpande, S., & Shigli, A. (2010). Dental aesthetic index: Applicability in Indian population: A retrospective study. J Indian Soc Pedod Prev Dent, 28(1), 13. doi: / Shivakumar, K., Chandu, G., Subba Reddy, V., & Shafiulla, M. (2009). Prevalence of malocclusion and orthodontic treatment needs among middle and high school children of Davangere city, India by using Dental Aesthetic Index. J Indian Soc Pedod Prev Dent, 27(4), 211. doi: / Tin-Oo, M., Saddki, N., & Hassan, N. (2011). Factors influencing patient satisfaction with dental appearance and treatments they desire to improve aesthetics. BMC Oral Health, 11(1), 6. doi: / Van der Geld, P., Oosterveld, P., & Kuijpers-Jagtman, A. (2008). Age-related changes of the dental aesthetic zone at rest and during spontaneous smiling and speech. The European Journal Of Orthodontics, 30(4), doi: /ejo/cjn009 Petersen, P., Bourgeois, D., Ogawa, H., Estupinan-Day, S., & Ndiaye, C. (2005). The global burden of oral diseases and risks to oral health. Bulletin Of The World Health Organization, 83(9), doi: /s Rosenblat, T. S. (2008), The Beauty Premium: Physical Attractiveness and Gender in Dictator Games. Negotiation Journal, 24: doi: /j x Sung, Y. P.(2005) The Influence of Presumed Media Influence on Women s Desire to be Thin Taylor, K. R. (2007, December). Effects of malocclusion and its treatment on the quality of life of adolescents. Retrieved from Van der Geld, P., Oosterveld, P., Van Heck, G., & Kuijpers-Jagtman, A. M.(2007) Smile Attractiveness. The Angle Orthodontist: September 2007, Vol. 77, No. 5, pp Wolfart, S., Thormann, H., Freitag, S. and Kern, M. (2005), Assessment of dental appearance following changes in incisor proportions. European Journal of Oral Sciences, 113: doi: /j x 15