Observational studyDental press journal of orthodontics2026
When does Orthodontics make a difference? Threshold effects in attractiveness perception and hiring intentions.
Observational study in Dental press journal of orthodontics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveTo evaluate the impact of orthodontic treatment on perceived smile attractiveness and hiring decisions in a Brazilian adult population.
methodsA cross-sectional observational study was conducted with 288 adult participants recruited via an online survey. Three clinical cases were selected, and standardized pre- and post-treatment smile photographs were shown in randomized order. Participants rated attractiveness on a 0-100 Visual Analog Scale (VAS) and indicated hiring intention ("yes," "no," or "can't tell"). Descriptive statistics, Mann-Whitney U tests, chi-square tests, and logistic mixed-effects regression models were used for data analysis.
resultsPost-treatment images showed significantly higher attractiveness ratings, compared with pre-treatment images (mean VAS: 54.2 vs. 36.4; p < 0.001). Hiring likelihood also increased after orthodontic treatment (44.0% vs. 27.9%; p < 0.001). Affirmative hiring decisions were consistently associated with higher attractiveness scores. In multivariable analysis, attractiveness was a significant independent predictor of hiring intention, while the interaction between VAS and treatment status was not significant (p = 0.201). Individual-level assessments demonstrated that many participants initially classified as non-hireable were reevaluated positively after treatment.
conclusionsOrthodontic treatment significantly improved smile attractiveness and increased hiring likelihood. Dental alignment alone was sufficient to shift social judgments, although overall facial esthetics also contributed. The identified attractiveness threshold marked the point at which orthodontic improvement began to influence employability perceptions. These findings highlight the psychosocial relevance of orthodontics beyond functional benefits.
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