Introduction: The purpose of this study was to record first impressions elicited by photographs of orthodontic patients before and after treatment to test the hypothesis that after treatment patients will elicit a more positive first impression.

Methods and Materials: Before (Tl) and After (T2) photographs of six orthodontic patients equally divided by gender and standardized for background facial attractiveness were selected. Three different malocclusions were represented: 1) Class 1 crowded, 2) Class 11 div 1, and 3) Class 111. 108 college students rated each photographed patient on three attributes: physical attractiveness, intelligence and social desirability. Participants recorded their responses on a 100 mm VAS, at a timed 12 sec interval. Statistical analyses were performed to determine the effect of treatment, malocclusion, patient gender and evaluator gender on first impressions. Statistical significance was denoted by P<0.05.

Results: T-test comparison of mean ratings showed that patients were rated more physically attractive (P<.001), intelligent (P<.001) and socially desirable (P<.001) after treatment. This trend was maintained when patients were separated by dental classification. Comparison of mean improvement for each characteristic showed that Class II patients improved significantly in social desirability ratings over Class I (P<.001) and Class III (P=.003) patients.

Female patients showed significantly higher ratings after treatment for attractiveness (P<.001) and social desirability (P<.001) only. Meanwhile, male patients showed significantly higher ratings for all three characteristics (P<.001) after treatment. Female patients improved significantly in physical attractiveness (P=.005) ratings over male patients. Male patients improved significantly in intelligence (P<001) ratings over female patients. Both male and female evaluators rated patients significantly higher for all three characteristics (P<.001) after treatment and were consistent in rating both genders.

Conclusions: Patients received significantly higher ratings in all three traits after orthodontic treatment. Assessment by dental classification and gender also showed significant improvement in all three traits after treatment, except for intelligence ratings for female patients. Evaluator gender did not significantly influence ratings for any of the traits. While there were some differences in the degree of improvement based on dental classification and gender, the overall premise of improved first impressions following orthodontic treatment held true.

LLU Discipline

Orthodontics and Dentofacial Orthopedics


Orthodontics and Dentofacial Orthopedics


Graduate Studies

First Advisor

D. Graham Stacey

Second Advisor

Joseph M. Caruso

Third Advisor

Jung-Wei Chen

Fourth Advisor

V. Leroy Leggitt

Degree Name

Master of Science (MS)

Degree Level


Year Degree Awarded


Date (Title Page)




Library of Congress/MESH Subject Headings

Orthodontics, Corrective -- psychology; Orthodontics, Interceptive -- psychology; Esthetics, Dental -- psychology; Social Perception; Social Desirability; Pattern Recognition, Visual; Self Concept; Personality Assessment



Page Count

xiii; 85

Digital Format


Digital Publisher

Loma Linda University Libraries

Usage Rights

This title appears here courtesy of the author, who has granted Loma Linda University a limited, non-exclusive right to make this publication available to the public. The author retains all other copyrights.


Loma Linda University Electronic Theses and Dissertations

Collection Website



Loma Linda University. Del E. Webb Memorial Library. University Archives