JHSM
Journal of Health Sciences and Medicine

Journal of Health Sciences and Medicine (JHSM) is an unbiased, peer-reviewed, and open access international medical journal. The Journal publishes interesting clinical and experimental research conducted in all fields of medicine, interesting case reports, and clinical images, invited reviews, editorials, letters, comments, and related knowledge.

eISSN: 2636-8579
Creative Commons CC BY-NC-ND 4.0 International License.
EndNote Style

Submit Manuscript

Index
Original Article
Artificial Intelligence versus human evaluation of pediatric smile aesthetics: a comparative study across multiple observer groups
Abstract
Aims: The aim of this study was to comparatively evaluate how pediatric smile aesthetics are perceived by children, parents, dentists, and Artificial Intelligence (AI) systems, with a particular focus on the potential role of AI in clinical decision support. Methods: The study utilized nine standardized frontal smile photographs featuring different aesthetic modifications of the maxillary central incisors. A total of 354 human participants (87 children, 97 parents, 80 pediatric dentists, and 90 general dentists) evaluated the images using binary aesthetic preference questions and a 0-10 aesthetic rating scale. Additionally, four AI systems (ChatGPT-5.2, Gemini 3, Grok 4.1, and Microsoft Copilot) independently evaluated the same images. Categorical data were analyzed using Chi-square-based tests, while aesthetic scores were analyzed using a generalized linear model (gamma distribution, log link function). Statistically significant differences were found between evaluator type and aesthetic preferences for most questions (p

Keywords : Artificial Intelligence, pediatric dentistry, smile aesthetics, clinical decision support

Download Article


1. Zaharia L, Grecu AG, Mesaro? A?, Aghiorghiesei AI, Ghiurca RS, Dudea D. The perception of aesthetic aspects in paediatric patients: a scoping review. Rom J Oral Rehabil. 2023;15(3):208-219.
2. Pollini A, Morton D, Arunyanak SP, Harris BT, Lin WS. Evaluation of esthetic parameters related to a single implant restoration by laypeople and dentists. J Prosthet Dent. 2020;124(1):94-99. doi:10.1016/j.prosdent. 2019.08.017
3. Ceylan G, Ozel GS, Memisoglu G, Emir F, Sen S. Evaluating the facial esthetic outcomes of digital smile designs generated by Artificial Intelligence and dental professionals. Appl Sci. 2023;13(15):9001. doi:10. 3390/app13159001
4. Rossini G, Parrini S, Castroflorio T, Fortini A, Deregibus A, Debernardi CL. Children’s perceptions of smile esthetics and their influence on social judgment. Angle Orthod. 2016;86(6):1050-1055. doi:10.2319/102715-722
5. Tarang C, Gunjan Y, Arora D. Recent trends in aesthetics in pediatric dentistry. Int J Oral Health Med Res. 2017;4(1):70-75.
6. de Sousa ET, da Silva BF, Maia FBM, Forte FDS, Sampaio FC. Perception of children and mothers regarding dental aesthetics and orthodontic treatment need: a cross-sectional study. Prog Orthod. 2016;17:37. doi:10. 1186/s40510-016-0149-6
7. Pithon MM, Santos AM, de Andrade ACDV, Santos EM, Couto FS, da Silva Coqueiro R. Perception of the esthetic impact of gingival smile on laypersons, dental professionals, and dental students. Oral Surg Oral Med Oral Pathol Oral Radiol. 2013;115(4):448-454. doi:10.1016/j.oooo. 2012.04.027
8. Al-Namankany A, Alhubaishi A. Effects of cleft lip and palate on children’s psychological health: a systematic review. J Taibah Univ Med Sci. 2018;13(4):311-318. doi:10.1016/j.jtumed.2018.04.007
9. Ghaffari M, Zhu Y, Shrestha A. A review of advancements of Artificial Intelligence in dentistry. Dent Rev. 2024;4:100081. doi:10.1016/j.dentre. 2024.100081
10. Carrillo-Perez F, Pecho OE, Morales JC, et al. Applications of Artificial Intelligence in dentistry: a comprehensive review. J Esthet Restor Dent. 2022;34(1):259-280. doi:10.1111/jerd.12844
11. Saini RS, Kaur K, Gurumurthy V, et al. Impact of Artificial Intelligence-based digital smile design on patient and clinician satisfaction and facial esthetic outcomes: a systematic review and meta-analysis. Digit Health. 2025;11:20552076251388392. doi:10.1177/20552076251388392
12. Ossowska A, Kusiak A, Swietlik D. Artificial Intelligence in dentistry: narrative review. Int J Environ Res Public Health. 2022;19(6):3449. doi: 10.3390/ijerph19063449
13. Dave BH, Shah VU, Bargale S, Deshpande A, Patel R, Sura S. Evaluation of parental perception regarding smile of children according to visual analog scale. J Integr Health Sci. 2018;6(2):41-44. doi:10.4103/JIHS.JIHS_16_18
14. Pithon MM, Magno MB, da Silva Coqueiro R, et al. Oral health-related quality of life of children before, during, and after anterior open bite correction: a single-blinded randomized controlled trial. Am J Orthod Dentofacial Orthop. 2019;156(3):303-311. doi:10.1016/j.ajodo.2019.04. 022
15. Tiro A, Nakas E, Arslanagic A, Markovic N, Dzemidzic V. Perception of dentofacial aesthetics in school children and their parents. Eur J Dent. 2021;15(1):13-19. doi:10.1055/s-0040-1714040
16. Lourenço O, Machado A. In defense of Piaget’s theory: a reply to 10 common criticisms. Psychol Rev. 1996;103(1):143-164. doi:10.1037/0033-295X.103.1.143
17. Shajilal RB, Peedikayil FC, Kottayi S, Sreedharan A, Ramesh A, Chethayil HM. Parental and child perception of esthetic restorative options for anterior caries in primary teeth: a cross-sectional study. Bharati Vidyapeeth Dent J Adv Stud. 2025;2:106-111. doi:10.4103/bvjd.bvjd_62_25
18. Kokich VO, Kokich VG, Kiyak HA. Perceptions of dental professionals and laypersons to altered dental esthetics: asymmetric and symmetric situations. Am J Orthod Dentofacial Orthop. 2006;130(2):141-151. doi:10. 1016/j.ajodo.2006.04.017
19. Pinho S, Ciriaco C, Faber J, Lenza MA. Impact of dental asymmetries on the perception of smile esthetics. Am J Orthod Dentofacial Orthop. 2007;132(6):748-753. doi:10.1016/j.ajodo.2006.01.039
20. Baaj RE, Alangari TA. Artificial Intelligence applications in smile design dentistry: a scoping review. J Prosthodont. 2025;34:341-349. doi: 10.1111/jopr.14000
21. Ba-Zar OA, Mehtiyeva N, Almizban NS. The role of AI in modern aesthetic dentistry. Saudi J Oral Dent Res. 2025;10(9):343-351. doi:10. 36348/sjodr.2025.v10i09.002
22. Gomes MC, Clementino MA, Pinto-Sarmento TCA, et al. Parental perceptions of oral health status in preschool children and associated factors. Braz Dent J. 2015;26(4):428-434. doi:10.1590/0103-6440201300 245
Article available in :
Volume 9, Issue 3, 2026
Page : 830-838
https://doi.org/10.32322/jhsm.1920254
Article Information
Received : 01 Nis 2026
Accepted : 03 May 2026
Published : 19 May 2026
Corresponding Author :

Enes Bardakçı: Department of Pediatric Dentistry, Faculty of Dentistry, Harran University, Şanlıurfa, Turkiye

[email protected]
Citation : Bardakçı E, Çelikel P. Artificial Intelligence versus human evaluation of pediatric smile aesthetics: a comparative study across multiple observer groups. J Health Sci Med. 2026;9(3):830-838. doi:10.32322/jhsm.1920254

Read: 244
Download : 74
Cited: 0
_Footer