JHSM

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.

EndNote Style
Index
Review
Smile aesthetics according to sex
Smile aesthetics is a multidisciplinary field that explores how the concept of beauty affects human memory, emotions, and perception. Intraoral and gingival components are central to soft-tissue aesthetics and key determinants of an aesthetically pleasing smile. A healthy periodontium, along with optimal gingiva color and texture, significantly contributes to aesthetic perception. This review aims to examine the influence of gender on smile aesthetics and to analyze the intraoral, psychological, and environmental factors that shape the perception and evaluation of smiling. The literature indicates that smile aesthetics is influenced by a range of factors, including age, occupation, psychological state, external influences, and biological variables such as gender. Gingival health, soft tissue characteristics, and intraoral harmony are consistently identified as foundational to aesthetic outcomes. Differences between genders in aesthetic perception and preferences are supported by multiple studies, suggesting potential biological and cultural influences. Gender appears to be an important variable in the evaluation of smile aesthetics, interacting with a variety of biological, psychological, and social factors. Further research is needed to clarify the mechanisms underlying these differences and to develop evidence-based guidelines for personalized aesthetic smile design.


1. Eren, H. 1998. Türkçe Sözlük. Ankara: Türk Dil Kurumu.
2. Tekel A. Estetik yargı ve estetik yargıyı etkileyen faktörler. Sanat Tas Derg. 2015;16:149-157. doi:10.18603/std.64941
3. Patzer GL. The physical attractiveness phenomena. 1st ed. Springer Science & Business Media; 2012.
4. Garber DA, Salama MA. The aesthetic smile: diagnosis and treatment. Periodontol 2000. 1996;11:18-28. doi:10.1111/j.1600-0757.1996.tb00179.x
5. Tjan AH, Miller GD, The JG. Some esthetic factors in a smile. J Prosthet Dent. 1984;51(1):24-28. doi:10.1016/s0022-3913(84)80097-9
6. Rubin LR, Rubin LR. The anatomy of a smile: its importance in the treatment of facial paralysis. Plast Reconstr Surg. 1974;53(4):384-387. doi:10.1097/00006534-197404000-00002
7. Ekman P, Friesen WV. Felt, false, and miserable smiles. J Nonverbal Behav. 1982;6:238-252.
8. Ackerman J, Ackerman M, Brensinger C, Landis J. A morphometric analysis of the posed smile. Clin Orthod Res. 1998;1(1):2-11. doi:10.1111/ocr.1998.1.1.2
9. Van Der Geld P, Oosterveld P, Bergé SJ, Kuijpers-Jagtman AM. Tooth display and lip position during spontaneous and posed smiling in adults. Acta Odontol Scand. 2008;66(4):207-213. doi:10.1080/00016350 802060617
10. Mercado-García J, Rosso P, Gonzalvez-García M, Colina J, Fernández JM. Gummy smile: Mercado-Rosso classification system and dynamic restructuring with hyaluronic acid. Aesthetic Plast Surg. 2021;45(5):2338-2349. doi:10.1007/s00266-021-02169-8
11. Sarver DM. The importance of incisor positioning in the esthetic smile: the smile arc. Am J Orthod Dentofacial Orthop. 2001;120(2):98-111. doi: 10.1067/mod.2001.114301
12. Liébart MF, Fouque-Deruelle C, Santini A, et al. Smile line and periodontium visibility. Periodont Pract Today. 2004;1(1):17.
13. Nold SL, Horvath SD, Stampf S, Blatz MB. Analysis of select facial and dental esthetic parameters. Int J Periodontics Restorative Dent. 2014; 34(5):623-629. doi:10.11607/prd.1969
14. Demirel K. Yumuşak dokunun estetik tedavi planındaki yeri. Aydın Dent J. 2015;1(1):1-6.
15. de la Parte-Serna AC, Monticelli F, Pradas F, Lecina M, García-Giménez A. Gender-based analysis of oral health outcomes among elite athletes. Sports (Basel). 2025;13(5):133. doi:10.3390/sports13050133
16. Carranza FA, Shklar G, Williams RC. History of periodontology. 1st ed. Quintessence Pub; 2003.
17. Gómez-Polo C, Montero J, Martín Casado AM. Explaining the colour of natural healthy gingiva. Odontology. 2024;112(4):1284-1295. doi:10. 1007/s10266-024-00906-4
18. Bhuvaneswaran M. Principles of smile design. J Conserv Dent. 2010; 13(4):225-232. doi:10.4103/0972-0707.73387
19. Abdulkarim HH, Habet B, Ahmadi AG, Wang MY, Rosales ER, Miley DD. Digital analysis of dentogingival factors influencing the gingival margin position in the esthetic zone. J Esthet Restor Dent. 2025;37(6): 1474-1482. doi:10.1111/jerd.13407
20. Chu SJ, TAN JHP, Stappert CF, Tarnow DP. Gingival zenith positions and levels of the maxillary anterior dentition. J Esthet Restor Dent. 2009; 21(2):113-120. doi:10.1111/j.1708-8240.2009.00242.x
21. Shahiryar A, Anees R, Chaudhary MAG, Shafique S, Anwar P. Gingival zenith variations in maxillary anterior teeth across age and gender in the Pakistani population. Pak J Med Dent. 2025;14(2):342-352. doi:10. 36283/ziun-pjmd14-2/052
22. Alhajj WA. Gingival phenotypes and their relation to age, gender and other risk factors. BMC Oral Health. 2020;20(1):87. doi:10.1186/s12903-020-01073-y
23. Tenenbaum H, Tenenbaum M. A clinical study of the width of the attached gingiva in the deciduous, transitional and permanent dentitions. J Clin Periodontol. 1986;13(4):270-275. doi:10.1111/j.1600-051x.1986.tb02221.x
24. Anand PS, Bansal A, Shenoi BR, Kamath KP, Kamath NP, Anil S. Width and thickness of the gingiva in periodontally healthy individuals in a central Indian population: a cross-sectional study. Clin Oral Investig. 2022;26(1):751-759. doi:10.1007/s00784-021-04053-w
25. Kashyap R, Zareena HS, Kumar A. Management of aberrant frenum: a case report. IOSR J Dent Med Sci. 2015;14:10-13.
26. Alwan AH. Association of frenum attachments with age and gender in a sample of iraqi people: a cross-sectional study. Al-Rafidain J Med Sci. 2024;7:168-172. doi:10.54133/ajms.v7i1.1169
27. Goodkind RJ, Schwabacher WB. Use of a fiber-optic colorimeter for in vivo color measurements of 2830 anterior teeth. J Prosthet Dent. 1987; 58(5):535-542. doi:10.1016/0022-3913(87)90380-5
28. Hassel AJ, Nitschke I, Dreyhaupt J, Wegener I, Rammelsberg P, Hassel JC. Predicting tooth color from facial features and gender: results from a white elderly cohort. J Prosthet Dent. 2008;99(2):101-106. doi:10.1016/S0022-3913(08)60025-6
29. JL W. A new classification of human tooth forms with special reference to a new system of artificial teeth. Cosmos. 1914;56:627-628.
30. Rosenstiel SF, Ward DH, Rashid RG. Dentists’ preferences of anterior tooth proportion-a web-based study. J Prosthodont. 2000;9(3):123-136.
31. Gillen RJ, Schwartz RS, Hilton TJ, Evans DB. An analysis of selected normative tooth proportions. Int J Prosthodont. 1994;7(5):410-417.
32. Yang S, Guo Y, Yang X, et al. Effect of mesiodistal angulation of the maxillary central incisors on esthetic perceptions of the smile in the frontal view. Am J Orthod Dentofacial Orthop. 2015;148(3):396-404. doi: 10.1016/j.ajodo.2015.03.021
33. Morley J, Eubank J. Macroesthetic elements of smile design. J Am Dent Assoc. 2001;132(1):39-45. doi:10.14219/jada.archive.2001.0023
34. Gill DS, Naini FB, Tredwin CJ. Smile aesthetics. Dent Update. 2007;34(3): 152-158. doi:10.12968/denu.2007.34.3.152
35. Bishara SE. Management of diastemas in orthodontics. Am J Orthod. 1972;61(1):55-63. doi:10.1016/0002-9416(72)90176-5
36. Adigun A, Yemitan T, Uti O. Relationship between maxillary midline diastema width and labial frenum attachment in a sample of nigerian adolescents: a cross-sectional study. Niger J Med. 2022;31(3):274-279. doi:10.4103/NJM.NJM_28_22
37. Moore T, Southard KA, Casko JS, Qian F, Southard TE. Buccal corridors and smile esthetics. Am J Orthod Dentofacial Orthop. 2005;127(2):208-261. doi:10.1016/j.ajodo.2003.11.027
38. Kozak E, Tuna SH. Dental orta hat simetri-asimetrisinin dentofasiyal estetik algı üzerine etkisi. Süleyman Demirel Üniv Sağlık Bil Derg. 2022; 13(2):263-270. doi:10.22312/sdusbed.1067023
39. Thomas PA, Krishnamoorthi D, Mohan J, Raju R, Rajajayam S, Venkatesan S. Digital smile design. J Pharm Bioallied Sci. 2022;14(Suppl 1): S43-S49. doi:10.4103/jpbs.jpbs_164_22
40. Janzen EK. A balanced smile-a most important treatment objective. Am J Orthod. 1977;72(4):359-372. doi:10.1016/0002-9416(77)90349-9
41. Cope G, Cope A. The periodontium: an anatomical guide. Dental Nursing. 2011;7(7):376-378. doi:10.12968/denn.2011.7.7.376
42. Sharma PK, Sharma P. Dental smile esthetics: the assessment and creation of the ideal smile. Semin Orthodont. 2012;18(3):193-201. doi:10. 1053/j.sodo.2012.04.004
43. Hulsey CM. An esthetic evaluation of lip-teeth relationships present in the smile. Am J Orthod. 1970;57(2):132-144. doi:10.1016/0002-9416(70) 90260-5
44. Yang Y, Zhang M, Jin L, et al. Gender- and age-related characterization of lip morphology: a three-dimensional analysis in a chinese population. Aesthet Surg J. 2023;43(12):NP990-NP1000. doi:10.1093/asj/sjad270
45. Zhang K, Huang L, Yang L, et al. Effects of transverse relationships between maxillary arch, mouth, and face on smile esthetics. Angle Orthod. 2016;86(1):135-141. doi:10.2319/101514.1
46. Al Taki A, Hayder Mohammed T, Mohammad Hamdan A. Influence of the smile line on smile attractiveness in short and long face individuals. Int J Dent. 2017;2017:2637148. doi:10.1155/2017/2637148
47. Niaki EA, Arab S, Shamshiri A, Imani MM. The effect of the buccal corridor and tooth display on smile attractiveness. Aust Orthod J. 2015; 31(2):195-200.
48. Desai S, Upadhyay M, Nanda R. Dynamic smile analysis: changes with age. Am J Orthod Dentofacial Orthop. 2009;136(3):310.e1-311. doi:10. 1016/j.ajodo.2009.01.021
49. Pithon MM, Nascimento CC, Barbosa GCG, Coqueiro RdS. Do dental esthetics have any influence on finding a job? Am J Orthod Dentofacial Orthop. 2014;146(4):423-429. doi:10.1016/j.ajodo.2014.07.001
50. Van der Geld P, Oosterveld P, Van Heck G, Kuijpers-Jagtman AM. Smile attractiveness. Self-perception and influence on personality. Angle Orthod. 2007;77(5):759-765. doi:10.2319/082606-349
51. Kolte RA, Kolte AP, Purohit AR. Gender-based evaluation of interproximal dimensions. Influence on interdental papillae and gingival thickness in maxillary anterior teeth. Int J Esthet Dent. 2023; 18(2):128-140.
52. Agarwal V, Mehrotra N, Vijay V. Gingival biotype assessment: variations in gingival thickness with regard to age, gender, and arch location. Indian J Dent Res. 2017;9:12-15.
53. Kolte AP, Kolte RA, Purohit MJ, Bajaj VA. Proportions in papilla, crestal papilla, and proximal contact area in maxillary anterior teeth: a cross-sectional study. J Indian Soc Periodontol. 2022;26(5):492-497. doi:10.4103/jisp.jisp_251_21
54. Jennes M-E, Sachse C, Flügge T, Preissner S, Heiland M, Nahles S. Gender-and age-related differences in the width of attached gingiva and clinical crown length in anterior teeth. BMC Oral Health. 2021;21(1):287. doi:10.1186/s12903-021-01639-4
55. Kolte R, Kolte A, Mahajan A. Assessment of gingival thickness with regards to age, gender and arch location. J Indian Soc Periodontol. 2014; 18(4):478-481. doi:10.4103/0972-124X.138699
56. Joshi A, Suragimath G, Zope SA, Ashwinirani S, Varma SA. Comparison of gingival biotype between different genders based on measurement of dentopapillary complex. J Clin Diagn Res. 2017;11(9):ZC40-ZC45. doi: 10.7860/JCDR/2017/30144.10575
57. Kolte RA, Kolte AP, Rathi P. Association of the gingival line angle with the gingival and interdental smile line: a gender based evaluation. J Esthet Restor Dent. 2019;31(6):601-607. doi:10.1111/jerd.12517
58. Al-Jabrah O, Al-Shammout R, El-Naji W, Al-Ajarmeh M, Al-Quran AH. Gender differences in the amount of gingival display during smiling using two intraoral dental biometric measurements. J Prosthodont. 2010;19(4):286-293. doi:10.1111/j.1532-849X.2009.00562.x
59. Sepolia S, Sepolia G, Kaur R, Gautam DK, Jindal V, Gupta SC. Visibility of gingiva-an important determinant for an esthetic smile. J Indian Soc Periodontol. 2014;18(4):488-492. doi:10.4103/0972-124X.138703
60. Kapagiannidis D, Kontonasaki E, Bikos P, Koidis P. Teeth and gingival display in the premolar area during smiling in relation to gender and age. J Oral Rehabil. 2005;32(11):830-837. doi:10.1111/j.1365-2842.2005. 01517.x
61. Al-Habahbeh R, Al-Shammout R, Al-Jabrah O, Al-Omari F. The effect of gender on tooth and gingival display in the anterior region at rest and during smiling. Eur J Esthet Dent. 2009;4(4):382-395.
62. Naranjo MJ, Gómez-Polo M, Gómez-Polo C, Celemin-Viñuela A. Study of attached gingiva space color according to gender and age in Caucasian population. J Esthet Restor Dent. 2023;35(6):834-841. doi:10. 1111/jerd.13038
63. Ho DK, Ghinea R, Herrera LJ, Angelov N, Paravina RD. Color range and color distribution of healthy human gingiva: a prospective clinical study. Sci Rep. 2015;5:18498. doi:10.1038/srep18498
64. Rakhewar P, Patil H, Thorat M. Identification of gingival pigmentation patterns and its correlation with skin color, gender and gingival phenotype in an Indian population. Indian J Multidiscip Dent. 2016; 6(2):87-92. doi:10.4103/2229-6360.197763
65. Humagain M, Rokaya D, Srii R, Dixit S, Kafle D. Gender based comparison of gingival zenith esthetics. Kathmandu Univ Med J. 2016; 14:148-152.
66. Kacar D, Cakmak F, Dogan A, Sevinc O, Barut C. Evaluation of lingual frenulum using geometric morphometrics. Int J Morphol. 2011;29(2): 313-317.
67. Kim HK. A study on the color distribution of natural teeth by age and gender in the Korean population with an intraoral spectrophotometer. J Esthet Restor Dent. 2018;30(5):408-414. doi:10.1111/jerd.12424
68. Veeraganta SK, Savadi RC, Baroudi K, Nassani MZ. Differences in tooth shade value according to age, gender and skin color: a pilot study. Prosthodont Soc. 2015;15(2):138-141. doi:10.4103/0972-4052.155035
69. Al-Zazai HSA, Al-Haddad K, Al-Harazi G, et al. Prevalence and etiology of maxillary midline diastema among university students, Hodeidah Governorate, Yemen: a cross-sectional study. J Contemp Dent Pract. 2024;25(10):968-975. doi:10.5005/jp-journals-10024-3763
70. Baskran R, Nivethigaa B, Balaji Ganesh S. The prevalence and gender distribution of midline diastema among patients attending a private dental college-An original study. Int J Dentistry Oral Sci. 2021;8:4124-4127. doi:10.19070/2377-8075-21000842
71. Elfadel II, Abuaffan AH. Prevalence and etiology of midline diastema among Sudanese University students. Indian J Dent Educ. 2016;9:15-20.
72. Ariyani AP, Anggraini W, Pratomo HG, Sistasia S, Sulistyowati I. Gender influence in maxillary incisor display and Buccal corridor. Malays J Med Health Sci. 2024;20.
73. Aşik S, Kök H. Perception of dental midline deviation and smile attractiveness by eye-tracking and aesthetic ratings. Aust Orthod J. 2021;37:187-196. doi:10.21307/aoj-2021.020
74. Melo M, Ata-Ali J, Ata-Ali F, et al. Evaluation of the maxillary midline, curve of the upper lip, smile line and tooth shape: a prospective study of 140 Caucasian patients. BMC Oral Health. 2020;20(1):42. doi:10.1186/s12903-020-1031-y
75. Cunha J, Fernandes GVO, Fernandes JCH, Lopes PC, Rio R. The ınterference of age and gender on smile characterization analyzed on six parameters: a clinical-photographic pilot study. Medicina (Kaunas). 2023;59(3):595. doi:10.3390/medicina59030595
76. Khan M, Kazmi SMR, Khan FR, Samejo I. Analysis of different characteristics of smile. BDJ Open. 2020;6:6. doi:10.1038/s41405-020-0032-x
77. Drummond S, Capelli J Jr. Incisor display during speech and smile: age and gender correlations. Angle Orthod. 2016;86(4):631-637. doi:10.2319/ 042515-284.1
78. Kolte AP, Kolte RA, Samarth GK. Association of the nasolabial angle and lip length with the gingival and interdental smile line-A gender based evaluation. J Esthet Restor Dent. 2021;33(3):503-509. doi:10.1111/jerd.12657
79. Wolfart S, Menzel H, Kern M. Inability to relate tooth forms to face shape and gender. Eur J Oral Sci. 2004;112(6):471-476. doi:10.1111/j. 1600-0722.2004.00170.x
80. Kolte RA, Kolte AP, Kharkar VV, Bawankar P. Influence of facial index, facial profile, lip size, and angulations of teeth on gingival characteristics of anterior teeth: a gender-based evaluation. J Esthet Restor Dent. 2020;32(5):496-504. doi:10.1111/jerd.12600
Volume 9, Issue 3, 2026
Page : 839-845
_Footer