Imagine two photographs of the same person taken from the side: one before orthodontic treatment and one afterward. Can adolescents tell which facial profile is more attractive? The answer is yes—and the difference is statistically significant.
That is the central finding of a recent study from the Faculty of Dentistry, Universitas Gadjah Mada, published in 2025. Supervised by Dr. drg. Cendrawasih Andusyana Farmasyanti, M.Kes., Sp.Ort(K), the study examined how adolescents perceive the facial-profile aesthetics of patients with skeletal Class I malocclusion after orthodontic treatment, particularly among individuals of Javanese descent.
Protruding Teeth, Expressive Faces
Skeletal Class I malocclusion is a condition in which the relationship between the upper and lower jaws is considered normal, but the upper incisors are protruded, extending farther forward than the ideal position. This condition affects the appearance of the facial profile, and among adolescents, facial appearance is not merely an aesthetic concern but is also closely connected to identity and self-confidence.
Lead researcher Dihya Dzaky Gibran, together with Dr. drg. Cendrawasih Andusyana Farmasyanti, M.Kes., Sp.Ort(K) and drg. Rr. Paramita Noviasari, designed a quantitative study using a questionnaire-based survey. A total of 386 non-medical students from the 2024 cohort at UGM were selected as respondents using Slovin's formula. They were asked to assess 12 facial-profile photographs, six before and six after orthodontic treatment, consisting of three female and three male profiles.
Each pair of photographs represented three degrees of upper-incisor protrusion: low, moderate, and high. Among the female profiles, the protrusion measurements were 5.5 mm, 8 mm, and 9.74 mm. Among the male profiles, the measurements were greater: 12.5 mm, 13 mm, and 16.82 mm. The photographs were assessed using a five-point Likert scale ranging from “very unattractive” to “very attractive.”
The Numbers Speak Louder Than the Mirror
The results were unambiguous. Post-treatment photographs received an average Likert score of 4, significantly higher than the pre-treatment photographs, with p < 0.05 based on the Wilcoxon Signed-Rank Test. This means that, in the eyes of the adolescent respondents, facial appearance after orthodontic treatment was indeed more attractive, rather than merely being perceived subjectively.
Interestingly, the Mann-Whitney test revealed that post-treatment photographs with a high degree of protrusion were rated significantly differently from photographs with moderate and low protrusion. However, there was no significant difference between the low- and moderate-protrusion groups (p > 0.05). In other words, the most noticeable visual changes occurred in cases involving the most pronounced protrusion.
“Orthodontic treatment significantly influences improvements in adolescents' perceptions of facial-profile aesthetics.” — Conclusion of the study by Dihya Dzaky Gibran, Dr. drg. Cendrawasih Andusyana Farmasyanti, M.Kes., Sp.Ort(K), and drg. Rr. Paramita Noviasari, FKG UGM, 2025
Why Adolescents, and Why Javanese?
The choice of adolescent respondents was not arbitrary. Adolescence is a period of intense self-image development. Physical changes, social pressures, and awareness of appearance reach significant levels during this stage of life. In this context, perceptions of facial profile are not trivial but are directly related to psychological well-being.
The selection of a population of Javanese descent also reflects an awareness that facial aesthetic standards are not universal. Craniofacial characteristics, including patterns of dental protrusion, vary across ethnic groups. Studies that use Western populations as their reference standards risk producing standards that are not clinically relevant to Indonesian patients.
By focusing on a Javanese population, this study provides more contextually relevant data—something that has remained relatively limited in the Indonesian orthodontic literature.
More Than Just Appearance
These findings have implications that extend beyond the orthodontic clinic. For clinicians, the data strengthen the argument that orthodontic treatment, particularly in cases involving pronounced protrusion, produces tangible aesthetic changes that can be perceived by people around the patient, not only by the patient themselves.
For the general public, the study serves as a reminder that behind the seemingly simple braces and orthodontic appliances lies a measurable scientific process. Every millimeter of incisor movement produces changes in the facial profile that can be detected even by adolescent observers.
And for adolescents considering orthodontic treatment, there is now one point that can be supported by data: the change is indeed visible.
Authors: Nanda Ayu; drg. Achmad Zam Zam Aghasy, M.Kes.
Photo: Pexels