THIEME 1 Original Article Esthetic Perception of Various Forms of Anterior Diastemas during Smiling Divya Singla 1 Neha Stan 1 Sanjay Mittal 1 Mandeep Bhullar 1 Isha Aggarwal 1 Rameez Hassan 1 1 Department of Orthodontics and Dentofacial Orthopedics, Bhojia Dental College and Hospital, Baddi, Solan, Himachal Pradesh, India received August 6, 2019 accepted after revision November 15, 2019 Address for correspondence Neha Stan, MDS, Department of Orthodontics and Dentofacial Orthopaedics, Bhojia Dental College and Hospital, Baddi, Solan, Himachal Pradesh, India (e-mail: nu.wondr8@gmail.com). Introduction Midline diastema is a common esthetic problem in mixed and perma- nent dentition. It is considered attractive in some cultures and unattractive in others. Aim The aim of this study is to compare the perceptions of anterior diastema by dental students and laypersons. Materials and Methods The study was conducted on 100 undergraduate students of Bhojia Dental College (n = 50) and Bhojia Nursing College (n = 50), Himachal Pradesh, India. A self-prepared questionnaire was given, which consisted of two parts: first part had personal details (name, age, sex, knowledge of diastema) and the second part contained an edited photograph of a patient who had reported to the Department of Orthodontics, Bhojia Dental College, with the chief complaint of midline diastema. The photographs were modified by photoediting software and arranged according to the previous studies on anterior diastema by Frush and Fisher, Lombardi, and Simian. A visual analog scale with scores 1–4 (1, most attractive; 2, attractive; 3, less attractive; 4, least attractive) was used to rank these photographs by the students. Comparison between various variables was made by using chi-squared test. Results Smile attractiveness from the most to the least attractive was Simian > Frush and Fisher > Lombardi > midline diastema among both dental and nursing students. Gender and presence of diastema had no relation with the students’ perceptions (p > 0.05). Conclusion The location and width of diastema had an important role in the perception of dental diastemas. Midline diastema was a gap with most negative perception. Abstract Keywords ► midline diastema ► smile ► perception ► spacing ► attractiveness DOI https://doi.org/ 10.1055/s-0039-3402302 ISSN 2321-1482. ©2019 Bhojia Dental College and Hospital, affiliated to Himachal Pradesh University Introduction Mouth is the most potent factor in making or marring the beauty of the face. In social interaction, our atten- tion is mainly directed toward the mouth and eyes of the face of the person speaking. 1 People’s concern about the beauty and attractiveness of their teeth began more than 2,000 years ago. 2 In the anterior region, diastemas affect smile esthetics. Midline diastemas are considered as unsightly. Broadbent 3 referred to transient midline diastemas during childhood as an “ugly duckling” stage. However, in the 1960s and 1970s diastema was considered a sign of beauty in many traditional African cultures, but, nowadays, most people seek dental treatment for diastema closure. 4 Midline diastema is a space (or gap) between the max- illary central incisors. The space can be a normal growth characteristic during the primary and mixed dentition and generally is closed by the time the maxillary canines erupt. 5 There are wide variations of perceptions of midline diastema among different cultures. The teeth on either side of a space are called “dents du bonheur” or “lucky teeth” in France. 6 Diastema in dentistry has been defined as a space >0.5 mm between the proximal surfaces of adjacent teeth. True mid- line diastema was defined as one without periodontal/ Dent J Adv Stud Published online: 20.01.2020