Do various degrees of tooth decalcification affect orthodontists', general dentists' and laypersons' ratings of smile esthetics?

Objectives: To compare the effect of various degrees of decalcification after orthodontic treatment (white spot lesions) on orthodontists', general dentists', and laypersons' ratings of smile esthetics. Materials and Methods: Eight photographs representing incrementally altered tooth decalcification lesions of maxillary anterior teeth ranging from mild to severe were shown randomly to the study participants. Photographs were rated by a matched sample of orthodontists (N = 42), general dentists (N = 52), and laypeople (N = 58). A visual analogue scale (VAS) was used to assess perceptions of smile esthetics. Results: The three groups of raters could distinguish between different decalcification levels. Raters gave more negative scores as the decalcification level increased. Conclusions: The three groups of raters were able to distinguish between various degrees of decalcification lesions. General dentists were the most critical of all groups when rating decalcification lesions.