Impac o den al aes he ics on sel -
es eem in s uden s a he Polígono
Su educa ion pe manen cen e in
Se ille, Spain
Ad iana Dayanei a Fe nández-Ce allos1, Da id Ribas-Pe ez1, Ma cela A enas-González1,
Luis Elkhou y-Mo eno1, Julio To ejón-Ma ínez1, E a Rosel-Galla do2 &
An onio Luis Cas año-Seique 1
Sel -es eem is a s able cha ac e is ic ha is usually main ained om adolescence o adul hood. People
wi h high sel -es eem a e men ally p epa ed o ace di e en challenges in hei li es wi h g ea
con idence. Assess he in luence o den al aes he ics on sel -es eem in s uden s a he Polígono Su
Educa ion Pe manen Cen e . A c oss-sec ional desc ip i e s udy wi h quali a i e and quan i a i e
a iables in which 92 pa icipan s om he pe manen educa ion cen e loca ed in he polígono su o
he ci y o Se ille. To iden i y i he e was a ela ionship be ween sel -pe cep ion o den al aes he ics
and sel -es eem, wo su eys we e conduc ed in he educa ional cen e , one o hem o de e mine
a high o low psychosocial impac o den al aes he ics and he Rosenbe g sel -es eem scale, which
e alua ed he le el o accep ance and espec ha pa icipan s had o hemsel es. Demog aphic
a iables analyzed we e gende , age, na ionali y, and occupa ion. To analyze ca ego ical a iables,
con ingency ables and he Pea son Chi-squa e es we e used. S uden s did no ha e a low sel -es eem
in ela ion o a high psychosocial impac o den al aes he ics p > 0, 05 (0.069), bu a high sel -es eem
indi e en o whe he hey had a high o low psychosocial impac o den al aes he ics. Howe e , he e
we e excep ions acco ding o gende (p = 0.019) o na ionali y (p = 0.030). Sel -es eem was no g ea ly
a ec ed by he psychosocial impac o den al aes he ics in he majo i y o s uden s e alua ed, bu i
was possible o s a e ha he e was a nega i e impac in he male gende and also by na ionali y.
Keywo ds Den al es he ics, Den al heal h su ey, Sel -Es eem, Sel pe cep ion
Sel -es eem is a s able ai ha gene ally pe sis s om adolescence o adul hood1. Re lec s how we eel abou
ou sel es and o en helps us achie e wha we desi e. People wi h high sel -es eem a e men ally p epa ed o
ace a ious challenges in hei li es wi h a s ong sense o con idence2,3. The gene al concep o quali y o li e
o igina ed in he ield o gene al medicine and has been de ined as he pe cep ion o people o hei posi ion in li e
wi hin he con ex o he cul u e and alue sys ems in which hey li e, and in ela ion o hei goals, expec a ions,
and s anda ds4. Some o al diseases, such as ca i ies and pe iodon al disease, a e among he mos common and
ha e an impac no only on aes he ics bu also on social and psychological le els5. Sel -concep is how each
indi idual pe cei es hemsel es spi i ually, physically, o socially. I can be acqui ed h ough expe iences in
socie y o h ough a ibu ions one makes abou his own beha iou 6. The Ox o d English Dic iona y desc ibes
sel -es eem as a good opinion o onesel ; high sel -es eem; con idence in one’s own wo h o abili ies, as well as
in one’s own es ima ion o assessmen o onesel 7.
Sel -es eem has also been de ined as an in e nal a i ude a he base o pe sonali y de elopmen , esponsible
o he psychological balance and adap i e p ocesses o an indi idual h oughou li e8. William James i s
desc ibed i in 1890, as he ex en o which people alue hei own quali ies, linking i o he le el o success o
ailu e hey may ha e achie ed9. In people’s li es, physical appea ance plays a e y impo an ole and den al
aes he ics has a signi ican impac 10. Pe cep ion o ce ain cha ac e is ics, such as colou , size, shape o posi ion,
can be psychologically impo an , e en i he e is no no iceable aes he ic o unc ional de e io a ion11. A
physically a ac i e pe son is o en pe cei ed as mo e iendly, in elligen , ex o e ed and in e es ing; howe e ,
1Uni e si y o Se ille, Se ille 41004, Spain. 2Uni e si y o G anada, G anada, Spain. email: [email p o ec ed];
[email p o ec ed]
OPEN
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when he e a e anomalies in he o al ca i y, such as ca i ies, missing ee h, o c owding, i can nega i ely a ec
he a ac i eness and aes he ics o he smile12.
Despi e signi ican imp o emen s in popula ion heal h h oughou his o y, heal h dispa i ies be ween
subg oups pe sis , wi h poo heal h concen a ed among socioeconomically ma ginalized g oups. This end
is also e iden in he o al heal h o hese popula ions13. The e is subs an ial e idence ha social class s ongly
in luences bo h mo bidi y and mo ali y a es14. Poo o al heal h is a e lec ion o socioeconomic inequali ies, as
well as low quali y o li e, is ela ed o he heal h o amilies ha a e acing g ea e socioeconomic disad an ages,
as i is di icul o hem o access di e en den al se ices15. Low-income people, uninsu ed heal h ca e se ice,
membe s o acial o e hnic mino i ies, u al popula ions, o immig an s, o his day, ha e ecei ed insu icien
a en ion16.
This s udy was applied o s uden s a he Pe manen Cen e o Educa ion o Poligono Su (CEPER),
mos o whom a e conside ed low-income indi iduals who we e unable o comple e hei s udies in ime and
summa izing hem a he ime o he su eys. This a ea o he ci y o Se ille has a high a e o social inequali y,
and ndoub edly, he quali y o li e is closely ela ed o he o al heal h s a us o i s esiden s17. The objec i e o his
s udy is o analyze whe he he e is a ela ionship be ween sel -es eem and den al aes he ics in CEPER s uden s,
as he e a e se e al s udies ha indica e ha subjec s a ec ed by poo den al aes he ics in he psychosocial
domain canno de elop adequa ely in he social a ea and end o be mo e in o e ed18. Consequen ly, he
p oposed concep ual hypo hesis was as ollows: Den al aes he ics in luences he sel -es eem o s uden s.
Ma e ials and me hods
Design and ype o s udy
A desc ip i e-analy ical s udy, wi h quali a i e and quan i a i e a iables, was ca ied ou using wo su eys, he
psychosocial impac ques ionnai e on den al aes he ics (PIDAQ) and he Rosenbe g sel -es eem scale, h ough
which he da a ob ained we e desc ibed and analyzed. Bo h su eys consis o mul iple-choice ques ions u ilizing
a deduc i e-induc i e me hod. I was de e mined whe he he e is a co ela ion be ween he pe cep ion o den al
aes he ics and he sel -es eem o he s uden s a CEPER in he ci y o Se ille in Ap il 2024.
S udy loca ion
The Polígono Su o Se ille is cu en ly ca ego ized as one o he a eas wi h he highes a es o po e y and social
con lic in he Spanish e i o y; i aces se ious p oblems o a social, u ban, and en i onmen al na u e. Th ough
s a is ical e e ences, analyses ca ied ou in a ious s udies and epo s, as well as he e y con igu a ion o i s
u ban en i onmen , i is clea ly e iden ha i is one o he mos ex eme cases o u ban inequali y in Spain.
The ma ked disad an ages i is cu en ly expe iencing ha e hei o igin in he concen a ion o impo e ished
popula ion, which a ose as a esul o he o iginal u ban p ojec : a social housing es a e loca ed on he ou e edge
o he ci y, buil be ween he decades o he 1960s and 1970s, whe e nume ous humble amilies om di e en
backg ounds we e eloca ed, e ic ed om his o ic neighbou hoods, o om p eca ious se lemen s such as
slums, shel e s, and subs anda d housing. This sec o o he popula ion su e s mo e in ensely om di e en
momen s o c isis and, un o una ely, has been neglec ed by he au ho i ies o long pe iods19.
Psychosocial impac o den al aes he ic ques ionnai e (PIDAQ)
This ques ionnai e has been used in p e ious s udies and was o iginally de eloped in English by Klages e al.
in 200620. The spanish e sion o he PIDAQ su ey was alida ed by Mon iel e al. in 2013, main aining an
in e nal s uc u e and psychome ic p ope ies closely aligned wi h he o iginal Klages ques ionnai e. I is
designed o assess indi idual sa is ac ion wi h he appea ance o hei ee h. I is di ided in o i e domains:
Den al sel -es eem and sel -con idence, social impac , psychosocial impac , aes he ic conside a ions, and pa ien
belie s. This assessmen includes 23 i ems wi h a 5-poin Like scale, o e ing i e esponse op ions: 1 = s ongly
disag ee, 2 = disag ee, 3 = nei he ag ee no disag ee, 4 = ag ee, and 5 = s ongly ag ee. I ems we e g ouped in o
one posi i e subscale, sel -con idence in den al appea ance (6 i ems), and h ee nega i e subscales: psychological
impac (6 i ems), social impac (8 i ems), and aes he ic conce n (3 i ems). A o al sco e can ange om 0 o 92
poin s. Sco es o 0 o 46 indica e a low impac , while sco es o 47 o 92 e lec a high psychosocial impac on he
indi idual.
Rosenbe g sel -es eem scale
The Rosenbe g sel -es eem scale, c ea ed by psychologis Mo is Rosenbe g in 1965, is widely used o assess
sel -es eem ac oss all age g oups. The scale consis s o en i ems, wi h i e posi i ely wo ded s a emen s and i e
nega i ely wo ded ones. I s pu pose is o measu e he le el o sel -accep ance and sel - espec among indi iduals.
Responses a e gi en on a ou -poin Like scale wi h he ollowing op ions: 1 = s ongly disag ee, 2 = disag ee,
3 = ag ee and 4 = s ongly ag ee. Fo i ems 1 o 5, esponses A o D, a e sco ed om 4 o 1. Fo i ems 6 o 10,
esponses A and D, a e sco ed om 1 o 4. Sco es o 30 o 40 poin s indica e high sel -es eem and a e conside ed
wi hin a no mal ange. Sco es be ween 26 and 29 e lec mode a e sel -es eem, sugges ing ha he e a e no
se ious p oblems, bu he e is a place o imp o e, while sco es below 25 indica e signi ican sel -es eem issues21,22.
Da a p ocessing and analysis echniques
Once su eys we e conduc ed and in o ma ion collec ed, he da a we e classi ied by gende , age, na ionali y, and
occupa ion. The esul s we e compiled in an Excel da a shee , a e which he SPSS so wa e (S a is ical Package
o he Social Sciences) was used o gene a e cha s and ables o analysis, allowing he in e p e a ion o he
ga he ed in o ma ion. In o de o analyse ca ego ical a iables, con ingency ables and he Pea son´s Chi-squa e
es we e used. The le el o signi icance was es ablished a p < 0.005.
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Resul s
The o al numbe o s uden s a CEPER was 408. The s udy popula ion included was 92 pa icipan s om he
mo ning and a e noon sessions a CEPER, he mean age o he s uden s who comple ed he ques ionnai e was
26.22 wi h a SD o 12.10, hei ages we e dis ibu ed be ween 16 and 79 yea s, o which 43.5% we e male and
56.5% we e emale. Inclusion c i e ia es ablished o selec he sample we e; s uden s who we e abou o en e
he wo k o ce o we e al eady employed and in egula in e ac ion wi h socie y, s uden s who ha e ag eed o
pa icipa e in he esea ch, and s uden s o any gende , na ionali y, and age. The only exclusion c i e ion was
hose s uden s who did no egula ly a end hei classes a CEPER Polígono Su . In Table1 i is possible o
obse e he dis ibu ion o pa icipan s acco ding o hei demog aphic cha ac e is ics. Based on occupa ion,
hey we e di ided in o ou ca ego ies: 68 we e s uden s, se en we e homemake s, 14 wo ked in cus ome se ice
and h ee we e in ol ed in cons uc ion and ade. The male gende g oup included 40 pa icipan s, and he
emale g oup included 52 pa icipan s. Acco ding o age, he popula ion s udied included 78 young s uden s, 12
adul s and wo senio s, na ionali ies o pa icipan s we e g ouped by con inen al o igin, wi h 62 spanish ci izens,
15 la in-ame icans and 15 A icans.
In Table2 shows ha he associa ion be ween low sel -es eem and low psychosocial impac was ze o (0),
while he ela ionship be ween high sel -es eem and low psychosocial impac was 49 (49), wi h a p- alue g ea e
han 0.05 (p = 0.69).
In Table3, wo men we e eco ded o ha e low sel -es eem, while 40 women had high sel -es eem, wi h a
p- alue o 0.019, indica ing s a is ically signi ican di e ences. In he g oup ha included male pa icipan s, 26
epo ed a low psychosocial impac , while 23 o emale gende epo ed a high psychosocial impac . Howe e ,
wi h a p- alue o 0.371, he e was no s a is ically signi ican ela ionship be ween psychosocial impac and
gende . Among he s uden s in he you h g oup, 68 had high sel -es eem, while no senio pa icipan had low
sel -es eem. Acco ding o he p- alue (0.040), he e was a s a is ically signi ican ela ionship be ween age and
sel -es eem. I was obse ed ha 52 young pa icipan s we e ound o ha e a low psychosocial impac , while
10 adul pa icipan s had a high psychosocial impac . Acco ding o he p- alue (0.004), he e was a s a is ically
signi ican ela ionship be ween age and sel -pe cep ion o den al aes he ics.
Wi hin he g oup o pa icipan s wi h Spanish na ionali y, 56 pa icipan s had high sel -es eem, while wo
pa icipan s om A ica had low sel -es eem. Acco ding o he p- alue (0.03), he e was a s a is ically signi ican
ela ionship be ween sel -es eem and na ionali y. I was obse ed ha 43 Spanish pa icipan s we e obse ed o
ha e a low psychosocial impac , while en pa icipan s o La in Ame ican o igin had a high psychosocial impac .
Acco ding o he p- alue (0.020), he e was a s a is ically signi ican ela ionship be ween na ionali y and sel -
pe cep ion o den al aes he ics. Based on occupa ion, i was obse ed ha 58 pa icipan s in he s uden g oup
had high sel -es eem, six homemake s had high sel -es eem, en people who p o ide cus ome se ice had high
sel -es eem, and wo indi iduals in cons uc ion and comme ce had high sel -es eem, while only wo s uden s
had low sel -es eem. Acco ding o he p- alue (0.690), he e was no s a is ically signi ican ela ionship be ween
occupa ion and sel -es eem. I was obse ed ha 46 s uden s we e ound o ha e a low psychosocial impac ,
i e homemake s had a high psychosocial impac , nine pa icipan s who p o ide cus ome se ice had a high
psychosocial impac , and wo pa icipan s who wo k in cons uc ion and comme ce had a low psychosocial
impac . Acco ding o he p- alue (0.046), he e was a s a is ically signi ican ela ionship be ween occupa ion
and sel -pe cep ion o den al aes he ics.
PIDAQ
To alLow impac High impac
Rosenbe g
Low sel -es eem 0 2 2
Medium sel -es eem 6 8 14
High sel -es eem 49 27 76
Pea son’s chi-squa e 0.069
Table 2. Compa ison o he esul s o he PIDAQ and Rosenbe g su eys.
Gende Age Na ionali y
M F Y A S SP LA AF
Occupa ion
S uden 32 36 63 4 1 48 9 11
Homemake 0 7 2 5 0 5 0 2
Cus ome se ice 6 8 12 1 1 6 6 2
Cons uc ion and ade 2 1 1 2 0 3 0 0
To al 40 52 78 12 2 62 15 15
Table 1. Dis ibu ion (n) o pa icipan s acco ding o hei cha ac e is ics. M male, F emale, Y young, A
Adul , S senio , S Spanish, LA La in-Ame ican, AF A ican.
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Discussion
Cu en ly, acial aes he ics has become an inc easingly cen al ac o in he li e o e e y indi idual. The lowe
hi d o he ace, and mo e speci ically den al aes he ics, plays a key ole in his aspec , as i is one o he
ea u es ha mos cap u es he obse e ’s a en ion. This has led o a signi ican inc ease in he demand o
den al ea men s o aes he ic pu poses, wi h he inal objec i e in many cases o imp o ing sel -es eem. The
associa ion wi h den al aes he ics and sel -es eem, such as he good aes he ics o a smile, can con ibu e o
psychosocial well-being and o al quali y o li e23. I is possible o a i m ha he app ecia ion o he beau y o a
smile encompasses mul iple subjec i e aspec s, whe e many ex e nal a iables could come in o play, such as age,
gende , na ionali y, o occupa ion. By compa ing he esul s o he PIDAQ and Rosenbe g su eys (p = 0.069),
he e was no s a is ically signi ican associa ion be ween a iables s udied. This sugges s ha , in his s udy, sel -
pe cep ion o den al aes he ics and sel -es eem we e no associa ed. I is e iden ha mos o he pa icipan s
did no exp ess signi ican in e es in he appea ance o hei ee h, expe iencing a low psychosocial impac o
den al aes he ics while main aining high sel -es eem. These esul s con adic he s udy by Anshika Sha ma e al.
in 2017, when hey e alua ed adolescen s be ween 10 and 17 yea s o age om S i Ganganaga , Rajas han, India,
who ound ha o he 1140 adolescen s s udied, 56.9% o den al diso de s had a high impac on sel -es eem, as
den al aes he ics plays an impo an ole in de elopmen and li e24.
Sel -es eem was associa ed wi h gende in he p esen s udy, due o he p- alue ob ained (0.019), which
indica es s a is ically signi ican di e ences. Howe e , wi h a p- alue o 0.371, he e was no s a is ically
signi ican ela ionship be ween psychosocial impac and gende . This means ha in his s udy, sel -pe cep ion
o den al aes he ics was no associa ed wi h gende . These esul s con adic a s udy conduc ed by S ojilko ić M.
e al. in 2024, hey s udied 410 pa icipan s, 80% o whom we e women aged 20 o 23 yea s, ha s udy showed a
signi ican ela ionship be ween PIDAQ sco es and age; S uden s who expe ienced a g ea e psychosocial impac
o den al aes he ics ended o ha e lowe sel -es eem25. A s udy conduc ed by Lukez A. e al. in 2015 suppo s
he connec ion be ween hese a iables. They included a o al o 155 indi iduals, o which 36% we e men aged
12 o 39 yea s. They ound ha he emale gende is associa ed wi h a g ea e psychological in luence o den al
aes he ics, while he male gende and ad anced age we e associa ed wi h sel -es eem. They concluded ha i
seems ha people a e less ocused on he de ails o hei smile and mo e on he dis inc i e misalignmen o hei
ee h26. Among he s uden s acco ding o he p- alue (0.040), he e was a s a is ically signi ican ela ionship
be ween age and sel -es eem. In young pa icipan s, hey we e obse ed o ha e a low psychosocial impac , while
in he adul g oup, pa icipan s had a high psychosocial impac . Acco ding o he p- alue (0.004), he e was a
s a is ically signi ican ela ionship be ween age and sel -pe cep ion o den al aes he ics. A s udy conduc ed
by Vene é A. e al. in 2017, wi h a sample o 301 s uden s om he Facul y o Medicine and Den is y o he
Uni e si y o Valencia, aged 18 o 30, ound ha he s uden s mos a ec ed by poo den al aes he ics exhibi ed
lowe sel -es eem and highe le els o pe ec ionism26.
Acco ding o he p- alue (0.03), he e was a s a is ically signi ican ela ionship be ween sel -es eem and
na ionali y. Acco ding o he p- alue (0.020), he e was a s a is ically signi ican ela ionship be ween na ionali y
and sel -pe cep ion o den al aes he ics. Ou esul s a e consis en wi h hose ob ained by Mazen e al., who
Rosenbe g
To al
PIDAQ
To alL-SF M-SE H-SE LI HI
Gende
Male 2 2 36 40 26 14 40
Female 0 12 40 52 26 23 52
Pea son’s chi-squa e 0.019 0.371
Age
Young 2 8 68 78 52 26 78
Adul s 0 5 7 12 2 10 12
Senio s 0 1 1 2 1 1 2
Pea son’s chi-squa e 0.040 0.004
Na ionali y
Spanish 0 6 56 62 43 19 62
La in-Ame ican 0 5 10 15 5 10 15
A ican 2 3 10 15 7 8 15
Pea son’s chi-squa e 0.003 0.020
Occupa ion
S uden 2 8 58 68 46 22 68
Homemake 0 1 6 7 2 5 7
Cus ome se ice 0 4 10 14 5 9 14
Cons uc ion and ade 0 1 2 3 2 1 3
Pea son’s chi-squa e 0.690 0.046
Table 3. Compa ison be ween gende , age, na ionali y, and occupa ion wi h he PIDAQ and Rosenbe g scales.
L-SF low sel -es eem, M-SE medium sel -es eem, H-SE high sel -es eem, LI low impac , HI high impac .
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conduc ed a s udy in 2023 wi h he pu pose o compa ing he pe cep ion o uppe den al midline de ia ion
on he a ac i eness o a smile among e alua o s om di e en e hnici ies, p o essions, gende s, and ages, and
measu ing o wha ex en he p esence o absence o he associa ed smiling s uc u es in luences he a e s’
e alua ions. They ound s a is ically signi ican di e ences (p < 0.05) be ween he wo e hnici ies s udied
and concluded ha he pe cep ion o uppe den al midline de ia ions was in luenced by ac o s o e hnici y,
p o ession, p esence o absence o s uc u es associa ed wi h smiles, as well as he gende and age27. In con as ,
Niaz e al., who conduc ed a s udy in 201528 and ound no associa ion be ween e hnici y and a i udinal sco e
was ound. The e we e s ong co ela ions be ween he alue o he oo h shade sel -assessed and p o essionally
assessed in all e hnic g oups, wi h he Spea man ank co ela ion coe icien ( ho) being ρ > 0.6. Rega ding
he ideally desi ed and pe cei ed alue o he oo h shade, weak co ela ions we e ound in all e hnic g oups
(Spea man’s ho being ρ < 0.4). Acco ding o he p- alue (0.690), he e was no s a is ically signi ican ela ionship
be ween occupa ion and sel -es eem. Acco ding o he p- alue (0.046), he e was a s a is ically signi ican
ela ionship be ween occupa ion and sel -pe cep ion o den al aes he ics. These esul s may con adic he
s udy conduc ed by Alqa awi e al. in 202429, which was ca ied ou wi h den al s uden s om a ious den al
schools in Ka achi, Pakis an, om Janua y o May 2022. E alua ion o he psychological aspec and sel -es eem
o he s uden s was conduc ed using he PIDAQ and Rosenbe g sel -es eem scale as pe cei ed by he s uden s
du ing he co id pandemic. Social impac showed a signi ican associa ion wi h psychological impac , aes he ics
conce n, and sel -es eem, while nega i ely co ela ed wi h den al con idence. The Rosenbe g sco e showed a
posi i e co ela ion wi h all a iables.
Once he su eys we e comple ed and he s a is ical analysis o he esul s was conduc ed, we can s a e ha
his s udy p esen ed se e al limi a ions du ing i s de elopmen , such as: limi a ions ega ding he calcula ion and
sample size, as he pa icipan s we e all s uden s om he educa ional ins i u ion who me he inclusion c i e ia;
ime limi a ions, as his s udy was me hodologically designed as a c oss-sec ional s udy, wi h he de elopmen
amed wi hin he pa icipan s’ school schedule and he academic yea o he examine who applied PIDAQ and
Rosenbe g su eys. Finally, i is possible ha con ounding a iables no aken in o accoun may ha e in e e ed
wi h he da a analysis, such as he numbe o isi s o he den is pe yea , o al heal h s a us, men al and physical
heal h s a us, social s a us, o academic pe o mance, acco ding o he pe cep ion o den al aes he ics. We should
be able o conduc p ospec i e s udies in which su eys would be possible be o e and a e in e en ions, which
mus include awa eness campaigns abou o al heal h. As a inal conside a ion, i is essen ial ha o al heal h
p o essionals unde s and di e en concep s such as sel -pe cep ion, sel -es eem, and he psychosocial impac o
den al aes he ics, and pe cei e needs and eelings o hei pa ien s in ela ion o hese a iables.
Conclusions
Once he esul s ob ained ha e been analyzed, acco ding o he objec i es se ou in his s udy, we can conclude
ha mos o pa icipan s had high sel -es eem and a low psychosocial impac o den al aes he ics, sugges ing
ha he appea ance o he ee h did no a ec hei sel -es eem. In ela ion o gende , i can be concluded ha in
his s udy men we e mo e a ec ed by hei sel -es eem in ela ion o den al aes he ics. Acco ding o age, den al
aes he ics did no in luence sel -es eem. A ican s uden s, exp essed low sel -es eem and high psychosocial
impac , inally he e was a s a is ically signi ican ela ionship be ween occupa ion and sel -pe cep ion o den al
aes he ics.
Da a a ailabili y
Da a a ailabili y: The da ase s used du ing he cu en s udy will be a ailable om he co esponding au ho on
easonable eques .
Recei ed: 14 No embe 2024; Accep ed: 29 Ap il 2025
Re e ences
1. Twigge, E., Robe s, R. M., Jamieson, L., D eye , C. W. & Sampson, W. J. The psycho-social impac o malocclusions and ea men
expec a ions o adolescen o hodon ic pa ien s. Eu . J. O hod. 38 (6), 593–601. h ps://doi.o g/10.1093/ejo/cj 093 (2016).
2. Paz, V. e al. E ec o sel -es eem on social in e ac ions du ing he ul ima um game. Psychia y Res. 252, 247–255. h p s : / / d o i . o g /
1 0 . 1 0 1 6 / j . p s y c h e s . 2 0 1 6 . 1 2 . 0 6 3 (2017).
3. Apolo Mo án, J. & Mi anda, V. L. Y Ri as Maldonado, N. Psicología Clínica Aplicada a La Odon ología (G upo Compas. Guayaquil,
2017).
4. Ma celo-Ingunza, J. e al. Calidad de Vida elacionada a La Salud bucal En escola es de Ámbi o u bano-ma ginal. Re is a
Es oma ológica He ediana. 25 (3), 194–204 (2015 jul). h p : / / w w w . s c i e l o . o g . p e / s c i e l o . p h p ? s c i p = s c i _ a e x & p i d = S 1 0 1 9 - 4 3 5 5 2 0
1 5 0 0 0 3 0 0 0 0 4 & l n g = e s .
5. Chak adha , K. e al. Sel pe cei ed psychosocial impac o den al aes he ics among young adul s: a c oss sec ional ques ionnai e
s udy. In . J. Adolesc. Med. Heal h. 32 (3). h ps://doi.o g/10.1515/ijamh-2017-0129 (2017).
6. Fuen es, M. C., Ga cía, J. F., G acia, E. & Lila, M. Au oconcep o y ajus e psicosocial en la adolescencia. Psico hema, 2011; 23(1),
7–12. PMID: 21266135. (2011).
7. AlHa bi, N. Sel -Es eem: A concep analysis. Nu s. Sci. Q. 35 (3), 327–331. h ps://doi.o g/10.1177/08943184221092447 (2022).
8. Do é, C. L’es ime de Soi: analyse de concep . Rech Soins In i m. 1 (129), 18–26. h ps://doi.o g/10.3917/ si.129.0018 (2017).
9. En ique, M. & Muñoz, R. El p oblema de La au oes ima Basado En La e icacia. Ed. PSOCIAL. 1, 1 (2014).
10. Da Sil a, F. B., Chisini, L. A., Dema co, F. F., Ho a, B. L. & Co ea, M. B. Desi e o oo h bleaching and ea men pe o med in
B azilian adul s: indings om a bi h coho . B az O al Res. 32, 1–10. h ps://doi.o g/10.1590/1807-3107bo -2018.32.0012 (2018).
11. Campos, L. A., Cos a, M. A., Bona é, F. S. S., Ma ôco, J. & Campos, J. A. D. B. Psychosocial impac o den al aes he ics on den al
pa ien s. In . Den . J. 70 (5), 321–327. h ps://doi.o g/10.1111/idj.12574 (2020).
12. Samsonyano á, L. & B oukal, Z. A sys ema ic e iew o indi idual mo i a ional ac o s in o hodon ic ea men : acial a ac i eness
as he main mo i a ional ac o in o hodon ic ea men . In . J. Den . 2014, 1–7. h ps://doi.o g/10.1155/2014/938274 (2014).
Scien i ic Repo s | (2025) 15:15550 5
| h ps://doi.o g/10.1038/s41598-025-00545-x
www.na u e.com/scien i ic epo s/
13. Cha i, M. e al. O al heal h inequali y in Canada, he Uni ed S a es and Uni ed Kingdom. Denis F, edi o . PLOS ONE. ;
17(5):e0268006. (2022). h ps://doi.o g/10.1371/jou nal.pone.0268006
14. Medina-Solís, C. E. e al. Desigualdades socioeconómicas En Salud Bucal: ca ies den al En Niños de seis a 12 Años de edad
[Socioeconomic inequali ies in o al heal h: den al ca ies in 6 o 12 yea -old child en]. Re . In es . Clin. 58 (4), 296–304 (2006).
PMID: 17146941.
15. Cha ee, B. W., Rod igues, P. H., K ame , P. F., Ví olo, M. R. & Feldens, C. A. O al heal h- ela ed quali y-o -li e sco es di e by
socioeconomic s a us and ca ies expe ience. Communi y Den . O al Epidemiol. 45 (3), 216–224. h p s : / / d o i . o g / 1 0 . 1 3 7 1 / j o u n a l . p
o n e . 0 2 6 8 0 0 6 (2017).
16. No h idge, M. E., Kuma , A. & Kau , R. Dispa i ies in access o o al heal h ca e. Annu. Re . Public Heal h. 41 (1), 513–535. h p s :
/ / d o i . o g / 1 0 . 1 1 4 6 / a n n u e - p u b l h e a l h - 0 4 0 1 1 9 - 0 9 4 3 1 8 (2020).
17. Ka aliauskienė, A., Šidlauskas, A. & Zabo skis, A. Associa ion be ween global li e sa is ac ion and Sel -Ra ed o al heal h condi ions
among adolescen s in Li huania. In . J. En i on. Res. Public. Heal h. 14 (11), 1338. h ps://doi.o g/10.3390/ije ph14111338 (2017).
18. Cas año Seique , A. & Fe ei a Cabañas, A. Peniche Ma cín R. P og amas De Odon ología Social (Ed Au og a ía Ba celona, 2024).
19. Gu ié ez F ancisco José To es. Polígono Su en Se illa. His o ia de una ma ginación u bana y social. Sc ip a No a. Re is a
Elec ónica de Geog a ía y Ciencias Sociales. ; 25 (2). (2021).
20. Klages, U., Claus, N., Weh bein, H. & Zen ne , A. De elopmen o a ques ionnai e o assessmen o he psychosocial impac o
den al aes he ics in young adul s. Eu . J. O hod. 28 (2), 103–111. h ps://doi.o g/10.1093/ejo/cji083 (2006).
21. Wood, C., G i in, M., Ba on, J. & Sande cock, G. Modi ica ion o he Rosenbe g scale o assess Sel -Es eem in child en. F on .
Public. Heal h. Jun 17 (9). h ps://doi.o g/10.3389/ pubh.2021.655892 (2021).
22. Simbaña Ninahualpa, Z. P., Macías Ceballos, S. M. & López Ríos, E. F. P e alencia de maloclusión y Necesidad de T a amien o
O odón ico e impac o psicosocial de La es é ica den al En adolescen es. Odon ología (Lima). 25 (1), 7–16 (2023).
23. Sha ma, A. e al. Objec i e and subjec i e e alua ion o adolescen ’s o hodon ic ea men needs and hei impac on sel -es eem.
Re . Paul Pedia . 35 (1), 86–91. h ps://doi.o g/10.1590/1984-0462/;2017;35;1;00003 (2017). A aliação Obje i a E Subje i a Da
Necessidade De T a amen o O odôn ico Do Adolescen e E Seu Impac o Sob e A Au oes ima.
24. S ojilko ić, M. e al. E alua ing he in luence o den al aes he ics on psychosocial well-being and sel -es eem among s uden s o
he uni e si y o No i sad, Se bia: a c oss-sec ional s udy. BMC O al Heal h. 24 (1). h ps://doi.o g/10.1186/s12903-024-04002-5
(2024).
25. Lukez, A., Pa lic, A., T inajs ic Z inski, M. & Spalj, S. The unique con ibu ion o elemen s o smile aes he ics o psychosocial well-
being. J. O al Rehabil. 42 (4), 275–281. h ps://doi.o g/10.1111/joo .12250 (2015).
26. Vene e, A. e al. Rela ionship be ween he psychosocial impac o den al aes he ics and pe ec ionism and sel -es eem. J. Clin. Exp.
Den . 9 (12), e1453–e1458. h ps://doi.o g/10.4317/jced.54481 (2017).
27. Musa, M. e al. E ec o he e hnic, p o ession, gende , and social backg ound on he pe cep ion o uppe den al midline de ia ions
in smile es he ics by Chinese and black a e s. BMC O al Heal h. 23, 214. h ps://doi.o g/10.1186/s12903-023-02893-4 (2023).
28. Niaz, M. O., Naseem, M. & Elcock, C. E hnici y and pe cep ion o den al shade es he ics. In . J. Es he Den . 10 (2), 286–298 (2015
Summe ). PMID: 25874275.
29. Alqa awi, F. K. e al. Impac o COVID-19 on he sel -es eem, psychological and den al es he ics o den al s uden s. Wo k 7 7 (2),
407–416. h ps://doi.o g/10.3233/WOR-220627 (2024).
Au ho con ibu ions
Concep ualiza ion D.R-P, E R-G and A CS , me hodology and w i ing D R-P, A DF and M A R, o iginal d a
p epa a ion w i ing A DF and M AR , e iew, and edi ing D R-P, J TM, L E M , A C-S and M AR, isualiza ion, L
E M and J TM; supe ision, E R-G. All au ho s ha e ead and ag eed o he published e sion o he manusc ip .
Funding
This esea ch did no ecei e ex e nal unding.
Decla a ions
Compe ing in e es s
The au ho s decla e no compe ing in e es s.
In o med consen
Signed in o med consen was ob ained om all pa icipan s be o e da a collec ion began, explaining he
pu pose and na u e o he s udy and gua an eeing ha hey could lea e he s udy a any ime wi hou acing
epe cussions.
E hical s a emen s
In he conduc o his in es iga ion, he e hical guidelines o he Decla a ion o Helsinki we e ollowed.
Pa icipan s we e in o med o he pu pose o he s udy and he olun a y na u e o hei pa icipa ion. They
we e in o med ha hei esponses would no a ec hei lea ning a CEPER, gi en he anonymous na u e o
da a p ocessing. The s udy was app o ed by he E hics Commi ee o he Social Den is y Founda ion (FOS)
unde egis a ion numbe 03/2024.
Addi ional in o ma ion
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