Influence of Social Media on the Perception of Dentofacial Aesthetics: A Cross-Sectional Study

By Madiha Tariq¹, Hammad Hassan², Uffaq Syed¹, Faiza Idrees¹, Muhammad Hassan², Salman Aziz³

DOI: https://doi.org/10.36283/PJMD13-2/012

How to cite: Tariq M, Hassan H, Syed U, Idrees F, Hassan M, Aziz S. Influence of Social Media on the Perception of Dentofacial Aesthetics: A Cross-Sectional Study. Pak J Med Dent. 2024;13(2): 74-81. Doi: 10.36283/PJMD13-2/012

Background: Social media has become an influential tool with its usage increasing immensely in recent years. This study aimed to assess the impact of social media on the perception of dentofacial aesthetics and its gender-wise comparison among general population of Pakistan.

Methods: This cross-sectional study was conducted from November 2022 to March 2023 using an online questionnaire developed on Google Forms, distributed among 500 participants via WhatsApp and Facebook groups among males and females with 18 years or above operating any social media account, using non-probability convenience sampling. SPSS version 25 was used, and categorical variables were compared using Chi-Square Test. p< 0.05 was significant.

Results: Out of a total of 455 people who responded, 125 (27.5%) were male, and 330 (72.5%) were female. Females were very frequent (n=244, 53.6%) users of social media (p=0.029), spending 4 to 6 hours every day (p=0.01). There was a significant gender disparity in social media usage, with females predominantly using Instagram (n=308, 93.3%) (p<0.001), Snapchat (n=170, 51.5%) (p=0.012), and TikTok (n=76, 23%) (p=0.042). Furthermore, smile is a key aesthetic element, according to most respondents (n=425, 93.4%). Four out of ten (n=169, 37.1%) followed aesthetic surgeons on social media, and around one-half (236, 51.9%) were influenced by social media beauty standards.

Conclusion: The impact of social media on the Pakistani population can be considered as high. People nowadays are influenced by social media applications and are seeking aesthetic treatment as an outcome. It is the responsibility of dentists to educate patients about the best treatment options.

Keywords: Dentists, Esthetics, Social media.

Social media usage and influence have tremendously increased in recent years, with thousands of new users joining every day ¹. Recently, advertisements, either on television or social media, have opinionated and asserted that a vibrant, toothy smile is a symbol of joy and attractiveness. Moreover, it has changed beauty standards and trends among the general population and dentists dealing with dentofacial esthetics². In recent years, increased exposure to idealized images seen on social media has increased the esthetic treatment demands of the patients³. People are now more than ever willing to get veneers, crowns, bleaching, fillers, and even complex surgeries and procedures to achieve that higher standard of ‘ideal smile’ widely promoted on social media by social media influencers and celebrities⁴.

It is human nature to compare ourselves to others, which leads to unhappiness with our bodies¹. Newer beauty standards influenced by social media, globalization, and ideals shown on the internet fueled this dissatisfaction, leading to increased demand for invasive and noninvasive surgical procedures such as fillers, Botox, rhinoplasty, plastic surgery, etc^5,6. People are now more inclined towards these procedures, especially after seeing before and after glamorous pictures, oblivious of their side effects^5,7.

These new ideal beauty standards, coupled with social media and globalization, led to the rise of plastic surgeons’ popularity and demand all over the world. A study in America reported that nearly half of their respondents used Google to get information about cosmetic surgery, and more than half used Facebook to find a plastic surgeon⁶. People who considered going through surgical procedures more frequently were more likely to follow a plastic surgeon on social media than people who considered going for surgical cosmetic procedures less frequently^7,8.

According to a study conducted on young women in Pakistan, the influence of social media posts about cosmetic treatment contributed to opting for cosmetic treatment procedures⁹. According to a study conducted on young adults in south India, more than half of the people affirmed that their self-confidence and social life were affected by their tooth color, and more than a quarter of people said that advertisements about teeth whitening had impacted them regarding the importance of teeth whitening¹⁰.

This study aimed to assess the impact of social media on the perception of dentofacial aesthetics in the general population of Pakistan and to compare the influence of social media on dentofacial aesthetic perceptions between male and female participants, identifying any significant disparities or patterns in influence and attitude.

The present study is a descriptive cross-sectional design, that was carried out between November 1, 2022, and March 1, 2023. The study received approval from the Institutional Review Board (IRB) of the University College of Medicine and Dentistry (Ref No: UCD/ERCA/22/12). Voluntary participants’ consent and statement of confidentiality were included in the questionnaire. Online questionnaires developed using Google Forms (Google Inc.) were distributed through WhatsApp and Facebook groups among the general population of Pakistan, using a non-probability convenience sampling technique. Based on a prior study, we estimated the prevalence of the influence of social media on facial esthetics to be 48.5%⁸. Utilizing a 95% confidence interval and a 5% margin of error, we calculated a minimum sample size of 384 participants for our study. The sample size was later raised to 500 participants for better representation and more precise estimation of population parameters.

The inclusion criteria included males and females 18 years or above using any social media account. Mentally disabled people, people below 18 years of age, and those without social media accounts were excluded from the study. The questionnaire consisted of 18 close-ended questions. The first part targeted demographics such as age, gender, province, and monthly household income. The second part of the questionnaire dealt with the usage and influence of social media, people’s perception of smiles and their facial esthetics, the effect of social media on facial/dental esthetics, the effect of social media on people’s confidence about their facial aesthetics, and its effect on their daily lives. The questionnaire was validated by face validity through expert review. Moreover, a pilot investigation was done on 30 subjects, and changes were made accordingly. Item analysis using Cronbach’s Alpha was performed, which came out to be 0.76.

SPSS version 25 (IBM Corporation, USA, New York) was used to input, store, and analyze data. Frequencies and percentages were displayed using descriptive statistics. The categorical variables were compared using the Chi-Square Test. A significance level of p < 0.05 was considered statistically significant.

A total of 500 people were approached; out of them, 455 responded. The response rate was 91%. The demographics of the respondents are tabulated in Table 1.

Table 1: The demographical information of the participants

The frequency of use of social media, type of social media platform, hours of use, following pages of facial esthetics on social media, and their gender-wise comparison have been illustrated in Table 2. There was a significant difference between males and females regarding the use of social media (p=0.029) and hours of use of social media. There was a significant difference between males and females regarding the use of social media platforms, except the platform of Twitter (p=0.126). Most females were Instagram, Snapchat, and TikTok users, whereas most males were using Facebook, Twitter, and other social media platforms (Table 2).

Table 2: Frequency of use of social media, type of social media platform, hours of use of social media, and their gender-wise comparison

The respondents’ views regarding the influence of social media on the perception of dentofacial esthetics and plastic surgery are tabulated in Table 3. Around 7 out of 10 respondents (n=353, 77.6%) have felt unsatisfied with their facial esthetics after looking at pictures of celebrities on social media with ideal esthetics. Around one-half (n=236, 51.9%) of the respondents have considered going through facial/dental esthetic procedures under the influence of social media, and a significant proportion of them were females. Most respondents (302, 66.4%) have compared their facial esthetics to the ideal, at least once, after seeing pictures of celebrities on social media.

Table 3: Views of the respondents regarding the influence of social media on the perception of dentofacial esthetics and plastic surgery

The comparison of the perception of dentofacial esthetics with the frequency of use of social media is exhibited in Table 4. There was a significant difference between the frequency of social media use and the perception of dentofacial esthetics. Those respondents who were more frequent users of social media were more unsatisfied with their facial esthetics and were influenced and inclined towards getting a procedure when it comes to dentofacial esthetics (Table 4).

Table 4: The comparison of the perception of dentofacial aesthetics with the use of social media

The advent of social media has brought about a transformative shift in how individuals perceive themselves and others. Social media platforms like Instagram, TikTok, and Snapchat have become central hubs for individuals to share images of themselves, often curated to present an idealized version of their appearance^1,5,7. In the current study, most respondents were very frequent users of social media; more females were using Instagram, Snapchat, and TikTok, while most men were using Facebook, Twitter (now known as X), and other social media platforms, and the most visited platform was Instagram. The results of the present study were consistent with the studies conducted in Russia, Turkey, and the United Kingdom, where the most used social media website was Instagram. Nonetheless, in the USA, especially in North America, the most used platform was Facebook^6,11-14.

Previous studies have reported the daily use of social media between 5 to 10 hours, with more aggressive use and dependency among younger age groups^15-18. In the present study, most participants, especially females, were using social media for 4 to 6 hours daily. In the present study, most of the respondents (n=286, 62.9%) were not following any aesthetic surgeon, which shows that not many people are actively seeking or engaging in invasive or non-invasive cosmetic procedures information; among the people who were following aesthetic surgeons, most were females. These findings were consistent with the results of a study by Kenneth et al., which showed that the majority of the people in the USA were not following any plastic or aesthetic surgeon⁶.

In the current study, the majority of the participants (n=425, 93.4%) agreed that a smile is an important aesthetic feature, admitted that their facial aesthetics affect their confidence (n=350, 76.9%), and agreed that a change in their facial aesthetics would improve their self-confidence. These findings were consistent with the results of the studies conducted by Armalaite et al., Shaista et al., Obeid et al., and Khalid et al^7,8,19,20.

In the current study, around one-half of the participants (n=241, 53%) agreed that beauty standards on social media affected their perception of dentofacial aesthetics. These results were consistent with the findings of the previous studies^8,21. Social media platforms substantially influence shaping beauty standards, including those related to dentofacial aesthetics. Celebrities and influencers often set trends in appearance, and dental treatments, such as teeth whitening, veneers, and orthodontic procedures, have become highly visible on these platforms^7,8,22. More than two-thirds of the respondents (n=352, 77.6%) in the present study felt unsatisfied, at least once, with their facial esthetics after looking at the pictures of celebrities on social media with ideal esthetics.

The influence of social media on dentofacial aesthetics directly impacts individuals’ treatment decisions. Research has shown that individuals are increasingly seeking orthodontic and cosmetic dental treatments to achieve the ideal esthetics they see on social media^4,8,23. In this study, one-fourth of the respondents (n=119, 26.2%) ‘sometimes’ considered going through dental or facial aesthetic procedures under the influence of social media, especially females. Moreover, the respondents who exhibited a higher frequency of social media usage demonstrated greater dissatisfaction with their facial esthetics and displayed a heightened inclination to be influenced towards seeking dentofacial esthetic procedures.

While social media can be a valuable source of information, it is also rife with misinformation and unrealistic expectations. Individuals may encounter sensationalized before-and-after photos, anecdotal stories, or unverified claims about dental treatments. This can lead to unrealistic expectations and dissatisfaction when real-life outcomes do not match the idealized images shared on social media^24,25.

The use of convenience sampling might limit the generalizability of the findings. The study relies on self-reported measures from an online questionnaire, which can be subject to biases like social desirability or inaccurate self-assessment. Moreover, the study primarily focuses on a few social media platforms and may not consider the impact of emerging or less popular platforms or the overall digital ecosystem.

Future research should consider longitudinal designs to observe how perceptions of dentofacial aesthetics change over time with continued social media use. Qualitative methods like interviews or focus groups could provide deeper insights into individual experiences and perceptions regarding dentofacial aesthetics and social media influence. Researching the effectiveness of educational or interventional strategies to mitigate the negative effects of social media on self-perception could be valuable for dental professionals and public health initiatives.

Social media’s impact on dentofacial aesthetic perception is significant. A majority of survey participants, particularly women who engage with social media for 4 to 6 hours daily, believe that enhanced facial aesthetics can elevate self-confidence. Forty percent follow aesthetic surgeons online, and about fifty percent are swayed by social media’s beauty norms. Frequent social media users expressed increased dissatisfaction with their facial esthetics and showed a greater inclination to be influenced toward seeking dentofacial esthetic procedures. Exposure to celebrities’ idealized images often leads to dissatisfaction with their facial features. Dental professionals must recognize these trends and offer factual advice to those aiming to enhance their dentofacial appeal in today’s digital era.

None

The authors declared no conflict of interest.

The study received approval from the Institutional Review Board (IRB) of the University College of Medicine and Dentistry (Ref No: UCD/ERCA/22/12).

MT: Conception and design, critical revision of the manuscript for important intellectual content, and Statistical expertise. HH: Conception and design, statistical analysis and interpretation of the data, drafting of the article, investigation, data curation, and draft preparation. US: Conception and design, critical revision of the article for important intellectual content, drafting of the manuscript, data curation. FI: Collection and assembly of data, drafting of the manuscript, data analysis, and interpretation of results. MH: Literature search, critical revision of the manuscript for important intellectual content, data interpretation, and proofreading. SA: Literature search, critical revision of the manuscript for important intellectual content, drafting of the manuscript.

1. Sampson A, Manoharan Andiappan HGJ, Newton JT. The effect of viewing idealized smile images versus nature images via social media on immediate facial satisfaction in young adults: A randomized controlled trial. J Orthod. 2020;47(1):55-64 https://doi.org/10.1177/1465312519899664
2. Laus I, Kovačević Pavičić D, Brumini M, Perković V, Pavlić A, Špalj S. Effects of visual stimuli from media on the perception of dentofacial esthetics. Acta Stomatol Croat. 2020;54(3):283–293. http://dx.doi.org/10.15644/asc54/3/6
3. Nazar A, Bader Munir M, Rafiq A, Khalid S, Hassan H. Success of veneers with indirect Resin Composite. Pak J Med Health Sci. 2021;15(12):3619–3622. http://dx.doi.org/10.53350/pjmhs2115123619
4. Ansari S, Abdullah Alzahrani A, Said Abomelha A, Attia Elhalwagy A, Mustafa Alalawi T, Mahmoud Sadiq T. Influence of social media towards the selection of Hollywood smile among the university students in Riyadh city. J Family Med Prim Care. 2020;9(6):3037. http://dx.doi.org/10.4103/jfmpc.jfmpc_442_20
5. Shivani Rana MK. The Dangers of Social Media and Young Dental Patients’ Body Image. Dent Update. 2018;45:902–910. https://doi.org/10.12968/denu.2018.45.10.902
6. Fan KL, James FG, Economides M, Black CK, Song DH. The Public’s Preferences on Plastic Surgery Social Media Engagement and Professionalism:Demystifying the Impact of Demographics. Plastic and Reconstructive Surgery. 2019;143(2):619-630. http://dx.doi.org/10.1097/PRS.0000000000005205
7. Perception and attitude of dental students and graduates towards business management as a subject in the dental Curriculum. Nat J Health Sci. 2023;8(3):112–116. Available from: http://dx.doi.org/10.21089/njhs.83.0112
8. Arab K, Barasain O, Altaweel A, Alkhayyal J, Alshiha L, Barasain R, et al. Influence of social media on the decision to undergo a cosmetic procedure. Plast Reconstr Surg Glob Open. 2019;7(8):e2333. http://dx.doi.org/10.1097/GOX.0000000000002333
9. Arif M. Role of social media for the adoption of cosmetic procedures among young Pakistani women. J Dev Soc Sci. 2022;3(II). http://dx.doi.org/10.47205/jdss.2022(3-ii)89
10. Hassan H, Rafique A, Andleeb S, Javaid M, Ahmad H, Khalid S. Post-insertion complaints associated with complete denture prosthesis in a tertiary care hospital. Rawal Med J. 2023;48(1):200-203. https://www.rmj.org.pk/?mno=81263
11. Vaca EE, Perez MM, Lamano JB, Turin SY, Moradian S, Fagien S, et al. Photographic misrepresentation on Instagram after facial cosmetic surgery: Is increased photography bias associated with greater user engagement? Aesthet Surg J. 2021;41(11):1778–1785. http://dx.doi.org/10.1093/asj/sjab203
12. Kacar Y. Instagram as one tool, two stages: self-presentational differences between main feed and story on Instagram. Atlantic Journal of Communication. 2023;22:1–6. http://dx.doi.org/10.1080/15456870.2023.2202401
13. Valero-Morales I, Nieto C, García A, Espinosa-Montero J, Aburto TC, Tatlow-Golden M, et al. The nature and extent of food marketing on Facebook, Instagram, and YouTube posts in Mexico. Pediatr Obes. 2023;18(5). http://dx.doi.org/10.1111/ijpo.13016
14. Hruska J, Maresova P. Use of social media platforms among adults in the United States—behavior on social media. Societies (Basel). 2020;10(1):27. http://dx.doi.org/10.3390/soc10010027
15. Zeba M, Awan OA. Leveraging social media to learn: A New Era for medical education. Acad Radiol. 2023;30(3):565–566. http://dx.doi.org/10.1016/j.acra.2022.05.010
16. Eitan T, Gazit T. No social media for six hours? The emotional experience of Meta’s global outage according to FoMO, JoMO and internet intensity. Comput Human Behav. 2023;138(107474):107474. http://dx.doi.org/10.1016/j.chb.2022.107474
17. Cheema ZT, Hassan H, Kayani SB, Aslam T, Aziz S, Cheema AT. Comparative analysis of E-learning in private and public sector medical and dental institutes in Pakistan. Pak J Med Health Sci. 2022;16(10):731–734. http://dx.doi.org/10.53350/pjmhs221610731
18. Khalid S, Aamir Rafique M, Azeem M, Jamil M, Hassan H, Abdullah HM. Perception of E-learning during COVID-19 among undergraduate dental students. Pak J Med Health Sci. 2021;15(10):3199–3203. http://dx.doi.org/10.53350/pjmhs2115103199
19. Armalaite J, Jarutiene M, Vasiliauskas A, Sidlauskas A, Svalkauskiene V, Sidlauskas M, et al. Smile aesthetics as perceived by dental students: a cross-sectional study. BMC Oral Health. 2018;18(1):225. http://dx.doi.org/10.1186/s12903-018-0673-5
20. Wahab A, Ju X, Jamieson L, Dreyer C. Modelling risk factors for high/low Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ) in the Australian adults. Eur J Orthod. 2021;43(2):200–207. http://dx.doi.org/10.1093/ejo/cjaa070
21. Abbasi MS, Lal A, Das G, Salman F, Akram A, Ahmed AR, et al. Impact of social media on aesthetic dentistry: General practitioners’ perspectives. Healthcare (Basel). 2022;10(10):2055. http://dx.doi.org/10.3390/healthcare10102055
22. Pearlman RL, Wilkerson AH, Cobb EK, Morrissette S, Lawson FG, Mockbee CS, et al. Factors associated with likelihood to undergo cosmetic surgical procedures among young adults in the United States: A narrative review. Clin Cosmet Investig Dermatol. 2022;15:859–877. http://dx.doi.org/10.2147/CCID.S358573
23. Baik KM, Anbar G, Alshaikh A, Banjar A. Effect of social media on patient’s perception of dental aesthetics in Saudi Arabia. Int J Dent. 2022;2022:4794497. http://dx.doi.org/10.1155/2022/4794497
24. Watson R. Appearance-focused Social Media Use, Unrealistic Beauty Ideals, and Body Image Dissatisfaction. J Res Gend Stud. 2022;12(1):114–129. http://dx.doi.org/10.22381/JRGS12120228
25. Tin-Oo MM, Saddki N, Hassan N. Factors influencing patient satisfaction with dental appearance and treatments they desire to improve aesthetics. BMC Oral Health. 2011;11(1):6. http://dx.doi.org/10.1186/1472-6831-11-6

This is an open-access article distributed under the terms of the CreativeCommons Attribution License (CC BY) 4.0 https://creativecommons.org/licenses/by/4.0/