Skip to main content

Thank you for visiting You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

Does dental appearance impact on employability in adults? A scoping review of quantitative and qualitative evidence


Background The importance of physical appearance in social and professional situations has been well studied. It has been suggested that improving dental appearance may increase employment prospects. This scoping review aims to map the current literature regarding the impact of dental appearance on employability.

Methods A scoping review was carried out in accordance with guidance from the Joanna Briggs Institute. Inclusion and exclusion criteria were developed iteratively, databases were searched and decisions on inclusion made in duplicate. Data were charted in Excel and synthesised using a visual map, study summary table and narrative description.

Results We identified 16 relevant articles: ten experimental simulation studies, two qualitative studies, one cross-sectional survey, one pre-/post-dental treatment survey, one retrospective cohort study and one narrative systematic review. Experimental simulations support the notion that visible dental conditions can negatively impact appraisals of employment-related personal characteristics. Negative impacts on job-seeking self-efficacy and willingness to apply for jobs have also been documented.

Conclusions The applicability of this evidence base to the UK health system context is uncertain and demonstration of real-life impact on employment is lacking. Further research is needed before programmes to improve dental appearance could be justified on the basis of improving employment outcomes.

Key points

  • Maps the existing literature on the link between dental appearance and employability.

  • Identifies where there are gaps in the literature and makes recommendations for further research.

  • Questions the NHS definition of 'clinically necessary' dental treatment.

This is a preview of subscription content, access via your institution

Access options

Rent or buy this article

Get just this article for as long as you need it


Prices may be subject to local taxes which are calculated during checkout

Fig. 1
Fig. 2


  1. Talamas S N, Mavor K I, Perrett D I. Blinded by beauty: Attractiveness bias and accurate perceptions of academic performance. PLoS One 2016; DOI: 10.1371/journal.pone.0148284.

  2. Willis J, Todorov A, Willis J, Todorov A. Making Up Your Mind After a 100Ms Exposure to a Face. Psychol. Sci 2019; 17: 592-598.

  3. Dion K, Berscheid E, Walster E. What is beautiful is good. J Pers Soc Psychol 1972; 24: 285-290.

  4. Johnson S, Podratz K, Dipboye R, Gibbons E. Physical attractiveness biases in ratings of employment suitability: Tracking down the 'beauty is Beastly' effect. J Soc Psychol 2010; 150: 301-318.

  5. Watkins L, Johnston L. Screening Job Applicants: The Impact of Physical Attractiveness and Application Quality. Int J Sel Assess 2002; 8: 76-84.

  6. Baert S, Decuypere L. Better sexy than flexy? A lab experiment assessing the impact of perceived attractiveness and personality traits on hiring decisions. Appl Econ Lett 2014; 21: 597-601.

  7. Tatarunaite E, Playle R, Hood K, Shaw W, Richmond S. Facial attractiveness: A longitudinal study. Am J Orthod Dentofac Orthop 2005; 127: 676-682.

  8. Schmidt K, Levenstein R, Ambadar Z. Intensity of smiling and attractiveness as facial signals of trustworthiness in women. Percept Mot Skills 2012; 114: 964-978.

  9. Mehu M, Little A C, Dunbar R I M. Sex differences in the effect of smiling on social judgements: An evolutionary approach. J Soc Evol Cult Psychol 2008; 2: 103-121.

  10. Murray J J, Vernazza C R, Holmes R D. Forty years of national surveys: An overview of children's dental health from 1973-2013. Br Dent J 2015; 219: 281-285.

  11. Steele J G, Treasure E T, O'Sullivan I, Morris J, Murray J J. Adult Dental Health Survey 2009: transformations in British oral health 1968-2009. Br Dent J 2012; 213: 523-527.

  12. Cronin M, Meaney S, Jepson N J A, Allen P F. A qualitative study of trends in patient preferences for the management of the partially dentate state. Gerodontology 2009; 26: 137-142.

  13. Wong B, Quick A N, Thomson W M. The impact of the popular media on cosmetic dentistry. N Z Dent J 2006; 102: 58-63.

  14. Binalrimal S. The Effect of Social Media on the Perception and Demand of Aesthetic Dentistry. IOSR J Dent Med Sci 2019; 18: 69-73.

  15. Khalid A, Quiñonez C. Straight, white teeth as a social prerogative. Sociol Health Illn 2015; 37: 782-796.

  16. RealSelf. U.K. Aesthetics Interest Survey. 2018. Available at (accessed May 2020).

  17. Health and Social Care Information Centre. 7: Outcome and impact - a report from the Adult Dental Health Survey 2009. 2011. Available at (accessed August 2020).

  18. Health Policy Institute. Oral Health and Well-Being in the United States. 2015. Available at (accessed August 2020).

  19. Sheiham A, Cushing A, Maizels J. The social impacts of dental disease. In Salde G (ed) Measuring oral health and quality of life. pp 47-56. North Carolina: University of North Carolina, 1997. Available at (accessed August 2020).

  20. Moeller J, Singhal S, Al-Dajani M, Gomaa N, Quiñonez C. Assessing the relationship between dental appearance and the potential for discrimination in Ontario, Canada. SSM Popul Health 2015; 1: 782-796.

  21. Sanders A E, Spencer A J, Slade G D. Evaluating the role of dental behaviour in oral health inequalities. Community Dent Oral Epidemiol 2006;34: 71-79.

  22. Siegrist J, Rosskam E, Leka S. Work and worklessness: Final report of the Task group on employment and working conditions, including occupation, unemployment and migrant workers: Review of social determinants of health and the health divide in the WHO European Region. 2016. Available at (accessed August 2020).

  23. UK Government. Work and Health Programme. 2019. Available online at (accessed November 2019).

  24. Hyde S, Satariano W A, Weintraub J A. Welfare dental intervention improves employment and quality of life. J Dent Res 2006; 85: 79-84.

  25. Peters M D J, Godfrey C M, Khalil H, McInerney P, Parker D, Soares C B. Guidance for conducting systematic scoping reviews. Int J Evid Based Healthc 2015; 13: 141-146.

  26. Tricco A C, Lillie E, Zarin W et al. PRISMA extension for scoping reviews (PRISMA-ScR): Checklist and explanation. Ann Intern Med 2018; 169: 467-473.

  27. Pithon M M, Nascimento C C, Barbosa G C G, Coqueiro R D S. Do dental esthetics have any influence on finding a job? Am J Orthod Dentofac Orthop 2014; 146: 423-429.

  28. McErlain M, Newton J T, Jeremiah H G. Does dental appearance affect employment prospects: a prospective cross-sectional study. J Orthod 2018; 45: 71-78.

  29. Halasa-Rappel Y A, Tschampl C A, Foley M, Dellapenna M, Shepard D S. Broken smiles: The impact of untreated dental caries and missing anterior teeth on employment. J Public Health Dent 2019; 79: 231-237.

  30. Kerr L. More than Just Pulling Teeth: The Impact of Dental Care on Patients' Lived Experiences. J Can Dent Assoc 2018; 84: i4.

  31. Douds A S, Ahlin E M, Kavanaugh P R, Olaghere A. Decayed Prospects: A Qualitative Study of Prison Dental Care and its Impact on Former Prisoners. Crim Justice Rev 2016; 41: 21-40.

  32. Newton J T, Prabhu N, Robinson P G. The impact of dental appearance on the appraisal of personal characteristics. Int J Prosthodont 2003; 16: 429-434.

  33. Feng X, Newton J, Robinson P. The impact of dental appearance on perceptions of personal characteristics among Chinese people in the United Kingdom. Int J Prosthodont 2001; 51: 429-434.

  34. Eli I, Bar-Tal Y, Kostovetzki I. At first glance: Social meanings of dental appearance. J Public Health Dent 2001; 61: 150-154.

  35. Montero J, Gómez-Polo C, Santos J A, Portillo M, Lorenzo M C, Albaladejo A. Contributions of dental colour to the physical attractiveness stereotype. J Oral Rehabil 2014; 41: 768-782.

  36. Shaw W C, Rees G, Dawe M, Charles C R. The Influence of dentofacial appearance on the social attractiveness of young adults. Am J Orthod Dentofac Orthop 1985; 87: 21-26.

  37. Kershaw S, Newton J T, Williams D M. The influence of tooth colour on the perceptions of personal characteristics among female dental patients: Comparisons of unmodified, decayed and 'whitened' teeth. Br Dent J 2008; DOI: 10.1038/bdj.2008.134.

  38. Williams D M, Chestnutt I G, Bennett P D, Hood K, Lowe R, Heard P. Attitudes to fluorosis and dental caries by a response latency method. Community Dent Oral Epidemiol 2006; 34: 153-159.

  39. Williams D M, Chestnutt I G, Bennett P D, Hood K, Lowe R. Characteristics attributed to individuals with dental fluorosis. Community Dent Health 2006; 23: 209-216.

  40. Singhal S, Correa R, Quiñonez C. The impact of dental treatment on employment outcomes: A systematic review. Health Policy 2013; 109: 88-96.

  41. Singhal S, Mamdani M, Mitchell A, Tenenbaum H, Quiñonez C. An exploratory pilot study to assess self-perceived changes among social assistance recipients regarding employment prospects after receiving dental treatment. BMC Oral Health 2015; 15: 2-7.

  42. Singhal S, Mamdani M, Mitchell A, Tenenbaum H, Lebovic G, Quiñonez C. Dental treatment and employment outcomes among social assistance recipients in Ontario, Canada. Health Policy 2016;120: 1202-1208.

  43. Eagly A H, Ashmore R D, Makhijani M G, Longo L C. What Is Beautiful Is Good, But.: A Meta-Analytic Review of Research on the Physical Attractiveness Stereotype. Psychol Bull 1991; 110: 109-128.

  44. Feingold A. Good-Looking People Are Not What We Think. Psychol Bull 1992; 111: 304-341.

  45. Centre for Open Science. OSF. Available online at (accessed May 2020).

  46. Edwards M, Macpherson L M D, Simmons D R, Gilmour W H, Stephen K W. An assessment of teenagers' perceptions of dental fluorosis using digital simulation and web-based testing. Community Dent Oral Epidemiol 2005; 33: 298-306.

  47. Pithon M M, Bastos G W, Miranda N S et al. Esthetic perception of black spaces between maxillary central incisors by different age groups. Am J Orthod Dentofac Orthop 2013; 143: 371-375.

  48. Henson S T, Lindauer S J, W Gardner G, Shroff B, Tufekci E, Best A M. Influence of dental esthetics on social perceptions of adolescents judged by peers. Am J Orthod Dentofac Orthop 2011; 140: 389-395.

  49. Tennis G H, Dabbs J M. Judging physical attractiveness: Effects of judges' own attractiveness. Person Soc Psychol Bull 1975; 1: 513-516.

  50. Sim S Y L, Saperia J, Brown J A, Bernieri F J. Judging attractiveness: Biases due to raters' own attractiveness and intelligence. Cogent Psychol 2015; DOI: 10.1080/23311908.2014.996316.

  51. NHS. Understanding NHS Dental Charges. 2020. Available at (accessed March 2020).

  52. Hill K B, Chadwick B L, Freeman R, O'Sullivan I, Murray J J. Adult Dental Health Survey 2009: Relationships between dental attendance patterns, oral health behaviour and the current barriers to dental care. Br Dent J 2013; 214: 25-32.

  53. Paisi M, Kay E, Plessas A et al. Barriers and enablers to accessing dental services for people experiencing homelessness: A systematic review. Community Dent Oral Epidemiol 2019; 47: 103-111.

  54. NHS. Understanding NHS dental charges. 2020. Available at: (accessed September 2020

  55. Benson P E, Javidi H, Dibiase A T. What is the value of orthodontic treatment? Br Dent J 2015; 218: 185-190.

  56. Feu D, Miguel J A M, Celeste R K, Oliveira B H. Effect of orthodontic treatment on oral health-related quality of life. Angle Orthod 2013; 83: 892-898.

  57. The National Archives. Health and Social Care Act 2012. Part 1 - 4. The Secretary of State's duty as to reducing inequalities. 2012. Available online at (accessed August 2020).

Download references


The authors gratefully acknowledge the input of Mrs Sandra White in identifying the research topic. This study was funded by Public Health England. The views expressed are those of the authors and not necessarily those of Public Health England or the National Health Service.

Author information

Authors and Affiliations


Corresponding author

Correspondence to Deborah Moore.

Electronic supplementary material

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Moore, D., Keat, R. Does dental appearance impact on employability in adults? A scoping review of quantitative and qualitative evidence. Br Dent J (2020).

Download citation

  • Received:

  • Accepted:

  • Published:

  • DOI:

This article is cited by


Quick links