Research summary : Does dental appearance impact on employability in adults?

This study wanted to look at the qualitative and quantitative evidence of the current literature regarding the impact of dental appearance on employability. 


  • Physical appearance in social and professional situations is well known to be of importance.
  • There is unquestionable evidence that ‘facial attractiveness’ can influence unrelated personal characteristics.
  • Judgements are subconsciously made in as little as 100 milliseconds. 
  • Not smiling can also negatively affect someone’s ratings- and women suffer a greater negative impact.
  • In the last 50 years, OH care has improved all around the world, so in turn we’ve seen a rise in the standard and the socially-accepted dental appearance- this includes missing, discoloured or misaligned teeth less and less. 
  • The changing importance of a good dental appearance is also swayed by television makeover shows and social media. 
  • Cosmetic dentistry was the ‘most desired non-surgical cosmetic treatment’ in 2018 (UK).

Reasons why poor dental appearance may negatively affect someone’s employability opportunities:

  • Difficulty talking, smiling or laughing (due to embarrassment)
  • Low confidence
  • Interviewers quickly make less favourable judgements 

Long term employment can indirectly decrease the risk of depression, cardiovascular disease and a myriad of other diseases. It would therefore make sense for the UK ‘return to work’ programmes to include help for access to dental care.


  • Scoping review 
  • PRISMA flow diagram:
  • Search engines/databases used: Google, Google Scholar, PsychINFO, Social Policy and Practice, Embase and Medline via Ovid- 982 studies identified

Results: Looking into various different studies, here were some findings:

  • A one-point increase in the ‘Dental Problem index’ was associated with a 7.7% reduction in being employed (controlled= age, gender, marital status, education, poverty and health status)
  • Malocclusion negatively impacted perception of intelligence, but not of honesty and work efficiency
  • Dental appearance assumptions- related to drug use, needing time off work.
  • Characteristics that are perceived more negatively: intelligence, education,  trustworthiness, laziness, reliability, sociability and friendliness.
  • In Canada- recipients of an employment-assistance programme were offered free basic dental care- employment outcomes were not significantly different 12 months after.
  • ‘Job- seeking self-efficacy’* increased after dental care

*self-confidence and willingness to make applications and attend interviews


  • A wide range of study types were found however few directly addressed the question of interest.
  • All relevant studies reported negative bias on ‘work-related personal characteristics’ 
  • Only 1 of the 3 studies that specifically investigated impact of DENTAL TREATMENT on employment reported any evidence of benefits.
  • Benefits of dental treatment seem to be related more to the increased confidence rather than directly related to being employed.
  • Further evidence such as from an RCT is needed


  • Further research is needed to provide sufficient evidence of the employability benefits that programmes to improve dental appearance can provide
  • However, from another perspective- this programme could be justified already in terms of ‘reducing health and social inequalities and capacity to benefit from publicly funded healthcare’

Nicole Hasoon BDS4

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