Method: 77 children were interviewed and examined clinically (48 in kindergartens; 29 in dental clinic). In the interview each child was asked to identify facial features on a photograph of a boy or a girl. The order of identification of facial features was recorded. The same interview was repeated with the same photograph but one incisor was deleted by digital means. This was repeated using a third photograph where both central incisors were deleted. Esthetic defects (absence, deformation, decay, malposition and discoloration) in the child's maxillary incisors were recorded. Parents report on previous dental treatment and esthetic issues of child front teeth were obtained.
Results: 59% of the children observed teeth in the 1st photograph, 67% in the 2nd and 68% in the 3rd. Of all facial features teeth were the first to be mentioned by one third of the children. Teeth were noticed by more children interviewed in the dental clinic than in the kindergarten. This difference was not statistically significant. 50% of the children noticed the difference between the 2nd and 3rd photographs. Children older than 5 years noticed the difference between the 1st and 2nd photograph more than any other age group. Regarding the ability to notice missing teeth, no significant differences were found between boys and girls, between children with or without esthetic defects in the maxillary incisors, and place of interview.
Conclusions: Preschool children's awareness of the absence of maxillary incisors is limited. Older children are more likely to notice the absence of these teeth.