AUCKLAND, New Zealand: Social media increasingly shapes ideas about what constitutes a healthy, attractive or socially acceptable smile. Researchers from Auckland University of Technology and the University of Otago in New Zealand have examined how social media use relates to adolescents’ dental self-confidence and psychosocial well-being. In light of their findings, they recommend less idealised smile imagery in oral health marketing and stronger safeguards for adolescents online.
Commenting on his recent study on social media use and adolescent dental self-confidence, Dr Khaled Ibrahim said treatment communication should emphasise oral health, function and realistic outcomes rather than a “perfect” smile ideal. (Image: Dr Khaled Ibrahim)
Lead author of the study Dr Khaled Ibrahim, lecturer in marketing and international business at Auckland University of Technology, told Dental Tribune International that the research was prompted by the growing role of social media in shaping how young people think about appearance, health and social acceptance. He noted that, although there is already a substantial body of research on social media and general body image, far less attention has been paid specifically to dental appearance.
During adolescence, young people are forming their identities, becoming more sensitive to how peers see them and, in many cases, undergoing orthodontic treatment. “We therefore wanted to understand dental self-confidence not simply as an individual or clinical matter, but as something that may be influenced by peer relationships, social comparison and digitally circulated appearance standards,” Dr Ibrahim commented.
In the study, the researchers analysed survey responses from 502 adolescents aged 12–17 and their parents or guardians. The findings showed that lower dental self-confidence was associated with greater social and psychological impact related to dental appearance, particularly worries about peer judgement and self-consciousness. Dr Ibrahim noted that concerns about dental appearance may become psychologically significant through everyday experiences, such as feeling uncomfortable when smiling, speaking or being photographed, or anticipating how others will react.
The researchers also assessed aesthetic concern, which they defined as private dissatisfaction with dental appearance against an internalised ideal. They found that this measure was not significantly associated with the social or psychological impact of dental appearance. The authors interpreted this finding as suggesting that dental self-confidence, being socially oriented, may be more closely associated with psychosocial outcomes than adolescents’ appraisal of their dental appearance itself. “This distinction is important because it suggests that practitioners should look beyond whether an adolescent believes their teeth are attractive and consider how they feel and behave around other people,” Dr Ibrahim noted.
Additionally, the study found that the link between greater dental self-confidence and a lower psychological impact of dental appearance was slightly weaker among adolescents who spent more time actively using social media. However, active social media use did not significantly alter the association between dental self-confidence and social impact, and passive use showed no significant moderating effect. The authors emphasise that the finding does not demonstrate that active use causes psychological harm.
Finally, the study showed that adolescents with a history of orthodontic treatment reported higher dental self-confidence but also greater social and psychological impact regarding dental appearance. This pattern may reflect greater attention to dental appearance among adolescents undergoing or having completed orthodontic treatment, the authors suggest. However, owing to the cross-sectional design, the study could not determine whether treatment produced these differences or whether adolescents with greater pre-existing concerns were more likely to undergo treatment.
Looking beyond clinical outcomes
For dental professionals, the findings underline the close association between adolescents’ confidence in their teeth and their social and psychological well-being. The authors suggest that consultations with adolescent patients should extend beyond clinical outcomes to include questions about comfort when smiling, speaking or being photographed, as well as the possible influence of appearance-focused social media content. They also recommend that clinicians manage expectations regarding aesthetic outcomes and discuss peer attention to visible dental appliances during treatment.
They also recommend that dental practices reconsider highly idealised smile imagery in their marketing. Communications could instead emphasise oral health, function, confidence and realistic, individually appropriate outcomes.
“The broader message is that dental well-being extends beyond the condition or appearance of the teeth.”—Dr Khaled Ibrahim, Auckland University of Technology
Co-author Prof. Lisa McNeill from the University of Otago’s Department of Marketing said the research was particularly timely amid continuing debate over adolescents’ social media use in New Zealand. A parliamentary inquiry completed in March recommended introducing age restrictions for social media platforms and advancing work to limit access for users under 16. “Social media use can have real consequences for children, and it is important to reflect on how children are engaging with such media,” she said in a press release.
Importantly, Dr Ibrahim stressed that the findings should not be taken to mean that social media use is inherently harmful or that orthodontic treatment caused the greater social and psychological impact reported by adolescents with a treatment history. Rather, their impact on adolescents depends on the social and psychological context in which they are experienced. “The broader message is that dental well-being extends beyond the condition or appearance of the teeth. It includes whether young people feel able to smile, speak, interact and present themselves without excessive concern about judgement. Recognising this wider context can help dentistry provide care that supports both oral health and adolescent well-being,” he concluded.
In related research previously reported by Dental Tribune International, nearly a third of young adults who had undergone aesthetic dental treatment said that social media had influenced their treatment decision. Posts from dentists and dental clinics were reported as the most influential type of content.
The study, titled “Dental self-confidence in digital health marketing systems: Adolescent well-being and social media use”, was published online on 25 June 2026 in Health Marketing Quarterly.
