Facial attractiveness: Ranking of end-of-treatment facial photographs by pairs of Chinese and US orthodontists
Tian-Min Xu, Edward L, Korn, Yan Liu, Hee Soo Oh, Ki Heon Lee, Robert L. Boyd and Sheldon Baumrindg
Beijing, China, Rockville, Md, Gwangju, Korea, and San Francisco, Calif
Introduction: In this study, we assessed agreement and disagreement among pairs of Chinese and US
orthodontists in the ranking for “facial attractiveness” of end-of-treatment photographs of growing Chinese
and white orthodontic patients. Methods: Two groups of orthodontist-judges participated: from the
University of the Pacific, School of Dentistry, in California and from Peking University School and Hospital of
Stomatology in China. Each judge independently ranked standard clinical sets of profile, frontal, and
frontal-smiling photographs of 43 white patients and 48 Chinese patients. Pearson correlations were
generated for a total of 1980 rankings by pairs of judges. Results: The resulting correlations ranged from
0.004 to 0.96 with a median of 0.54. Of these, 18.7% were lower than 0.4; 41.0% were lower than 0.5;
68.8% were lower than 0.6; 91.6% were lower than 0.7; and only 8.4% were greater than 0.7. As had been
anticipated, correlations between judges were higher when they ranked patients of their own ethnicity than
when they ranked patients of different ethnicity, but the differences were smaller than had been expected.
The rankings of no pair of judges correlated negatively. This is to say that no pair of judges, whether of the
same or different ethnicity, ranked the patients so that those 1 judge tended to find attractive were
consistently found unattractive by the other. Conclusions: The distribution of levels of agreement between
pairs of orthodontists did not differ substantially whether the pairs included 2 US orthodontists, 2 Chinese
orthodontists, or 1 US and 1 Chinese orthodontist. As might be expected, the pairs of Chinese orthodontists
agreed with each other slightly better on average when ranking Chinese patients, and the pairs of US
orthodontists agreed with each other slightly better on average when ranking white American patients, but
the overall differences were small. These findings appear consistent with the inference that, on average,
judgments of “facial attractiveness” by orthodontists at the 2 venues are more similar than had been
expected for patients of Chinese and white ethnicity. (Am J Orthod Dentofacial Orthop 2008;134:74-84)
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