Abstract Aim We aimed to investigate the association of perceived orofacial esthetics with loneliness, social isolation, and social withdrawal. Subject and methods Cross-sectional data from an online survey of the adult population in Germany ( n = 3270 individuals, 18–74 years; January 2025) was used. A quota-based approach was used (ensuring representativeness in terms of sex, age, and federal state). Outcomes were measured using established tools (German versions of the De Jong Gierveld tool, Bude Lantermann tool, and 25-item Hikikomori Questionnaire). The German version of the Orofacial Esthetic Scale (OES-G) was used to quantify perceived orofacial esthetics. Linear regressions were used. Results Mean perceived orofacial esthetics score was 22.7 (SD 6.9), varying from 0 to 35. Even after adjusting for various covariates, favorable perceived orofacial esthetics were associated with lower loneliness ( β = −.03, p < .001), lower social isolation ( β = −.02, p < .001), and lower social withdrawal ( β = −.33, p < .001). Sex-stratified regressions yielded similar results. However, it is worth noting that the association of favorable perceived orofacial esthetics with lower loneliness was significantly more pronounced among women (compared to men). Conclusion As the very first study, we found that favorable perceived orofacial esthetics were associated with lower loneliness, lower social isolation, and lower social withdrawal. The observed sex differences in loneliness underscore the importance of further research to achieve a more detailed understanding of how social norms and psychological factors contribute to this variation.
Hajek et al. (Wed,) studied this question.