Columnist Chido Nwakanma listened in to a professor talk about how arrangement of jaw and teeth affects how a persons looks, and shares what he learnt.
Do you consider yourself attractive, dear reader? What is the basis of your self-assessment? Is it the feedback of your friends and family or what your mirror tells you?
Experts say there is a link between dentofacial appearance and beauty. Broken down means the arrangement of your jaw and teeth affects how you look. That is the province of specialist dental care practitioners called orthodontists.
Prof Ifeoma Linda Utomi is one of only about 70 orthodontists in Nigeria. She is a rare breed working in an arcane field. However, on Wednesday, 8 December 2021, Ifeoma Utomi professed her discipline in the simplicity and brevity of the truly distinguished. In doing so, Prof Utomi brought smiles to the faces of her colleagues, and regular folks from other disciplines gathered to hear her.
Prof Ifeoma Linda Utomi presented the 367th Inaugural Lecture of the University of Lagos on the subject, “Beauty, Braces and Being: Restoring the smile, transforming the life’.
The professor of orthodontics is of the Department of Child Dental Health, Faculty of Dental Sciences, College of Medicine, University of Lagos. “Orthodontics is the speciality of dentistry concerned with the diagnosis, prevention and correction of misaligned teeth and mal-aligned jaws and consequently transforming the life by restoring the smile, improving the aesthetics (beauty), physical and mental well-being of the individual,” Utomi explained.
What Orthodontists bite into
She shared many exciting vignettes from her career as a consultant and academic.
Adults are increasingly embracing braces as part of orthodontics. Modern braces come in varying colours that enable some users to do colour-matching with their fashion!
“In recent years, wearing orthodontic appliances (braces) has become a source of pride and upward social mobility in Nigeria, especially among children. This trend is not limited to Nigeria. Children wearing these appliances (braces) tend to show off, derive social relevance from them and some are unwilling to take off their braces even at the end of treatment.
“We carried out a study at the Lagos University Teaching Hospital to assess patients’ attitudes to their orthodontic appliances. Our study showed that 69% of the patients were happy to admire their appliances in the mirror while 63.1% were glad to let their friends see their appliances. On the other hand, some were worried about their appliances with 80.3% in the moderate worry group, and 17.9% and 1.85% in the low and high worry groups respectively. These worries were related to some of the inconveniences associated with wearing orthodontic appliances”.
Studies at LUTH showed that Nigerian patients stopped usage of their braces because it restricted their food choices as against Caucasians who stopped because of pain.
“Another study on challenges and motivating factors of orthodontic treatment in patients aged 10-28, showed the desire to improve their dentofacial appearance as the most important motivating factor of treatment.
However, more than three-quarters of the patients (82.6%) were teased about their appliance. Seventy-three per cent had difficulty in eating, 65.8% with oral hygiene, and 37% with speech. Sixty-four per cent of the patients wanted to discontinue treatment for several reasons including restriction to soft diet, (37.5%), pain (20.8%), appearance (16.7%), missing school (12.5%).
Beauty as from old
In previous similar studies in Caucasian populations, pain was considered the worst aspect of treatment. In this study, diet restriction was considered the worst aspect of treatment and was the most common reason for desiring to stop treatment. Patients were advised to avoid hard foods like nuts, chicken bone, kpomo and saki.” Children and adolescents form the bulk of patients. Females lead for adults.
So, back to the question of beauty and attractiveness.
Greek and Roman artists, including Polycleitus, Marcus Vitruvius Pollio, and Leonardo Da Vinci, provided the earliest guidelines for assessing and improving facial appearance and beauty in the fifteenth and sixteenth century. “The great Renaissance artist, Leonardo Da Vinci (1452-1519), based on the earlier work of Vitruvius, produced the proportions of the human head and the human form, which has important clinical implications. The guidelines used by clinicians today are mainly based on these earlier works and remain relevant. “
Renaissance artists indicated that front and side views of the human face are of equal height in well-proportioned faces. To understand the implications for Nigeria, Prof Ifeoma Utomi and her team studied Nigerian faces.
“Using the cephalometric radiograph, I assessed the anteroposterior skeletal jaw relationship (the hard tissue profile) of 100 Hausa-Fulani children with normal occlusion. In comparison with previous Nigerian studies, our study showed that the upper and lower jaws of the Yorubas and Igbos were more protrusive than that of the Hausa-Fulanis. The study showed that the cephalometric values for the Hausa-Fulanis were closer to that of Caucasians”.
Cephalometric x-rays (also called ceph x-rays or radiographs) show a side view of your head, exposing teeth, jaw, and surrounding structures.
Cephalometric x-ray of three dominant ethnic groups showed differences. Hausa-Fulani shows a flat profile. Yoruba showed protrusive upper and lower jaws. The Igbo also showed the protrusive upper and lower jaws.
An expensive field
“Based on these ethnic differences, who then can be considered more beautiful? The answer is that each ethnic group defines its own concept of beauty such that the concept of beauty is not generalisable. These findings show that orthodontic evaluation and treatment cannot be generalised across ethnic groups. Papers and articles from this study have been published in peer-reviewed journals with numerous citations”.
There were many other insights. Many of the patients who report to the dental clinic to improve their appearance do so on self-referral. Appearance mattered so much to such people.
Utomi explained: “As an orthodontist, I have seen a lot of children, adolescents and adults who were dissatisfied with the arrangement of their teeth, jaws and overall facial appearance (beauty). This dissatisfaction with their beauty negatively impacted their well-being and quality of life. It has caused some to be depressed, experience teasing and bullying and have difficulty socialising with others. This tends to wipe the smile off their faces. Using orthodontic appliances (braces), the orthodontist restores their smile, beauty, and well-being, transforming their lives into the whole fulfilled essence of existence”.
Using photographs, graphs and other pictorials, the youngish and beautiful professor made understanding her life’s work and its implications for society easy to understand. Dentistry is an expensive field, so Prof Utomi recommended increased funding for the training of specialists in the area. She also asked the government to fund early childcare of malocclusion or lousy dental and jaw formation.
Love unending
Ifeoma Utomi appreciated a long list of mentors, associates, and helpers. Her five children received plaudits for their giant strides from a proud mum. She then ended on a note of humour.
“Many a time, when I mention my name, the first response I get is a question – “Are you related to …?? So, today, I publicly declare that Professor Pat Utomi is my husband and the love of my life. For the past 36 years, I have been married to this most amazing gentleman, a God-fearing man (Catholic) of great integrity, courage, compassion, wisdom, and outstanding intellectual and entrepreneurial capacity, an awesome father to our children.
“About 38 years ago, when I was an undergraduate at the College of Medicine, University of Lagos, you came and swept me off my feet. It has been a love unending for us since then with five wonderful children added to our bouquet.”
Fittingly, Pat Utomi presented a bouquet of red roses making Vice Chancellor Prof Oluwatoyin Ogundipe quip about Valentines.
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