Esthetics in the oro-facial region are important for perceived oral health and a 
common reason for treatment of discoloured, missing or crowded teeth. As one of 
the fundamental bricks of a patient's oral health, changes in the domain of 
oro-facial esthetics resides within the oral health-related quality of life 
(OHRQoL) of an individual. Four main dimensions, oral function, oro-facial pain, 
oro-facial appearance and psychosocial impact, are suggested to cover the 
concept of OHRQoL. The aim of this systematic review was to map the impact from 
oral conditions with principal impact on the oro-facial appearance dimension of 
OHRQoL (PROSPERO: CRD42017064033). Publications were included if they reported 
Oral Health Impact Profile (OHIP) mean or median domain scores for patients with 
esthetic treatment need relating to tooth wear, orthodontics, orthognathic 
surgery, frontal tooth loss or tooth whitening. A search in PubMed (Medline), 
EMBASE, Cochrane, CINAHL and PsycINFO 8 June 2017 and updated 14 January 2019, 
identified 2,104 abstracts. After screening of abstracts, 1607 articles were 
reviewed in full text and 33 articles included. These 33 articles reported 
OHIP-data for 9409 patients grouped in 63 patient populations. Median oro-facial 
appearance impact scores on a standardised 0-8 scale, for populations with 
treatment need relating to tooth wear, orthodontics, orthognathic surgery, 
frontal tooth loss and tooth whitening, ranged from 0.13 for tooth wear to 3.04 
for tooth whitening populations. In conclusion, a moderate impact for the 
oro-facial appearance dimension of OHRQoL was found in patients with different 
conditions with esthetically related treatment need.