ABSTRACTObjectiveThis study aimed to analyze which facial, gingival and dental characteristics are associated with confidence in smiling among 75 subjects seeking treatment in a northern Brazilian public dental university.Materials and MethodsClinical examinations and three standardized photographs of each subject were taken by one trained examiner. In addition, a questionnaire was applied to assess confidence in smiling. The subjects were dichotomized into two groups, non‐confident (n = 36) and confident (n = 39) in smiling. Chi‐square/Fischer exact test were used to associate the facial, gingival and dental characteristics between groups.ResultsThe subjects that reported to be non‐confident in smiling were statistically associated with smile type (p = 0.030) and wrongly positioned teeth (p = 0.047). On the other hand, gender (p = 0.491), marital status (p = 0.217), gum pigmentation (p = 0.930), midline (p = 0.176), volume of the upper (p = 0.380), and lower (p = 0.615) lips were not associated with self‐reported confidence in smiling.ConclusionIn patients seeking dental treatment in a public dental university, non‐confidence in smiling was associated only with some oral and intraoral characteristics and not with demographic characteristics.Clinical SignificanceThis study showed that only smile type and wrongly positioned teeth were statistically associated with confidence in smiling. Dentists should pay attention to those intraoral characteristics, but the clinical decision making should always include the patients' perception. (J Esthet Restor Dent 29:E56–E66, 2017)