One of the most challenging tasks in daily practice when it comes to defining treatment goals and how to attain them is the communication with the patient and the self-reflection of the treating dentist. Failures due to mis-communication are common, especially in esthetic dentistry. The purpose of this study was to evaluate the influence of dental education on students' and dentists' judgment of patients' dental appearance.Based on internationally accepted guidelines about dental esthetics, a questionnaire was developed to measure "dental appearance" (QDA). Eleven items defined a QDA score (0 = "absolutely dissatisfied", 100 = "absolutely satisfied"). The QDA was completed by 29 patients (21 women, 8 men) before and after a complete oral rehabilitation, including restoration of the anterior teeth. Overall, 95 students (1st, 5th, and 10th Semester) and 30 dentists evaluated the patients' esthetics before and after rehabilitation on a visual analog scale (VAS; 0 = "absolutely unesthetic", 100 = "absolutely esthetic").Students and dentists alike judged a significant esthetic improvement after treatment (P ≤ 0.0001). Significant differences could be found when comparing the students' and dentists' judgment and the patients' self-evaluation (P ≤ 0.05).Since it seems that students judge dental appearance differently from patients' self-assessment, teaching esthetic rules at university should incorporate the aspect of patient feedback in order to avoid misconceptions.