Smile design

Slide-011

Smile design is a fundamental concept in cosmetic dentistry and when analyzing a smile we need certain parameters upon which to compare an existing situation against. We can’t just place veneers on someone‚Äôs teeth, for example, and hope that they will look okay.

We need to be able to objectively describe the existing smile and we also need to know exactly what the ideal smile should be for each particular patient. If we can accurately describe these two end points we can determine precisely what treatment is required to achieve the perfect smile for anyone.

When we analyse a smile we assess, in detail, each of the following factors:

General factors used to analyse a smile:

  1. Patient Age
  2. Sex
  3. Facial midline compared with the dental midline
  4. Facial long axis versus dental long axis
  5. Facial complexion

Teeth-specific factors used to analyse a smile:

  1. Smile line (the imaginary line joining the incisal edges of all the upper teeth and how this relates to the upper border of the lower lip)
  2. Lip line (the lower border of the upper lip during smiling and how this determines the amount of tooth and gum that shows during a smile)
  3. Incisal edge position (the ideal incisal edge position of the front teeth is determined by phonetics [observations of the patient pronouncing certain sounds], the visibility of teeth displayed during rest and also the amount of overlap of the lower teeth when closed)
  4. Buccal corridor (the biting edges and shape of the back teeth as seen during smiling)
  5. Tooth Shape (are the teeth, square, oval or rounded?)
  6. Tooth width:length ratio (the central incisors especially have an ideal width:length ratio of approximately 80%)
  7. Proportion (ideally the size of each tooth is related to the size of its adjacent tooth. This is called Golden Proportion which suggests that the ideal mathematical ratio between the apparent widths of the centrals, laterals and canines is 1.6 : 1 : 0.6)
  8. Dominance (generally the central incisors should be seen as the dominant teeth within the smile)
  9. Symmetry (symmetry between the central incisors is essential). Asymmetry of teeth further back from the centre can be acceptable and even pleasing.
  10. Incisal embrasures (these are the little gaps seen between adjacent teeth at their biting edges)
  11. Contact areas (these are the points at which each tooth touches the next tooth)
  12. Emergence profile and facial contour (this is the angle from which a tooth exits the gum and the contour of the visible surface of the teeth)
  13. Secondary anatomy (lobes and grooves in the visible tooth surface. These reflect light in different directions and make a tooth look natural)
  14. Tertiary anatomy (this refers to the smaller lines and abrasions on the tooth surface and impart further character to the teeth)
  15. Colour (some teeth appear to be a single colour, monochromatic, while others are composed of a multitude of different colours, polychromatic)
  16. Translucency and opacity (the enamel of some teeth is translucent allowing light to penetrate deep within the tooth whereas others show great opacity not allowing much light to enter)
  17. Further characterisation (some teeth may have certain coloured spots, lines or cracks)

Gum specific factors used to analyse a smile:

  1. Contour (what is the shape of the gums as they meet the teeth?)
  2. Embrasure (what is the shape of the gums between the teeth?)
  3. Symmetry (are the gum margins symmetrical? Symmetry of the gum margins of the central incisors is particularly important)

Occlusion

  1. How do the teeth bite together when all teeth are contacting versus when the jaw joints are in their ideal position?
  2. How do the teeth relate as the lower jaw protrudes forward so that the front teeth touch on their tips?
  3. How do the teeth relate as the lower jaw moves left and right?
  4. How do the teeth relate as the lower jaw moves forward and to the side?

It is only after analysis of each smile using the above criteria that we can begin to know what is wrong and also what we can achieve.

Treatment in cosmetic dentistry may encompass any or all of the following:

  1. Restoration of tooth structure with Composite resin (of which there are various types)
  2. Restoration of tooth structure with Porcelain (of which there are various types)
  3. Gum treatment to rectify disease or change the shape of the gums
  4. Orthodontics to move teeth into more ideal positions

Experienced cosmetic dentists in Brisbane

Whitehouse Dental offers the reassurance of an experience-based cosmetic dental service in Brisbane with proven results. Feel free to get in touch to discuss your particular cosmetic dentistry needs or concerns. You can call in for a consultation or ask a quick question via phone or our easy web enquiry form on the right.