Smile design

 

Smile design is the process of choosing the design and shape of the composite veneers or porcelain veneers a patient wish to have before the veneers are placed on the teeth. It is one of the most important aspects of designing a desirable and beautiful smile as it allows the patient to communicate visually with the dentist, the shape of the teeth or veneers they wish to have rather than patient trying to verbally describe the shape of teeth they want to have which is open to misunderstanding by the dentist or the dental technician or both.

The design of the smile allows the dentist to liaise with the lab technicians more accurately what shape teeth patient wish to have which is important when making the Trial Smile for a new smile. Trial Smile ensure patient expectations are more accurately met by seeing the shape of the veneers and achievable result either on a model of patient’s teeth (wax up models) or digitally.

Smile design is not limited just to composite bondings or porcelain veneers and it can also include orthodontic treatments such as Invisalign to align teeth better and improve the smile by closing gaps or correction of crowding. With orthodontic treatment alone, however, shape of the teeth are not changed.

What factors can be considered in shape of the teeth when designing a new smile?

The most visible teeth when one smiles are the 8 top teeth in vast majority of the population. In particular the top 6 teeth play an important role in what is seen and noted when one smiles, otherwise know as canine to canine teeth.

When a smile is designed, depending on the clinical dictation of the way teeth work together, their position and characteristics, patient can choose what shape teeth to have. Bellow is a list of some of the possible teeth designs and shapes that one can be consider.

 

In all these designs the main Golden Proportions principles are followed which in short follows the guide lines for best smile design in relation to the;

  1. Relative size of the teeth to compare with each other for the best width to length ratios.
  2. Symmetry of the teeth on the left and right side relative to middle line
  3. Horizontal alignment to ensure the edge of the teeth are aligned with eye line
  4. Having similar width of canine to canine as the space between the eye corners on nasal bridge.
  5. The width proportion of the top 6 teeth visible relative to each other when one smiles.

Achieving these guidelines clinically is very much affected to position of the teeth in the mouth, bite of a patient, health of the teeth and the gum, the  presence of gaps which can be symmetrical or asymmetrical from the middle line of the teeth, possible crowding of the teeth and some other factors.

What are the main differences in the smile designs shown above?

Other important factors need to be considered in a smile design is the shape of the teeth and in particular the embrasures which is the shape of the corners of the front teeth which can be either more of a square shape or a rounder shape. Generally speaking the more square the embrasures, the more masculine the teeth shape and the more the rounded corner the more feminine the design of the teeth.

In addition the length of the teeth tips relative to each other (the horizontal line as some people prefer to) have the tips of the teeth at the same level or alternatively to follow the natural design which means the tip of the teeth have slightly different length. These are the two main differences between the smile designs pictures shown above.

In addition the length of the teeth tips relative to each other (the horizontal line as some people prefer to) have the tips of the teeth at the same level or alternatively to follow the natural design which means the tip of the teeth have slightly different length. These are the two main differences between the smile designs pictures shown above.

In close inspection of the design photos one can see at one extreme we have “aggressive style” in which teeth have very square tips (embrasures) and all the tips from canine to canine are the same length. On the other hand in “oval style” teeth have more rounded tips and similar length. In “youthful style” the embrasures are more of rounded tips with the canines and the front incisors at the same length and the small incisors in between them having slightly shorter length.

Natural style, Softened style and the Youthful style are some of the most popular design shapes.

Patients must be aware that achieving such results does not just limits to to seeing the photos of different designs and requesting it. Teeth are dynamic and have chewing function and it is possible sometimes not possible to clinically achieve a specific design. Trail Smiles have an important role in showing what is achievable clinically.