Most people perceive a nice smile as a set of straight white teeth. Some may go a step further and describe a nice smile is also about nicely shaped teeth with certain anglulation to the face and that a right amount of gum is shown.
Those are about right, just that a nice smile is also beyond that. For a start, a nice smile is not just about a set of straight teeth but also having a nice smile arc.
Let’s discuss the science behind a nice smile. We can broadly categorise this into 3M which are macro, micro and mini aesthetics.
Macro: looking at the face in general with focus on the relationship of the teeth to the face.
Mini: focus on the smile framework like the gingival and tooth display on smiling, gummy smile, buccal corridors, alignment and colour.
Micro: analyse the shape of the teeth and tooth proportion like height, width, gingival shape.
At each level, there are parameters that are used to look at a component objectively. A clinician should be able to identify the variation from the ideal or desired parameter and come up with a treatment option to address that.
The downside of 3M is that it can be too detailed for most clients during their first dental visit. When speaking to most clients I will normally use ABC instead of 3M for communication.
Alignment: Where we look at the arrangement of the teeth. Often Invisalign can be used to address this.
Brightness: Where we look at the colour of the teeth. Often teeth whitening or veneers can be used to address this.
Contour: Where we look at shape of teeth if its too squarish, too round etc. Often, the treatment can range from ceramic veneers or composite bonding or laser gum contouring.
ABC facilitates understanding for the clients about their dental issue but doesn’t provide the clinician with the parameters to improve the smile. More often, as a clinician I would normally rely to the 3M analysis for treatment planning.
Of course a nice smile is more than science, sometime I do need to use gut feel or clinician’s hunch to make some decision, sometime, not too often fortunately.
Having said that, with advancement in technology we can create a simulation of the possible outcome(s) that can help both parties to see the desired outcome. With that, the workflow will be for the clinician to reverse engineer dentistry to produce the outcome desired.