Your smile represents you
Research has shown the important role of a beautiful healthy and natural smile on human relations.At first meeting our eyes focus on the teeth and smile.There are papers stating that harmonious natural smiles boost self confidence.
Smile design is the art of establishing a consept of natural looking good functioning teeth that are in harmony with the oral and facial enviroment and compatible with ones desires.Within this consept what we want to achieve is non visible, natural, good looking teeth and oral condition that is not recognized on the spot as artificial.Since bright white,big and non harmonious restorations aways stick out and give a fake image which distracts ones eyes immediately.
With the increresing demand for better looking lately esthetic dentistry belongs to the fastest growing and evolving fields in dentistry.To meet the needs of the patients everyday new materials techniques and concepts are developed and a variety of treatment modalities are provided.
When do we need esthetic dentistry?
- If you have an asymetry at your font teeth concerning size and form
- If you have gaps between teeth(diastemas) which affects also your speech,
- If you are not satisfied from the colour of your teeth.
- If you have dental misalignments and/or irregularities,
- If you havecrown-bridge work or fillings that do not please you esthetically.
- If you aappear on photos mouth shut?
- If you feel like closing your mouth before public.
If one or more of the above mentioned situations suit you then its time to visit a doctor giving the service of esthetic dentistry.
What are the factors affecting smile design??
When we start a smile desigm for our patients age,gender,lips,gums,tooth colour and shape and their position,face form,and skin colour are the prerequisites that have to be taken into consideration.
Aging brings with itself changes not only at soft tissues like (cheeks,lips,gums) but at the hard tissues like(tooth and bone) as well. Skin looses its elasticity and starts to get wrinkled and prolaps,teeth get darker and you see some tissue changes like abrasions,abfractions,chipping etc.Face lift or botox fillings can help a lot to solve soft tissue problems. Some discolorations can easily be solved with bleaching whereas more severe ones can easily be fixed with laminate veneers. Composite bonding may solve problems related to tooth form deformities,abrasions,chippings from aging or minor problems. Porcelain crowns and veneers are used to adjust more complicated cases and help not only to restore the smiles but at the same time to regain the self confidence that is lost as well.
On the other hand with aging one witnesses changes in the profile as well.Due to the collapse of the hard tissues there is a rebound of the soft tissues as well.So not very seldom we see people with lesser nose tip to chin tip heights.At those people we see very dominant chin tip and a collapsed upper lip segment. Those changes may inevitably cause tmj (joint) problems.
Here what you see is that the chewing mechanism is not in tact and what we call the smile frame constituting of lips and cheeks is in collapse and makes people look older than they really are. Together with that situation abrasions and some parafunctions (grinding, bruxing) may cause some dimensional changes and chippings at teeth as well. In those situations porcelain fillings or crowns will compensate the dental prolapse whereas porcelain laminate veneers or porcelain crowns can restore front segment problems by giving the patient afunctional healthy and esthetic smile.
There are differences between the men and women smiles
Lips are one of the very important issues when dealing with a smile design. It’s thickness, thinness, flabiness, fatness, hollowness especially lower lipline curvature will determine the form and the ideal position of the restoration.Sometimes after the dental treatment the lips may require additional esthetic interventions to support the smile line concept.
Gum architecture is one of the major components of the smile design concept. When esthetically evaluated problems and solutitions for gum tissues are as follows.
- Unhealthy Gum Looks redish,swollon,has a shiny and inharmonious appearance.before estetical procedures gum tissue has to be periodontally treated.
- Gummy smile Are challenging situtions.The teeth may look very small. With some resective gum recontouring the exaggerated appearance of the gum tissue is masked.
- Gum recessions After periodontal diseases the gum tissue receeds.In those situations from donor sites or from other graft sources grafts are taken and harvested at those sites rto cover the defects.
- Irregular gumline The golden proportion can also be applied to gum tissues .Either from gum recessions,eruption irregularities or uneven irregular gum contours if the symetry of the gum tissues are not achieved according to the desired esthetic arhitecture a complete smile design is not going to be accomplished unless a minor gum recontouring is done.
- Gum pigmentation Inherited or otherwise caused pigmentations have to be removed before smile design procedures.
Tooth shades,^forms and positions
- For situations where we are not happy with the colourof the teeth the first treatment modality is bleaching.But for tetracycline stains or stains caused by overdose of fluor uptake bleaching may not be the choice of treatment.For those cases laminate veneers made of composite or porcelain will be more adequate.
- Malpositions of the teeth have to be corrected actually by orthodontics.but sometimes patient not wanting orthodontics for any reason can have for a better smile some restorative work as composite or laminate veneers an in more extreme cases porcelain crowns.
- Cracks and abrasions have to be dealt with when doing a smile design.For that purpose the best treatment modality are porcelain veneers:By utilizing this treatment we can overcome further cracks and abrasions and give the patient a better smile.ıf the patient is a bruxer or grinder the restorations have to be taken care of by using a night guard (a protective mouth guard used at nights during sleep)
- Diastemas (gaps between teeth) .These cases are either treated with direct composite fillings or in cases where it is contraindicated composite or porcelain laminates are sutable to restore the gaps
- Old restorations can either be replaced economically with new composite fiilings or where there are limitations for the case it will be more appropriate to go for veneers,since it has to be kept in mind that within1-2 years those fillings discolorate easily when ones diet includes discoloring agents such as tea,coffee,wine and last but not the least smoking.
Face form plays an important role in smile design.Generally we find some parallelism between the face form and the form of the teeth.For example someone having a rectanguler face has nornally long and cornered teeth whereas a round face man usually has rounded teeth.Sometimes to change this we have to apply some illusions such as using a longer and cornered teeth to make him look thinner or just the opposite to make a thin faced man look not as thin as he is we may use more square and wide teeth and mask his faces thinness.
By designing a smile we have to encounter many variables.Skin colour is one of them.Teeth shades must be in accordance with skin colour..For instance the tooth shade which we pick for a dark skinned rman if applied to a whiter skinned person will look extremely dark.So we have to bare in mind to chose a tooth colour which is in hormony with the skin.
Smile Design Concept Criteria
These criteria can be categorized as:
The ratio of the width of the central incisors to the width of the face and the ratio of the height of the central incisors to the height of the face have to be 1/16. Beside this in nature among geometrical figures there is a ratio symbolized by the number phi. For a esthetic pleasing smile teeeth have to obey that rule. For instance the ratio of the width of the central incisors to the width of lateral incisors or the ratio of the width of the lateral incisors to the width of the cuspides are examples for this rule of nature.
In an ideal smile the imaginary line that passes through the pupils is parallel to the line tangent to the the edges of the two central incisors.
The disharmony of the form and size of the incisors is very important for symetry for it can be easily recognized . For that reason for an attractive smile it is very important to achieve a symetry.
The curvature that is obtained by drawing a line tangent to the incisal edges have to be parallel to the lower lip line. As long as that harmony is achieved the person will have a more young and attractive smile.
The gum line reflected during smile has to beparallel to theupperlip line curvature . Gum line is more like a frame and adds meaning to your smile.
The Width of the Smile
For an esthetic smile also the back teeth have to appear to some extent . If not dark corridors are spotted which spoil the smile harmony.
Embrasures are the trianguler spaces between the teeth . Those spaces gradualy gets bigger when you go posteriorly.
The ratio of the width to the height of the two central incisors correspond tto the golden proprtion . This is a number you get when you divide 1 to the number phi . The height of the tooth has to be bigger than the width.
Shadows at Teeth
The teeth are not monochromatic. Natural teeth are not pure white, the colour and translucency varies at different parts. If we divide the body of the tooth in 3 sections 1 – The cervical third is yellowish even at the whitest and brightest teeth. 2 – The middle third is less yellowish. 3 – The incisal third is more greyish and translucent.