Smile aesthetics related to teeth and gums is also very important today despite the fact that the first thing come to mind is the solution of problems such as toothache, bad breath and tooth loss when talking about oral care. Aesthetic problems resulting from carious teeth, gum diseases, crowding of teeth, abnormal colorings and tooth loss can affect people’s social lives negatively. In addition, it can even cause a lack of self-confidence which can result in avoidance of laughing/smiling in public.
Sometimes, even if people have healthy teeth, they may want to aesthetically improve the disproportion of teeth and gums or deformities. A beautiful smile gives people psychological power and will also give a better impression to people in front of you.
More beautiful smiles can now be provided with many methods and the concept of “aesthetic dentistry” has more place in our lives with the advancement of technology and scientific studies.
What is Smile Design?
One of the first concepts that come to mind when talking about aesthetic dentistry is ‘smile design’. Smile design is the process of making the teeth, which have aesthetically distorted appearance due to various reasons, to be as natural and beautiful as possible considering the face shape and needs of the patient. The smile design, which is a multidisciplinary approach, is performed by applying many processes together.
What processes does the smile design include?
The procedures to be performed are determined individually since the aesthetic requirements of each patient will be different. Factors such as facial features, gender, age and expectations of the patient are taken into consideration while determining these procedures.
First, existing carious teeth and gum diseases are treated, tooth cleaning procedures are applied. Then, operations are determined according to the needs of the patients. These are generally; Gingival aesthetics interventions called gingivectomy, teeth whitening (bleaching) methods, recovering tooth deficiencies with implant and prosthetic applications, porcelain laminates and coatings, zirconium coatings and orthodontic treatments (dental braces).
How is ‘Smile Design’ made?
In smile design, it is very important to understand the aesthetic expectations of the patient correctly and to determine the needs correctly. First problems are identified, then plans are made on models prepared through the measurements taken from the patient’s mouth. Then, measurements are made by using special programs in the computer environment with oral and facial photographs of the patients and compliance with the shape of the face is calculated. Reports and images closest to the result that can be obtained after the treatment are presented to the patient with temporary restorations prepared in accordance with the original, and their opinions are asked.
After the planning is completed, the level disorders in the gums are treated first if the orthodontic treatment is not required. If there are teeth deficiencies, planned implant procedures and other necessary surgical applications are performed. Teeth whitening procedures are applied if needed after the recovery periods of surgical applications are completed. After this stage, visual and formal defects in the teeth are sometimes eliminated through aesthetic composite fillings. In cases where this method is not enough, porcelain laminates and coatings and zirconium coatings may become a part of treatment. Generally, porcelain laminated applications have minimal wear on the teeth or no wear at all. If porcelain or zirconium applications are deemed appropriate, some changes can be made in the rehearsals made within the stages by taking the ideas of the patient again. The shape and contour of the lips are also taken into account during all these gum and dental applications and rehearsals, and the targeted design is finalized.
Sometimes medical aesthetic applications are also used during smile design. The smile can be featured by applications such as dermal filling on the lips and facial areas.
Golden Rules in a Perfect Smile?
In order to have a perfect aesthetic smile, the tooth structure and ordering should be smooth and teeth should not be crooked. The teeth on the top should be taken to the forefront and should be more apparent than other teeth. Teeth need to be sparkling, and there should be no stains. The lip and gum should be compatible with each other. The order of the tooth structure should also be compatible with the face.
Which Details Should Be Considered While Making Aesthetic Smile Design?
Patient satisfaction can be seen as the first stage. The patient is interviewed before starting treatment. After the interview, the parts that the patient feels uncomfortable about his/her smile are determined. Plan is made accordingly, treatment begins. While making the smile design process, attention is paid to the lip structure, the length of the teeth, the gingival characteristics and the compatibility of the lips and teeth.
Is Face Shape Important in Smile Design?
Of course it is important. Teeth are whole with face and smile. For this integrity, tooth structure and face shape must be in harmony. Gender is also important to achieve an aesthetic smile. Because while making more delicate oval teeth for women, more angular teeth are made for men.
Is Smile Design Different for Men and Women?
Gender is very important in smile design since the smile form of men is square or rectangular, and the smile form of women is round or oval.
What Are The Criteria To Be Considered While Making Smile Design?
Age: Wear occurs in the teeth with advancing age. Loosening occurs in the muscles of the upper lip and sagging downwards due to the effect of gravity in the muscles of the lower lip. In this way, the visibility of the teeth in the upper jaw decreases, while the visibility of the teeth in the lower jaw increases. Thanks to the ideal design and styling, the patient is provided to have a young and attractive smile again.
Gender: The dental structures are different in women and men. In women, the corners of the teeth are determined with a soft curve, while in men, the structure of the teeth is angular and more prominent. In women, the smile line is determined by a curve parallel to the lower lip, while the smiling line in men becomes flatter. While the two front teeth of women are longer, the length differences of them are less in men.
Facial features: There should be a certain connection between the facial features and the form of the teeth. The ideal tooth shapes of the people are hidden in the appearance of their facial features. Making an angled tooth to a person with round facial contours will spoil the overall harmony of his/her appearance. In this way, the person will be getting an artificial smile.
Contour and shape of the gums: The level of gingiva visible during a smile is very important. The level of this puts the smile into perspective. The appearance of the gums at a higher rate will affect the person’s attractiveness and beauty, and the gums that appear at a low rate will provide artificiality in the smile. The ideal gum level is in contact with the upper lip line. What should not be forgotten is that pink aesthetics is as important as white aesthetics.
Lips: The thickness of the lips, the shape, the symmetry of the corners, the harmony of the lips with the teeth help create the most beautiful smile aesthetics. The curve on the lower lip during a smile should follow the upper teeth. In addition, the distance between the two lips and the size of the teeth should be in harmony during the smile.
Teeth Features and Placement:
The positioning of the teeth and their properties should be evaluated from various perspectives. These perspectives are;
Vertical symmetry: The vertical line passing through the middle of the forehead, the tip of the nose and the tip of the chin must pass between the first tangents of the upper and lower teeth. The symmetry of the teeth on both sides of this line is very important for an aesthetic smile.
Horizontal parallelism: The line passing through the middle of the pupils and the straight line passing through the ends of the incisors should be parallel to each other. Otherwise, curvature occurs in the mouth.
Smile line: In order to have a cheerful, attractive and young smile, the line connecting the cutting edges of the upper front teeth and the line during the smile of the lower lip should follow each other.
Teeth proportions: To obtain an aesthetic smile, the appearance of teeth from front to back must be reduced to a certain extent. Its mathematical ratio should be 0.618. This is considered the golden ratio. The harmony in nature and living things is balanced according to this golden ratio. Therefore, the teeth must adapt to this ratio, too.
Embrasures: These refer to the triangular spaces between the ends of the neighboring teeth. These embrasures are needed to provide a young smile for the person. Embrasures are destroyed in older people due to wear of the teeth. These are redesigned during the design of the smile, resulting in a young smile.
Color: In order for the teeth to have a natural appearance, each region should not be the same color. No matter how white the teeth are, the parts that are closer to the gums become more yellowish, while the ends are more grayish and transparent. The middle parts of the teeth show the saturated color of the tooth. In order to provide a natural appearance, transparent colors should be created by professional adjustments during smile design.
The condition of teeth and gums, location, form of teeth, proportion and colors of each other should be evaluated while designing the smile. During these evaluations, people’s facial proportions, age, gender, skin colors and most importantly their expectations from this process must be evaluated. Creating a beautiful and young smile can be achieved through the harmony of the lips and teeth, the harmony of the gums and facial proportions. The gaps between teeth and colorings or distortions in the teeth negatively affect the smile. These problems are solved with laminate veneer restorations, tooth whitening process, full dental ceramic restorations and orthodontic treatment.
In cases where there is asymmetry in the gums or receding gums or when the gums are seen more, the smile is affected negatively as a matter of course. In this case, patients can undergo various gingival surgeries. These operations include procedures such as gingivoplasty and gingivectomy. Due to the various applications that can be made on both the teeth and the gums, a smile design, which is compatible with the face and character of the person, is appropriate. The people’s smile not only affects their appearance but also helps them feel well psychologically.
Which Exclusive Treatments Are Made In The Smile Design?
- Bleaching time may vary. Ton can be opened with an average of 40 minutes. Whiteness can be preserved for up to 1 year by paying attention to the eating and drinking habits of the person to protect the tooth.
- Porcelain laminates are adhered to the teeth. It is possible to obtain a white aesthetic smile with the use of laminate.
- Zirconium is a widely used technique. Since zirconium is a translucent metal, it is effective in giving an aesthetic appearance. It is necessary to apply to a specialist physician during these applications.
- In orthodontic technique, perplexed tooth structure is treated by applying porcelain brackets.
- In implant treatment, missing teeth are completed. The tooth is given an aesthetic appearance.
What is the Time Period of Treatment?
The duration of treatment can vary from 1 to 8 days, depending on the patient’s dental complaint.