We know a smile influences perceived attractiveness. However, little information is known about how patients perceive their own smiles. Various considerations are important in determining the success of cosmetic dentistry because patients and dentists may focus on different aspects of the smile.
One study used standardized photographs of males and females that framed lips and teeth only (Dunn et al. 1996). Various groups were asked to individually rank the photos in order from most appealing to least appealing. The preferred female smile showed natural teeth, a high lip line, a display of many teeth and symmetry to the smile. The best male smiles revealed a moderate display of teeth, a moderate lip line and symmetry. The most prevalent response for an attractive smile involved a light tooth shade. Many respondents found that a dark shade was the least attractive aspect of a smile.
Another study showed that frontal and profile views are rated differently by patients. This is important when orthodontic braces or treatment is being considered. Many general dentists and orthodontists will consider the profile view for major orthodontic procedures but may not always take it into account when planning for minor procedures. This study reveals that the profile view should be carefully considered to reach an aesthetically acceptable conclusion to treatment.
Some dentists now offer smile analysis. This examination should consider both subjective and objective criteria. Subjective criteria are based on the patient's perception of their smile. Objective criteria include measurements to quantify data. Any analysis should consider tooth shade, distribution of color, defects and discoloration of the tooth structure, crowding, spacing, visible fillings or dental crowns, shape and size of teeth and the amount of gum tissue shown when smiling. Once you and your dentist determine the areas of your smile you would like to improve, a treatment plan for reaching an acceptable aesthetic result can be obtained. This plan may include tooth whitening. If you have any tooth-colored dental restorations in visible areas, these will need to be replaced after whitening because the tooth whitening agent will only affect natural tooth structure. Veneers, crowns or orthodontics may be used to straighten teeth or close spaces. Bonding, veneering or crowning teeth can cover any defects (like broken teeth or chipped teeth) or discoloration. These procedures can also change the size and shape of teeth.
Prior to a smile analysis, a thorough exam, including appropriate radiographs, should be completed to ensure that more pressing concerns such as tooth decay and infection are not present. Depending upon the results of your smile analysis, your dentist may wish to take impressions of your teeth to create study models. These models can be used to help dental treatment planning and create a diagnostic wax-up of possible treatment results.
The most important thing you and your dentist need before, during and after treatment is an open line of communication. This is especially important to help ensure that your expectations and the achievable results are consistent. Good luck with the smile analysis and any subsequent cosmetic treatment.
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