Crafting a stunning smile is not merely a technical endeavor; it’s an artform, and it’s an intricate blend of science, artistry, and a deep understanding of human aesthetics. At the core of this transformative process lies the crucial first step: designing the smile. This initial phase sets the stage for the entire veneer procedure, and is what differentiates between satisfactory outcomes and truly breathtaking results.
Starting with the End in Mind
Before diving into treatment planning, it’s imperative to have a clear vision of the desired outcome. The first step must always be to design the smile and to design the smile based off of the patients face. Only after you have done this can you start to treatment plan and figure out how to best get to this result. A successful cosmetic case isn’t just about fixing teeth; it’s about creating a smile that seamlessly integrates with the patient’s facial features, enhancing their natural beauty rather than overpowering it.
This initial design phase is where the line is drawn between dentists who dabble in cosmetics and cosmetic dental specialists. While many may offer cosmetic treatments, those who specialize and excel understand that crafting a smile goes beyond technical proficiency; it requires a keen eye for aesthetics and harmony. Once you have created beauty and movement in the smile and the face you can engineer a treatment plan to get you there, but you first must design the beauty and that is the most important and most challenging step.
The Power of In-Mouth Smile Design
The only way to truly see how a smile will fit in the face is by sculpting the smile directly in the patient’s mouth using flowable composite. This method provides invaluable insights into how the teeth interact with the lips and facial movements. Human beauty is dynamic, and designing smiles based solely on photographs cannot capture the same level of movement and harmony as in-mouth design.
During the initial consultation, the smile design journey begins. Full-face photographs are taken as a reference for the patient before and composite is added. Flowable composite is then applied to the teeth to create the ideal shape, size, and position of the teeth. No etching or bonding agents are used at this stage, only airdry the teeth, and focus solely on creating teeth that fit and enhanced the patients face and smile.
If you need to adjust the gingival height you can place the composite over the gums to give the appearance of a higher gum line. If teeth are too long or need to be cut back, use a sterile black marker to blackout the parts that you plan to take away later.
Once the smile design is complete, take another full face photo to show the patient along side the original. Initial and final videos can also be taken to show the patient how their new smile will look when they talk and move. It is important to not let the patient look in the mirror and to only compare the photos and videos because this rough smile design will not hold up to scrutiny up close and that is not the intent.
Developing the Artistic Skill
In order master smile design, you must hone their artistic abilities. Contrary to popular belief, artistic talent is not innate but can be cultivated through practice and repetition. When you learn how to draw, you will train your eyes to see deliberately, and will develop the ability to see and design beautiful smiles that harmonize with the individual’s face.
Begin by sketching teeth and faces, focusing on nuances such as tooth inclination and the prominence of central incisors. While there are guidelines to follow, the key is to practice and observe how different design elements impact facial aesthetics. Watch some how to draw videos to learn how to draw an “ideal” face and smile. Once you have mastered the draw the “ideal” take picture of your patients or celebrities and practice drawing their faces, their teeth, and play around with how different teeth and smiles effect the face.
Practical Application and Mastery
Once comfortable with sketching, transition to practicing on models using flowable composite. Practice designing smiles according to different facial structures, aiming for both speed and accuracy. Have your lab print you some extra models and take different face photos and design the models with flowable to fit the photos that you are looking at. This will take a lot of practice and patients, but the control you will have to deliver amazing results every time will be more than worth all of the effort.
Your goal is to be able to mock-up any patients smile in about 4 minutes. This takes practice and persistence. Do not get discourages if you don’t see progress right away, this is a skill that anyone can learn but is very difficult to get a grasp of. If you become frustrated with the amount of time and effort that you are spending, take solace in the fact that once you do have this skill mastered that you will possess the skill that only the beset cosmetic dentists have. And once you have this skill mastered you too will have the skills to create smiles like the best.
