Smile Design / The importance of a great smile

By Dr. Susan Markic

If I were to describe Smile Design to a patient in 20 words or less, I would say that it’s a proven esthetic approach to creating a natural smile that is in complete harmony with a person’s face shape. This is the essence of the approach.

Professional Smile Design takes a balanced course to blending both the beautiful (the art) with measured proportions, sizes and function (the scientific). It’s blending everything we know in dentistry to create a truly beautiful smile.

When a patient doesn’t feel comfortable with their teeth, and it effects their day to day interactions, they start to consider a solution. With unusual or crooked smiles, it’s not uncommon for a person’s self-confidence to be low, and their quality of life impacted. Smile Design candidates often tell us that they don’t feel like they fit in. These feelings can be very isolating and restrictive.

We have found that the best candidates for this treatment are patients that have experienced real problems because of how their teeth look, along with the feelings associated with their condition. These patients usually shy away from full mouth smiles, and almost instinctively cover their mouth when talking. They are also the type that stifle laughter (or don’t laugh). Generally their full range of emotions can be affected, which in turn impacts their confidence level. Often people just frustratingly ask their dentist; “what can I do about my smile?”

Sometimes, in cases like this, a patient’s perspective is not accurate. The candidate may be focusing in on one particular esthetic point that they don’t like, or feel others notice. A smile analysis will look at the total picture and how it all fits together. For example, how the gum line affects the overall appearance of the teeth. Does it need to be reduced? How does the face look? Is it symmetrical or misshapen? Everything is considered when adding all the small parts to the eventual big picture.

Patients are usually surprised at how involved they are in the process. It typically starts with a simple dental question; “what would you change if you could?” Patients can usually identify the main areas of concern, and the dentist is there to help them see how it all works together. An extensive interview is at the heart of the process. Records are also required, and will include smile measurements, face views from all angles, and extensive photos. Sometimes 3- D models are created to look at the integrity of the teeth.

A patients overall health is also taken into consideration as poor hygiene can often be part of their starting condition. All of the options are looked at, and then the patient is brought back into the picture. This is a fully structured program. Although Smile Design can radically improve a person’s over all look, it’s not for a patient who wants a single tooth replaced. That’s not how it functions. Smile Design focuses on the overall smile appearance. It could be a conversation for the future, but it’s not relevant for one or two teeth requiring replacement.

For some patients there may be an alternative to smile design when spacing or alignment is the only concern. Orthodontics (braces) maybe all that is required. Often, this can solve the problem entirely. But, it’s also used in conjunction with an overall aesthetic plan. The best part about our Smile Design program is the positive feedback that we get from our patients. They tell us enthusiastically about the changes they have undergone and how they feel about themselves. They have higher confidence levels and better self-esteem.

Many times, patients even go for a full makeover and add a new wardrobe. Smile Design was the start of a new approach to their way of communicating. It also improves their career success because now candidates have a bigger impact on people with their first impression.

Smile Design is not the pursuit of perfect teeth. We take a natural approach that looks at the characterization of a person’s face. All of this is discussed in the beginning. Sample images are produced and looked at to see if everything can look more natural.
There’s a lot of back and forth communication between the doctor and patient about the desired effect. Our pre-planning will help you know how it will appear in the end. Digital photos and digital imaging will reveal the possible final appearance. Plus, three dimensional models of the teeth, or a combination of the two methods help to show the final result. In some cases, temporary veneers can be tried out before everything goes into the finishing stages.

Often, complementary procedures are part of the Smile Design. Many times procedures at the gum line or periodontal work may be required to expose more of the person’s teeth. Of course, the previously mentioned orthodontics are usually part of the plan. An elective tooth removal may be required for proportions reasons as well.

Sometimes, patients need root canal treatment to get their teeth ready, and another specialist may be involved in the team approach. Regular dental care is the foundation for all Smile Design programs. You need good dental health first before you can get a good final result – no cavities or other general dentistry problems. Smile Design is a separate approach to general work. This procedure is a personal decision, so it may not be for every candidate but many realize how important undergoing the process is.

Many parts of Smile Design are included in typical dental insurance coverage. Generally, this is considered a diagnostic procedure. Records are commonly covered (X-Rays, exams) some additional procedures may be covered (extractions, gum work) and more advanced work (like crowns) may be covered due to the improvement in the tooth strength. Improvements like whitening will fall more into the cosmetic area, so they may not be covered.