There are many factors to consider when creating a beautiful smile design. Beauty is in the eye of the beholder and a smile design definitely fits the saying. These are universal principles, however a patients personal preferences will also need to be discussed prior to fabrication of the veneers or all porcelain crowns. The top 10 smile design considerations are listed below, broken down into two segments, facial and dental components.
Facial Components:
- Interpupillary Line- Helps to determine the horizontal placement of the centrals which will need to be parallel to this point.
- Lips- Helps determine both the horizontal as well as the appropriate length of the teeth.
- Eyes, Ears,& Nose- Helps to determine the long axis of the face (vertical) which the dental midline will need to be parallel with.
- Buccal Corridor- This could fall into the facial or dental component but because a smile shot is used to determine it, I will place it here. The buccal corridor is the negative space between the cheek and the buccal surface of the maxillary teeth. Too much negative (black) space is considered unaesthetic while too much tooth exposure is unacceptable as well because a hint of negative space helps to create depth.
Dental Components:
- Dental Midline- It must be parallel to the facial midline.
- Incisal Length- This will be determined by a few factors (lip at rest tooth exposure, placement to lower lip while smiling, phonetics and function)
- Tooth Dimensions- Golden Proportion is a great starting point.
- Axial inclination- Teeth should be placed with a slight angulation towards the belly button.
- Incisal Embrasures- The incisal embrasures should gradually progress in depth as they move from the midline back to the bicuspids.
- Gingival Levels- Should be symmetrical and follow the same smile line as the incisal edges of the teeth with the zeniths just to the mesial of the midpoint of each tooth.
Tip: These universal smile design considerations should always be evaluated in both the diagnostic wax phase and the temporary phase prior to moving to final restorations.