Using facial landmarks to dictate tooth position can enhance esthetics and conserve tooth structure.
By Michael Apa, DDS of Aesthetic Advantage in New York
In order to create individual smiles that compliment patients’ facial features and enhance their overall facial beauty, clinicians can adopt a technique that uses facial landmarks to dictate tooth position. This method not only can enhance the esthetics, it can also ultimately allow the practitioner to be more conservative in tooth reduction.
Where Symmetry Comes In
To understand this type of procedure, it helps to have a general understanding of the word “beauty,” which is defined as the phenomenon of the experience of pleasure through perception of balance and proportion of stimulus. In short, something is perceived as beautiful when some type of harmony or balance exists. During the last decade of cosmetic dentistry, “smile design” has focused mainly on modifying the position and restoring the teeth of patients seeking a better-looking smile.1 This approach became the foundation for laboratories and practitioners communicating in the design process. It also resulted in perfectly symmetrical smiles’ being duplicated for each individual patient. However, if carefully analyzed, it is apparent that patients’ faces are not symmetrical,2 and that delivering or creating complete symmetry in an asymmetrical environment creates a disharmony that can be easily visualized. Therefore, it is of utmost importance to analyze the facial features or “the frame” in which the smile is being created. Within this process, the objective is to design the smile creating symmetry with features and, in a sense, tying the features of the face together by balancing them with the smile.
The challenge for educators in this situation is teaching something that is abstract in a clinical, methodical way. It is important to understand that esthetic dentistry combines both an artistic component along with a comprehensive dental approach.
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