The $55 billion cosmetic dentistry industry now spans the United States, Middle East, South America, and China. The number of cosmetic dentists in the United States increased 16% in 2016 alone. With the explosion of celebrity culture and social media, the importance of personal appearance has rapidly escalated. The high demand for cosmetic dentistry has led to it becoming an art form.
I’ve regarded my practice this way for decades. Improving one’s smile is no longer just the practical application of improving the overall health and functionality of teeth. It’s important to consider factors such as light reflections, color dynamics, optical illusions, perspective, and proportions. Applying these principles is what makes true dental artistry possible.
What You Need to Know
There are a fantastic number of details that make a tremendous difference in the overall outcome of any cosmetic dentistry result. The obvious things discussed in dental school are shape and color. Beyond that, there may be little else covered concerning what makes things look best.
Occasionally, you hear about “translucency” and “tooth contour.” You might even get something on being able to make out differences in colors in various places on the tooth. If you really “get” those things, you are well on your way to figuring out what can be involved in cosmetic dentistry. You have located the tip of the iceberg, as they say.
After a solid foundation in the above, the next hurdle, if you will, is mastering what is “giving your restoration away.” In other words, what is it about the veneer or crown that doesn’t look like a tooth? Here is where things like light reflections and color dynamics come into play.
One of the more challenging skills to master is the way light plays off the surface of the tooth. There are very exacting ways light reflects off teeth. Just as importantly, there are ways that light reflects off veneers or crowns that never happens on teeth. This is the most common error that gives away that you have delivered a “fake tooth.”
The fascinating part is that it’s most often this very thing that patients are referring to when you’re having difficulty figuring out what’s not right about your crown. They tell you they don’t like the new crown you made them because it doesn’t look real or that it doesn’t look like “their” tooth.
I have found that this problem is oftentimes more important than the color. A perfectly colored tooth can look fake all day long and is totally unacceptable, while a real looking tooth that isn’t “perfect” in color can be tolerated more easily because it looks real.
So, how can these principles be applied when creating the perfect smile? When you consider the smile and not just a tooth or teeth, things multiply quickly. You need to consider the color as it relates to the remaining teeth because, depending on how many you do, you may be able to enhance the overall color of the full set.
Most often, you need at least 8 upper anterior teeth to increase the brightness of the whole smile. Many times, a chemical whitener is all you need for the lower teeth because they generally don’t show much in a natural smile or while laughing.
When it comes to the shapes and reflections, they all must harmonize and be proportionate to each other. There are many proportions and shapes that occur naturally in smiles, and, again, there are some that never occur. Obviously, the “never occurs” are unacceptable. One bad-looking tooth is not as bad as several bad-looking teeth. To put it another way, you must know intimately what real teeth look like, each individually and then all together with all the similar characteristics of a matched set.
This is where all the considerations we’ve addressed above come together to create a smile that looks real, because all the shapes, color dynamics, light reflections, and proportions relate to each other in ways that are convincing. After you have all of that down, you now position the full set in the best place as it will be framed by the lips and gingiva. This will include how the lips and gingiva present relative to the face and head—for example, how protrusive or angled the smile shows.
The Next Step
If you’re an aspiring cosmetic dentist, take a lot of pictures and speak in depth to your patients about what they want to get out of their smile. The things that are important to patients are so varied it will surprise you. More often than you can imagine, patients will have some aspect they consider more important than anything else, and to make a customer happy, you better get that part right.
Sometimes people like fake. When you study your delivered case pictures, look at them with this perspective in mind. What is giving your smile creation away as fake? What should or shouldn’t be there? Also, if you are serious about being a cosmetic dentist, consider getting a full ceramic lab with a skilled technician in your office as soon as you can. This will cure more problems than you can imagine. It also will allow you to consistently deliver great outcomes.
If you’re a patient, ask as many questions and look at as many pictures as you can. Great cosmetic dentists will have many, many pictures and videos of their work. Poor or inexperienced ones will not. Without this evidence, you can only rely on your gut instinct or how well the conversation went with the dentist.
You want to make sure the cosmetic dentist has answered all of your questions in a way that is simple and easy to understand. If not, and it is confusing in any way, you may be in for a confusing outcome. Clarity all the way through will ensure you are smiling in the end.
Dr. Moore, principal of Cosmetic Dental Associates, decided to dedicate his life to dentistry after an orthodontist literally saved his smile from buck-toothed ruin at a young age. In addition to the normal training of a dentist in traditional math and sciences, he took the highly unusual step of engaging in formal art education as well. This combination has enabled a career of creating beautiful smiles: lifelike diamond-cut teeth that have empowered his patients to command the careers and live the lives they’ve always wanted. He can be reached at john@33smile.com.
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