Smile Assessment and Aesthetic Dentistry Notes

Smile Assessment and Aesthetic Dentistry

Two Articles on Smile Aesthetics

  • Golden Proportion (Levin): Suggests a mathematical ratio exists in nature, art, and aesthetically pleasing smiles.
  • 10 Commandments of Smile Aesthetics (Mercado): Proposes specific steps for evaluating smile aesthetics.

Initial Reactions to the Articles

  • Some aspects of the 10 Commandments seem too rigid with specific measurements.
  • There's skepticism on whether golden proportion truly applies clinically due to individual variations.

Golden Proportion

  • Levin proposed that the proportion of visible tooth width during a smile should follow the golden ratio for an appealing smile.
  • The golden ratio concept is used in advertising and architecture.

Clinical Application and Considerations

  • While the golden proportion and 10 Commandments offer guidelines, they shouldn't be strict rules.
  • Individual patient needs and preferences should be prioritized.
  • Ethnic and gender variations exist in preferred smile aesthetics.
  • Studies show that populations may not always align with golden proportion principles.

Patient Expectation

  • Clinicians need to understand what the patient wants and manage expectations realistically.
  • Aesthetic changes must be functionally viable for the patient.
  • Digital smile design templates can be overly stylized and might not meet individual patient needs.
  • A reversible trial is a must to gauge patient approval before any invasive work.

Functionality and Stability

  • Orthodontic treatments require retainers to maintain tooth position; teeth naturally want to return to a neutral zone.
  • Consider the long-term impact of aesthetic changes on functionality and stability.
  • Aging and procedures like Botox can affect tooth positioning.

Key Takeaways on Treatment Protocol

  • Patient expectation has to be realistic and achievable.
  • Balance aesthetics with functionality and long-term stability.
  • Use reversible methods to trial changes and obtain informed consent.
  • Aesthetic dentistry is elective not disease treatment, so the importance of patient input grows as treatment get more complexe.