7 Common Problems in Cosmetic Dentistry (Porcelain Veneers)

Practitioners of esthetic dentistry are to smile design as Starbucks baristas are to the perfect latte. Point being, you want the most skilled individuals performing this most important of jobs, and the dynamics behind your smile (in addition to your morning coffee) should be left to the professionals! Imagine flashing your pearly whites while the dental team is giving jumping high fives to each other and the Rocky Theme Song resounds through the office!

While a perfect smile is an excellent way to display a job well done, it is also very beneficial to take note of what happens when violations of smile design principles occur and how dentists can restore any violations back to an ideal form. This will leave you waltzing out of your final appointment with the dental team yelling, “Go book your headshots, Hollywood!” In all seriousness… here are 7 common problems the Docs at Atlanta Dental Spa see in consultations:

1. The Crooked Smile Epidemic

It is crucial that dentists be aware of a patient’s natural head position when examining facial plans. Professional makeup artists and hairstylists also practice at this skill! The dentist’s process involves performing a correct facial esthetic analysis while viewing the face as a whole, instead of focusing solely on the mouth. A vertical line drawn through the middle of the face focuses attention from the tip of the nose to the middle of the chin, allowing for a more exact frame of reference in the smile design, and thus a straighter smile. A win for the dentist, and a long-lasting win for the patient!

2. The Reverse Smile

The flashiest of smiles display a symmetry not only amidst the teeth, but also in the curve of the lips. A reverse smile is when a concave curve is created, resulting in a smile line that comes across as unhappy. To ensure your smile is as happy as a kid in an ice cream shop (disclaimer: brush your teeth after eating ice cream!), your dentist must analyze your tooth lengths and lip shape. They should determine whether there is a need to shorten the canines or lengthen the incisors in order to correct a happy concave smile. This is most effectively done using digital techniques such as photography, video, and digital mock-ups of the teeth. Pucker up and tell your teeth to get ready for their close-up!

3. The Social Six

The violation of the Social Six refers to altering the color and shape of only the six top front teeth. Correcting these teeth without also creating contrast with the back teeth can leave patients with an artificial, narrow-looking smile. Your dental team must take pretreatment photographs and evaluate front and lateral smile views in order to produce a natural looking smile for your paparazzi moments. On the other hand, too much brightening of the back teeth can result in a denture-like appearance; picture the candy mouth during Halloween. Finding a happy balance is key, especially when it comes to perfecting your smile.

4. Ignoring The Golden Proportion

The Golden Proportion was a standard traditionally applied when creating ideal smiles, but today’s “smile artists” lean toward less regimented designs based on an individual’s proportions. Think of Nintendo Gameboy compared to present day’s PlayStation 4; the art of phasing out archaic versions for more modern ones is simply a way of life. With that said, if the less regimented designs are not done correctly, an offset of ratios will create an artificial appearance. And thus, using computer programs to draw lines and proportions on images of a patient’s teeth helps dentists visualize the process for the patient, and also communicate correct proportions with the laboratory during preplanning. If space in the mouth is limited, your dentist can narrow or slightly rotate the lateral teeth to create room for the central teeth. Having the mindset that no one mouth is the same as the next can help ensure better smiles for generations to come. Just think, your future grandchildren’s children’s grandchildren will have the most radiant, and proportional mouths.

5. Over-Contoured Teeth

Teeth can look over-contoured if there isn’t distinction between how light bounces back on different zones on the teeth. Because ceramists work under the confines of preparation designs they are forced to obscure the reflective and deflective zones when building up porcelain, and often times create over-contoured teeth. Depending on how lines and angles are manipulated, teeth can appear short and fat, long and narrow, or more rectangular and curved. Moving angles outward creates wider looking teeth, and moving them inward creates narrower looking teeth. This violation can be reversed if ceramists are given a properly designed mock-up and use the correct thickness when preparing the porcelain veneers. When done correctly, this approach will leave your smile looking full, and human.

6. Ignoring Negative Space

Just like in all areas of life, it’s important to establish boundaries in the space around a tooth. When designing a smile, it is crucial to provide adequate room for angles between teeth. Worn tooth edges in a smile result in reduced or non-existent angles. This unfortunately leads to a flat smile line and aged appearance – no one wants that! Therefore, clinicians must recreate the natural angle progression to restore appropriate tooth lengths and curves. All of this can be done provided there is room to recreate negative space, and properly address the angles in the design stages. Magicians can stick to their smoke and mirrors, because dentists have this covered!

7. Overlooking Gum Margins

The last smile design violation is asymmetrical gum margins. This version of smile design exercises the age old game of symmetry versus harmony. In this case, more emphasis should be placed on harmony versus symmetry. This puts the focus on a general, recurring theme amongst the tooth groups rather than mirror images.

Gum margin positioning is significant in people with medium-to-high smile lines. The smile line is the location of the lip when a person smiles. Pretreatment images are absolutely necessary when it comes to effectively evaluating gum margins. This helps everyone visualize the esthetics to come and further ensure that the results will reflect the expectations. In short, stay harmonious when it comes to smile design, as creating exact symmetry can disrupt the balance and beauty of a smile. Who knew smile design could be so Zen? Namaste, my friends.

Being aware and educated about these 7 most common violations of smile design helps both patients and esthetic dentistry professionals achieve more successful outcomes when it comes to gaining a million dollar smile. Digital photography and modern technology lend a large hand to the success of today’s cases, helping the professionals properly evaluate and restore a smile into ideal form, and helping patients understand the process and giving a realistic image of the final results. Dentistry and technology; working together in harmony.