Smile Analysis! BY DR V J Vadgama

Symmetry - Symmetry around the centreline of our face is of great importance for an aesthetically pleasing smile. Even when this is not 100% possible, the illusion of symmetry should be created. The front two upper central incisors should be symmetrical in size, length and shape. Horizontal Alignment - Ideally the smile line should be aligned so it is parallel to the horizontal. Smile Line - The edges of your upper teeth should be parallel to the lower lip when you smile. Gum Line - The gum line connects the highest points of the gum levels of the upper teeth. Ideally this line should follow the line of the upper lip, to ensure minimum gum exposure and optimum display of the teeth on smiling. Smile Width - With a narrow smile the side teeth are often in shadow. A wider smile allows one to see the ideal progression from the front to the back teeth, this is more attractive! Golden Proportion - The rule of Golden Proportion describes an ideal ratio of the visible widths of the front six teeth Tooth Proportion - These are the guidelines for the ideal proportions of each tooth to achieve a beautiful smile. 100% height and 75% in width Embrasures - Embrasures are the small triangular spaces between the tips of the teeth. These are artistically created by the ceramist and dentist to ensure a natural look. Lips - Lips are to teeth as a frame is to a picture! The shape, fullness and symmetry of your lips can be optimised for the ideal smile.   ESTHETIC CHECKLIST FOR YOUR NEW CROWN/VENEER/BLEACHING Colour Will the colour of the crown blend in with the rest of your teeth, or do you want the crowns to stand out by being lighter? In general it is better for the front teeth to be the same shade since the light makes the teeth stand out and the dark makes them recede. The colour varies, but it should match or blend in with the surrounding teeth. The objective is to make the crown look as natural as possible. Younger people usually have more translucence, and sometimes spots of blueness appear towards the biting edge of the upper front teeth.The degree of translucency or opaqueness will vary with the materials used to make the crown. Expect less translucency with porcelain - fused - to - metal crowns.The most translucency will be evident with the all porcelain or glass crowns, but they may lack the strength that the metal provides. Length Are they too long or too short?Ideally, the biting edges of the upper teeth should just touch the bottom lip when you say " forty five" Remember, if you want a younger smile line the two front teeth or central incisors should be slightly longer than the two lateral incisors. If the front teeth can't be lengthened, consider having the laterals slightly shortened to give the effect of the front teeth being slightly longer. Computer imaging is a good alternative to having the dentists cut away porcelain or add length by baking new porcelain; it can give everyone a preview of the proposed change, then if everyone agrees change is required it becomes easier to predict that the treatment result will be favourable. Gums Make sure the gum tissue looks healthy. It should outline each tooth in a half moon shape.Red, puffy or bleeding gums are unhealthy.   Midline An imagined vertical line drawn between the two front upper teeth should be in line with the middle of the face.If not perfectly in line, it should be parallel to the facial mid-line at least. Shape Shape is one of the most important aspects of a crown since it must duplicate the form of the natural tooth.Bring in old photographs of yourself if you have them to help the dentist create the best form for you.Your tooth should not be bulky, and it should not look like the gum is pushing it out of the mouth.It should slide right under and fit flush with the gum-line. Texture If you want a natural looking tooth, it is important to match the surface and the characteristics of adjacent teeth.If the adjacent tooth surface has ridges or other irregularities on the front surface, these should be included when the porcelain is glazed in order to make the light reflect the same way as it would off the natural tooth. Warning :When discussing the type of materials to use in your crown, take into consideration your gum-line.For strength, you may choose a porcelain fused to metal crown.However, if you have a high lip-line, a metal margin can eventually show if the gum recedes.There is a compromise solution; metal on the inside and porcelain on the front, sometimes called a porcelain butt joint.This may be a good example of trading off some function for aesthetics, since the porcelain butt joint may not be as strong as a metal margin, but the aesthetic result can be more pleasing.   Adjacent teeth Look at the teeth on either side to see if they can be improved with cosmetic contouring or a new filing before the new crowns are water. Arrangement of teeth Does the tooth placement look natural? Sometimes an addition of a little porcelain or a slight reshaping can make a tooth look a bit irregular and more natural. Final note Take your time and do not be too rushed to consider each of the above factors.In addition to viewing your restorations close up be sure to hold the mirror at arm's length to see how others will see your new smile.   Now you are ready to analyse your smile Smile Analysis Are your two upper front teeth slightly longer than the adjacent teeth? Are your two upper front teeth too long? Are your two upper front teeth too wide? Are your upper six front teeth even in length? Do you have a space between your front teeth? Do your front teeth protrude or stick out? Are your front teeth crowded or over lapping? When you smile broadly, are your teeth all one colour? Do your teeth have white or brown stains If your front teeth contain tooth colour fillings, are they your tooth shade? Is one of your front teeth darker than the others? Are you lower six front teeth straight? Are your lower front teeth even in appearance? In a full smile, the back teeth normally show.  Are your teeth free of stains? Do the necks of your teeth show erosion, that can be seen or felt by a fingernail? When you smile, does your top lip rise and show your gums? Do your fillings and crowns look natural? Gums Have your gums receded from the necks of the teeth? Does the curvature of your gum each tooth create a half moon shape? Breath Is your mouth free from decay or gum disease that can cause bad breath? If you could alter your smile, what would you most like to change? ARE YOU A CANDIDATE FOR COSMETIC DENTISTRY? Why change your smile? If you're happy with it, don't! But ask yourself the following questions: 1.  Are you self-confident about smiling? 2.  Do you ever put your hand over your mouth when you smile? 3.  Do you photograph better from one side of your face? 4.  Is there someone you believe has a better smile than you? 5.  Do you look at magazines and wish you had a smile as pretty as the models? 6.  When you read a fashion magazine, are your eyes drawn to the models smile? 7.  When you look at your smile in the mirror, do you see any defects in your teeth or gums? 8.  Do you wish your teeth were whiter? 9.  Are you satisfied with the way your gums look? 10. Do you show to many or to few teeth when you smile? 11. Do you show too much or to little gum when you smile? 12. Are your teeth to long or too short? 13. Are your teeth too wide or too narrow? 14. Are your teeth too square or too round? 15. Do you like the way your teeth are shaped? If you answered "no" to every question except 1, 9 and 15, you are content with your smile. IT'S AS OLD AS THE PYRAMIDS We are not the only people to place a high premium on the smile. In fact, throughout history many of the civilizations noted for achievements in other areas also demonstrated an interest in cosmetic and restorative dentistry. For example, two false teeth encircled with gold wire believed to have been designed as substitutes for missing molars were discovered years ago in the ancient Egyptian cemetery of EL Gigel. On another continent, four thousand year-old references mention the Japanese custom of tooth staining called ohaguro, suggesting it may have been designed to prevent decay. At the height of the Mayan civilization, a system of dental decoration involved filing the teeth into intricate shapes or decorating them with jadeite inlays.