By  Saiesha K. Mistry, BDS, MSc, AAACD

“In my opinion, it is in the smile of a face that the essence of what we call beauty lies ... But if the smile spoils the face, then the face is an ugly one indeed.” ~Tolstoy

A comprehensive smile design treatment plan is incomplete without an esthetic analysis defining the endpoint of the treatment. To obtain consistently high-quality results, it is necessary to analyze the features that the evaluation comprises. Creating a smile that complements the person's face and personality is our goal, and therefore, we must relate the teeth to the facial structure with a facial analysis, smile analysis, and dental analysis.

Facial Analysis

An assessment of the face as a whole must be done on two planes, the frontal and sagittal. The purpose of this analysis is to evaluate the relationship of the features to each other and to the smile.

“Today a smile design not only means designing teeth, but also creating a smile that truly complements the patient’s face and personality.”

Smile and Dental Analysis

The smile analysis comprises details of the lips and the teeth and gums as one unit, while the dental analysis provides insight into the characterization and individuality of the teeth. By following a systematic approach through the accepted sequence, we are well on our way to performing a smile analysis that allows us to understand all the data better, and thus, create a successful result. To begin, start with the entire face, and then narrow the focus to the smile from there.

Smile Design Sequence:

1. Establish the incisal edge position
2. Develop midline symmetry
3. Establish the gingival margin
4. Create silhouette form of the central incisors
5. Develop relative proportions of lateral incisors and canines
6. Extend the smile into the corners
7. Design the shape and texture of individual teeth

By following a systematic approach, designing a smile becomes predictable and easy! The details are in the collection of data, and then using the data exactly where required to build a beautiful smile.

To dig deeper into smile design, read Dr. Mistry’s article, "Principles of Smile Design, Demystified," in the Journal of Cosmetic Dentistry, 

You can also take her AACD CEntral course, “Smile Design: Predictability,” for CE credit!