The Power Of A Smile

By Jessica Boden
Posted On Mar 15, 2012

How-To-Whiten-Teeth By: Daniel E. Lofaso – One of the most important signs of youth and beauty is a good smile. Here are the basics of how to achieve it. One of Molson beer’s most popular commercials starts with a male camper walking into a supply store and locking eyes with a beautiful store clerk. The nervous camper finally gets up the courage to approach the young woman. She smiles at him, revealing a set of hideous teeth that sends the camper running. The commercial makes a humorous play on a fundamental truth: No matter how lovely (or handsome) you are, your smile is critical to your appearance. Without a good smile, the rest won’t really matter. “A stunning smile is one of the essential elements of a beautiful face,” says Michael Maroon, DMD, of Advanced Dental in Berlin, Conn. “Your smile is also the number one determining factor of whether you look young or not.” Just how that perfect smile is achieved by cosmetic dentistry is both an art and a science, and relies on everything from the repair and replacement of damaged teeth to your dentist’s understanding of facial harmony. Patients also have their own goals in mind when they come for a “smile design,” and these—in addition to budget and dental health—will determine what procedures should be done. “To me it’s all about the end result,” says Anthony Vocaturo, DDS, of the Cosmetic and Wellness Center of New Jersey. “People can prejudge and say ‘I want veneers,’ but ultimately if a crown or bonding works better I will advise them of the aesthetic and health benefits.” In dentistry as in art, a great deal relies on the skills of the practitioner—in this case the dentist— a big reason why Drs. Maroon and Vocaturo co-founded the Academy of Comprehensive Esthetics (ACE), a 2,000-member organization of dentists dedicated to cosmetic dentistry—in other words, to perfecting a beautiful smile.

Facial Harmony

The first step toward achieving a great smile, as any cosmetic dentist will tell you, is to examine your dental health and take care of any issues related to cavities, gum disease, infections, etc. There is no point investing in beautiful teeth if they are not healthy. The next step is to understand facial harmony, which is the relationship and balance of the different parts of your face to each other. At its best, facial harmony means perfectly adjusting your smile to your face. By examining features such as gaps in the teeth, tooth discoloration, excess gums, tooth size and length, and how your teeth meet (occlusion), your cosmetic dentist will assess how to correct these imperfections in balance with your face. He or she will then determine the treatments needed to transform your smile. The look a patient seeks will be another factor in smile transformation. A patient who wants a sophisticated, mature, intelligent-looking smile, for example, will want a design that results in teeth of relatively even lengths. In contrast to this is a more youthful look, where the teeth are less regular, not having been naturally worn down with age; it’s all about the look the smile aims to instill. To achieve facial harmony with the right smile, cosmetic dentists adhere to certain “golden rules,” principles and proportions that teeth, the smile and facial structures must conform to in order to look attractive. These are extensions of Leonardo Da Vinci’s Rule of Thirds, in which the Renaissance artist discovered that in most ‘beautiful’ faces the distance is the same between the hairline and the brow, between the brow and the tip of the nose, and between the tip of nose and the tip of the chin. Each is roughly an equal third of the face. With teeth there are other golden rules of proportion. Length of teeth should be appropriate for the length of face; too long and they look ‘horsey.’ Width of teeth should likewise be appropriate; too wide and your smile looks ‘toothy.’ A small, oval face should not have large, square teeth. And so forth. “With interior decorators you can give them a frame and they know what picture is going in it,” says Dr. Vocaturo. “Similarly, [dentists] are getting the frame, but we have to figure out what the picture is.”

Dental Artistry

Cosmetic dentists study the impact of your smile on facial aesthetics through visual and photographic analysis. They look at “gingival” aesthetics such as uneven gum contours or excessive gingival display; micro-aesthetic subtleties of your teeth such as light reflection and coloration; and finally macroesthetics which analyze proportions and consider the overall appearance of your teeth relative to your facial features. Using a variety of tools, from photos and 3D digital imaging to impressions and wax mockups, the cosmetic dentist then creates a custom plan for each patient. “There is a skill and art level involved in designing a smile,” says cosmetic dentist Dr. Pamela Doray, who practices in Philadelphia, Pa. “The focus is making sure it’s designed individually for each patient, then the second part is having the patient look at the results and provide feedback.” Gender is an obvious factor in determining the size and shape of the teeth. “It’s something that you see out there, the perception that masculine teeth have stronger lines to them, squarer, while feminine-looking teeth are more curved, softer, rounder and more diminutive,” says Dr. Doray. Among the more subtle cosmetic considerations are skin tone, hair color and functionality. Dr. Doray uses the “temps” during the feedback process to determine the proper shade. “You have to make sure the [skin and teeth] colors blend. Hair color also factors in…there are nuances of shades to consider,” she says. “And we can check to see if the function is fine, if the speech is good and whether they like [the feel of] it.”

Smile Design Impact

An extreme smile makeover can get expensive, up to $1,000-$3,000 per tooth if the patient requires treatments such as veneers or dental implants. If a patient only needs orthodontic treatment (braces) and a teeth whitening they may end up in the $5,000 dollar range for everything. Regardless of treatment, patients will always be happier with a smile that looks natural. “The quality and type of smile that people get should look like it belongs to them,” says Dr. Maroon. “It should look and feel like they’ve always had it.” That, of course, is one of the secrets to looking younger—improving a part of you while keeping it natural looking, rather than different looking. The teeth are no exception, yet many people make significant investments in cosmetic surgery to look younger and forget about their smile.

before after dental fix

“A lot of times when people have aesthetic dentistry done they essentially look like they have years taken off their life. If you smile and your teeth look old, people will be able to tell your age right away” says Dr. Maroon. Says Dr. Vocaturo, “The biggest compliment I get from patients in their 40s and 50s is when they say, ‘This is exactly the way my teeth looked when I was 20.’”


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