In my early years of dental practice I would reason with my patients that a natural, age appropriate smile would give them the most pleasing and beautiful result. Most rejected my logic. I still maintain that there is nothing more beautiful than nature.
I remember one patient many years ago, Bernie, a ninety year old gentleman who only wanted pearly white teeth. We argued and I lost. I made him dental plates that revealed “toilet bowl” white teeth. He was happy even though he looked ridiculous.
Thirty five years later patients are still coming in to my practice wanting whiter teeth as if color were the only criteria for a pleasing smile.
The reasons for this are apparent to most dentists, yet patients have always been susceptible to the whims of the world of advertising, and television (Extreme Makeover). We have been taught above all, that yellow discolored teeth are bad and should be changed. I agree. Yellow teeth are not attractive, but here at Dr. Polansky’s office we use other criteria in addition to color to create natural, age-appropriate dentistry.
CRITERIA FOR A NATURAL SMILE
1. The smile is generated by the face.
The dentist and the lab technician should evaluate the size, shape and proportions of your face. This very important first step will provide information that will dictate the appropriate size and shape of the teeth. Teeth are not square and flat like Chiclets. Bernie chose Chiclets, I wanted him to have tapered teeth that matched the shape of his head. The whiter the teeth are the bigger they will appear too.
2. The lips and gums are taken into account.
Along the same lines, the lips and gums provide the frame in which the smile is revealed. High lip lines reveal a lot. Female lips tend to rise higher than male lips. Gum lines and contours can create problems as well especially when the lip line is high.
3. Tooth position is important.
Dentists have a lot of leeway in creating smiles in spaces that have less room available for the proper number of teeth. On close inspection, many of your favorite celebrities have beautiful smiles, yet they are missing some important teeth…the spaces are closed but the dentist knew the rules of camouflage so only “his hairdresser knows for sure.” Tooth position is also determined by the way teeth work. Teeth placed in a poor position can fracture or loosen because they interfere with the bite. Another good reason for a thorough evaluation.
4. Creative license can yield pleasing results.
A good technician will sometimes use his or her artistic ability to leave a small space or create a small overlap for a more natural look.
5. The pitch, or the angle that the teeth emerge from the gums.
Once again the dentist and technician can show creative skills.
6. And finally the shade or color of the teeth.
Of course the color is important. The point is that I made it the last barometer of a pleasing smile. If all of the other factors fit properly…the patient will see how little color controls the result.