The Evolution of Smile Design

How smile design has evolved over time.

Smile design has evolved quite a bit over the years in dentistry.

by Dr. Lee Ann Brady

How Smile Design Has Evolved in Dentistry

How smile design has evolved over time.In truth, esthetic dentistry is relatively new compared to the age of modern dentistry. When I first learned to treatment plan esthetics and start with tooth position, we would take a printed copy of a smile photo that was 8.5 x 11, tape a piece of ortho acetate to the front and draw in the proposed changes to tooth position and contour with a sharpie marker.

In this way, we could play with adding incisal edge length, changing the position of free gingival margins, etc., without damaging the photo. Of course, alternate designs required more sheets of acetate and it was hard to share with the patient and the lab.

Then times changed and the same planning could be done with white line outlines using presentation software like Keynote and Powerpoint. This was easier to do and create lots of alternative plans once you got comfortable with the technology. Today we have similar systems that are apps and can be used on smartphones and tablets. They also allow us to place impacts, measure tooth proportion, and so on.

Morphing software with Photoshop is another approach, as we can literally alter the photograph and show patients what their new smile will look like. All of these systems use digital design. Then, creation has to be done using analog technology by transferring the design to a wax-up on mounted models.

Today we have the ability to stay completely in the digital world and do our digital smile design treatment planning on a scan of the patient’s teeth, even integrating photography. Then this design can be sent to the lab to generate a snap over trial smile. The lab can even use it to fabricate provisionals with no analog steps in the process.

Maybe someday soon we can use these digital treatment plans and send the output to virtual reality glasses. Then the patient can see their proposed new smile as if it is already a reality.

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