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What is in a Smile?


This is to illustrate that when the teeth are the desired shape and in the desired position whitening alone can completely change a smile. This patient also has a lower smile line covering just the necks of her teeth. If she has a fuller lip it would cast a shadow making the teeth look slightly darker. A thinner lip would make them look slightly brighter.

Patients come through the doors of Dental Associates of Walpole daily searching for a brighter, more pleasant and youthful smile. Within seconds, they are requesting to get their teeth whitened. This would be the natural thought from a patient with this desire, but is it really that simple? Will it give them the results they are imagining? The answer is the same one I often received in dental school from professors… it truly depends!

The way someone’s smile looks, feels, and functions can make a huge impact on their life. It can make you look and feel younger. Eating meals can become a joy again, if it wasn’t before! But let’s assume function is not an issue.

Patients often perceive whiter and brighter automatically creates an esthetic smile. This is where a patient and a dentist differ in their evaluation. For some patients, whitening will do just that. Let’s break down what might be going through your dentist’s mind. If I am your dentist, at least you know it is going through mine!

When I do a smile analysis for a patient asking for a “better” looking smile, I start outside of the mouth. I look at the shape of your head. The overall shape of the head can mimic tooth shape. Some heads are more oval, rectangular, or triangular as are their teeth. Matching these up can make the smile flow and one that flows is truly how to create one that is custom, fits the patient, and is esthetic.

Next, I look at the lips. Lips are the frames for the teeth. Lip lines, meaning how high the lips rise when we smile and how much teeth and gums show are important. One very overlooked piece of analysis and often makes or breaks the perceived color/shade of the teeth is the shadow the lips create. A full lip casting a shadow makes teeth darker.

what is in a smilephotoforblog

This shows a full lip which casts a shadow over her teeth. She also has lipstick on which brings up the point of how different lips colors can make teeth brighter/whiter or muted. These veneers are also very opaque which some patients like to see a solid color. It is more natural for teeth to have multiple shades or layers to them and slightly more characterization than a perfectly smooth surface as seen here.

That patient needs brighter teeth to reach the same perceived level of brightness. It is a term called metamerism for those as nerdy as I am.

Let’s chat about those pesky gum tissues that we call gingiva, which we talk about at every cleaning visit. Would the patient’s smile be better showing less gum tissue? Are the teeth short because of these extra tissues? If so, we might want to do some dental “plastic surgery” on these tissues. That is an extreme case. So, let’s ignore it for now.

Now to the teeth, which are what most of you, if you are still reading want to hear about. If you like the shape, size, position, and overall color of your teeth, whitening is for you. Teeth have slight colors to them, shades of white if you will. Some teeth have grey, yellow, or orange bases to them. So, whitening will make dark yellow to light yellow. But it still will have the slightest base color to it. If you want to change any of the other areas, more than whitening needs to be done. Changing position is best done with orthodontics like Invisalign. So maybe we move the teeth and whiten them. If you like the position but not the shape, size, or color then veneers may be for you. The possibilities and treatment plans can get more involved. The more one wants to change in their smile often means the more teeth involved and the more procedures done to them. Each procedure could be its own blog.

Please come on in and ask any of us to discuss a smile evaluation with you. Our goal is to provide you with the information and treatment that best fits your needs! The final take away is bright and white isn’t always the best answer!

By Dr. Lyle Smith, D.M.D.

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