Digital Smile Design - Dec 2, 2020

Are dentists losing sight of good esthetic dentistry?

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Do you ever find that your patients are more interested in the look of their teeth than the health of their mouth? Do you feel like the emphasis in dentistry is moving from health and function, to ‘beauty’ and esthetics? As dentists, it might be time we took a step back and asked ourselves...

Do all dental restorations really improve people’s lives?

Does every imperfect gingival outline really need to be perfect?

Does every off-white tooth need to be a brilliant white? 

Are big teeth and wider smiles really the way to be happier and healthier?

There’s no doubt that addressing these concerns can benefit patients in certain circumstances. However, the decision to do so should be backed by solid ethical reasons. Will this treatment make a difference to our patient’s health, confidence or happiness? We must always remember the difference between recommending implants, aligners or veneers because we believe a patient’s smile could benefit from them, and recommending them because we recognize when these improvements could really impact a patient’s quality of life. A beautiful smile by itself will not bring the expected or desired happiness if it functions only as a superficial patch to hide deeper emotional issues or systemic health problems.

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As healthcare providers first and foremost, we must bring dentistry back to what really matters: protecting and restoring our patients’ health and confidence. Above all, physical and mental wellbeing must be our focus. Beautiful smiles should be the consequence of dental treatment, not the priority.

Unfortunately, we are increasingly seeing these principles switch places. And what’s more, we see examples of esthetic dentistry which ignore the real, underlying health problems – or even make them worse. The ‘10 veneers fever’ taking over dental social media accounts, when the reasons for having veneers are not properly considered or addressed by treatment, is working against the patients, instead of for them


Are dentists losing sight of good esthetic dentistry?

It’s not just the focus on beautiful smiles that we must address, it’s also our definition of what makes a beautiful smile. In my opinion, dentistry is just beginning to understand how much we don’t know about esthetic dentistry. I believe that we as dentists are losing connection with nature; we are disconnecting from nature so much and getting used to handmade smiles that when we see nature we think our restorations are better. Most of the restorations we do have shapes and textures that don’t even exist in nature. The more we lose natural structures, the more difficult it is to do beautiful work.

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With scanning technology, there is no excuse for creating restorations in shapes produced by humans, rather than nature. We can scan natural smiles and copy the perfect imperfections that make them beautiful and organic. We can’t beat nature, so why are we trying to?

And creating a beautiful smile also goes beyond the teeth. Modern dentistry is starting to understand how much we don’t know about smile design and esthetics. Interdisciplinary dentistry is facially-driven and should start with good smile design as the initial vision that shows us where to go. To become better smile designers, we must invest time in understanding the face, the smile design principles and comprehensive dentistry. This is the goal of the Orofacial Club – the world’s first symposium which brought together dentists and plastic surgeons to connect the face and the smile in global diagnosis and treatment.

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The three challenges of modern dentistry

This is also part of the three main challenges we believe that all modern dentists come up against in their work. How to deliver natural-looking smiles, how to make better decisions for our patients (understanding that beauty is the consequence, not the priority) and how to make patients value the importance of oral health and dentistry in their lives. Instead of making ‘beauty’ the priority, we should focus on healthy, confident smiles...


The goal of a healthy smile

A healthy smile, which functions as it should, is what all of our patients deserve. Having a healthy smile is important for our systemic health – there is a beautiful relationship between the mouth and the body, and this is something that really empowers the role of dentistry in society. It’s important for our patients to understand the value of taking care of their oral health and how this can impact their general health.

With this focus on health in mind, we believe that any first dental appointment should include airway diagnosis as part of a comprehensive diagnosis. In fact, our belief in the importance of airway dentistry led us to hold DSD Airway Day in June 2020. In this unique event, we hosted one-to-one virtual interviews with world-leading airway experts on how we can address this issue and identify patients for whom this is necessary before jumping into treatments.


Watch all
interviews with airway experts on our new video-streaming platform, Watch DSD.

Besides this connection with our systemic health, we also have an emotional connection – which also has an important role to play in our health. Smiling with confidence can even be seen as a medicine of sorts; smiling with confidence every day generates reactions in our body that can impact our overall health and wellbeing.


A confident, natural smile

When it comes to the appearance of a patient’s smile, the most important thing is that they are happy. If their mouth is healthy and the patient is happy with the way their smile looks, why change it? Our goal as dentists and smile rehabilitators should be to recover health and confidence, giving our patients a smile that is confident, not perfectQuote 2 copy 2@4x

There is also a wealth of research that shows the importance of smiling with confidence – psychologically, spiritually and also for overall general health. We know that when you smile with confidence, you have a greater chance of being healthy and a greater chance of being happy. 


Beautiful behavior vs beautiful appearance

If as a profession we put our focus on beauty and only esthetic dentistry, are we placing more value on a patient’s appearance than their behaviour? I can imagine humble, kind, honest, proactive, intelligent people living happily for years with a missing premolar, uneven gums and slightly crooked, worn down, yellow teeth – but extremely healthy. In the same way, someone with outwardly ‘perfect’ veneers might be suffering from health or emotional issues. With this focus, I can only imagine that dentistry may have an even bigger, noble and profound role to play in the modern world.

Can we do better than this as healthcare providers? What know-how should we acquire to move away from being superficial beautiful smile providers to become real health and confidence providers? I would love to know what you think...

While you’re here, if you’re thinking about enhancing your skills in smile design, treatment planning and digital dentistry clinical solutions, this might be of interest to you...

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