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Posted on August 15, 2014
Facial Esthetics and Teeth

Every so often I get a question about gum height or tooth size from my patients. What they are actually asking is a question about esthetics, the balance and harmony of a smile. What makes up a nice smile is a number of components; when they all line up you just know it! Let me break those components into zones to discuss them. It can be like those cosmopolitan quizzes you take to compare your smile.

Lip zone – What gives John Elway his goofy smile? Two things, the first of which is his ability to lift his upper lip WAY up when he smiles. The effect of the Rizoris muscle, the muscle that lifts your upper lip is extremely variable. Ideally, the lip would raise up to show 1mm of gum tissue above the front teeth. Some folks can get the lip higher and some lower. The lip zone is almost unalterable. When you are happy, you automatically raise your lip unless you try to smile less or train yourself to give a “Hollywood Fake” smile. Mr. Elway could use some coaching.

Tooth zone- The tooth zone by comparison is alterable but at a cost. When you get braces, you put the teeth into a more esthetic place but not a more stable place. With braces come significant cost and a lifetime in retainers. Esthetically the teeth have rules we can use to categorize a nice smile.

Symmetry, are the front teeth below your nose in the midline of your face? 1point

Level, are the front teeth level with the canines, both along the edges and at the gumline, with the laterals 1mm shorter both at the edge and along the gumline? 3 points

Are the teeth too upright or too inclined? They should be at 70 degrees from level. 2 points

Are the teeth colored homogeneously? Teeth have a wide variation of shade, but ideal is about the same whiteness as the sclera of your eyes, not more white and not less. 5 points

Do you have gaps or crowding issues? 5 points

Do you have worn, chipped or teeth with old fillings? If no then take the points. 3 points

Do your teeth have the golden proportion? The front four should be 1.6 times longer than they are wide. In fact, looking head on, the entire dentition follows this rule as you look at the forward facing surfaces of the teeth. Ever wonder what was wrong with Mike Shanahan’s teeth? His tooth zones behind his canines were not visible, likely a cross bite! 5 points

Overall, we notice others’ teeth if something is out of wack or they are white and straight. Tom Cruise used to only have three front teeth but they were straight and white; his smile was famous! If you have 13 or more points you win!

Jaw zone – The upper and lower jaws relate to your skull and to each other. That relationship is what creates the overbites, deep bites, narrow smiles and worn front teeth. There are only two ways to alter the jaws, by modifying growth or by surgery. Surgery as an adult is risky, very costly, not covered by insurance and often relapses. A much better albeit limited approach is to correct jaw discrepancies with braces DURING THE GROWTH OF THE JAWS. For all intents and purposes, jaw growth is over about age 12. That’s why you get an orthodontic consult at age seven, or in my office the first time you come in!

I hope this little summary helps you “rate” your smile or your child’s. Please call or email for a more specific or in-depth talk about your smile. I am always available for tooth talks! Yours for now. Greg Evans www.biggrinswithdrgreg.com.