Know Your Smile

● Teeth

1- Is the tip of your teeth shown in a short smile while your teeth are separate from each other?

As you smile or speak, the ridge of your teeth should come into appearance to a small extent. Should the edge of your teeth be worn out or that your smile line was lower than usual, it may seem as if you do not have teeth or that you have forgotten to wear your artificial teeth. In such cases, resin composite, capping, or laminate could be instrumental in overcoming the problems. Prior to this procedure of course, your dentist needs to check your occlusion, i.e. the position assumed by the two sets of teeth relative to each other when the mouth is closed.



2- Are the two front teeth of your upper jaw a little taller than their adjacent teeth?

In a natural setting, the two upper central teeth should be somewhat taller than the lateral teeth endowing an overall younger look. These teeth should be as tall as the canines towards the side of the mouth. The smile line is a hypothetical line which passes through the edge of the upper jaw’s frontal teeth running parallel with the upper edge of the lower lip. If this line were inclined downwards, the smile would look young. Should it be horizontally even, however, it would signify tooth attrition (i.e. wearing or grinding through friction) and thus aging. Composite or porcelain laminates are recommended treatment plans in such cases.




3- Are the two front teeth of your upper jaw significantly taller than their adjacent teeth?

This would give us what is commonly referred to as a rabbit smile. To remove this problem, the lateral teeth can be elongated with composite or laminate or the central ones shortened.



4-  Are the two front teeth of your upper jaw significantly wider than their adjacent teeth?

Wide teeth make the face look chubbier. Orthodontic and operative dentistry treatment plans can correct the ratio and breadth of teeth. There are cases of course that require work on four or even six frontal teeth.



5-  Are the six front teeth of your upper jaw equal in height?

This condition could set in through attrition and bruxism (which is the involuntary or habitual grinding or clenching of the teeth), or the tooth edges having been crushed abraded the teeth to have the same height and ultimately making a person look older. Porcelain veneers can be resorted to remove such conditions.

                                                The height of teeth and smile older

6- Are there gaps among your front teeth?

In case these gaps were a new development, they could be the result of gum disease or certain habits such as pressing the tongue between the teeth which could be treated. If you wish to close these gaps, you have the three options of composite, porcelain laminate veneer, or orthodontic treatments.



7- Are your front teeth protruding?

Alongside having an unpleasant appearance, teeth protruding out of the mouth may lead to facial abnormalities. The best treatments in these cases are orthodontic options followed by capping with crowns or laminates.

                                      Protruding teeth and discolored

8- Are your front teeth crowded and misaligned?

Misaligned and crowded teeth not only unbeautify the appearance of a smile but also prevent complete cleaning of the teeth, heightening the probability of gum diseases and tooth decay. The best treatment in such a case is orthodontics even among adults. The other options available to those who are not interested in orthodontics and whose teeth are not very severely out of range include composite and laminate treatments and also capping.



9- Are your teeth not the same color when you smile?

Difference of color in teeth may be caused by different reasons such as germs, bad-colored fillings, tetracycline staining, and tooth decay. Each of the above cases requires its own specific treatment including composite and porcelain veneers, bleaching, etc.



10- Are there any white and/or brown stains on your teeth?

White stains that grow on the tooth enamel are due to shortage of calcium which can be overcome by microabrasion, i.e. slight grinding of the enamel, composite restorations, or porcelain laminates. Brown stains are generally caused by high residuals of fluoride in drinking water (technically called fluorosis) and can be treated through microabrasion, bleaching, and composite or porcelain laminates.



11- In case your teeth have been filled with tooth-colored materials, does the color of those materials match the color of your teeth?

White fillings become discolored after a few years in the mouth and require polishing. Colored food products such as coffee, chocolate, and soft drinks and also smoking cigarettes increase the speed of such discolorations. At times, complete re-fillings are recommended.



12- Is one of your front teeth darker than your other teeth?

It may well be that your tooth’s nerve has become partially or completely damaged if it has gotten darker in color. If so, the tooth nerve should be primarily treated and then corrected color-wise through bleaching. In some instances, composite or laminate or even capping should be used to correct the external color of the tooth.



13- Are the front teeth of your lower jaw disorderly and misaligned?

Orthodontic treatment is the prime option for crowded and misaligned teeth of the lower jaw. If the misalignment were limited, composite or porcelain laminate and also contouring of the protruding edges of the teeth can improve the appearance to a certain degree.



14- Are the front teeth of your lower jaw not the same height?

Inconsistency of height among teeth attracts the attention of the addressee when one is talking. To remove this problem, a slight contouring of the teeth’s edge either with or without composite restoration can be effective.



15- In case your back teeth are displayed in a broad smile, do they appear without stains, fillings of unpleasant colors, and difference of color?

Discolorations on the back teeth can be due to black fillings, tooth decay, or damaged white fillings. Accordingly, the previous fillings have to be replaced by new white fillings.



16- Are the cervical parts of your teeth worn out and scraped such that there appears a recession in them that you could feel with your fingernails?

The factors behind these problems include horizontal and harsh brushing, gum recession, rubbing the nails against the teeth, frequent intake of acidic ingredients such as lemon juice, and malocclusion, that is when the two sets of teeth fall disorderly on top of one another. Such factors compromise not only the appearance of the teeth but also increase their sensitivity which would progress rapidly if left untreated since the dentin abrades five times faster than the enamel. The best solution here would be composite restorations or gum grafts.



17- Do your gums appear in a broad smile?

If your gums appear considerably into view when you put on a broad smile, you have either a short upper lip or short teeth. You need to do more in terms of your dental hygiene to prevent gum diseases. You should also refrain from capping your front teeth and it would be wiser to use composite fillings for them.


18- Do the fillings and capping of your teeth appear natural?

The natural appeal of a capping is very much determined by the work of dental technicians. Make sure you ask your dentist to have your capping produced by highly qualified technicians.




● Gums

19- Are your gums pink and even or red and swollen?

Healthy and normal gums are pink in color and strong in texture. Redness and inflammation in gums are indicative of their unhealthiness which could have come about for various reasons including germs and plaque and damaged fillings and crowns. To treat such a gum, the germs and plaques around the teeth and gums should be first removed. Subsequently, if there were damaged fillings or crowns around those specific teeth, they should be corrected or replaced. Ultimately, the best way to look after your teeth would be to brush them after every meal and floss them and also use mouth washes or diluted salt water.

Diseased gum

Healthy gum

20- Have your gums recessed?

Should you feel that your gums have receded, do not ignore them. As the gums retreat, the roots of the teeth become visible and subject to rapid sensitivity, attrition, and even decay. In such cases, it would be best to consult a periodontist to have gum graft or other necessary treatments.



21- Are the gums around your teeth crescent-like?

Healthy gums hold teeth and fill the spaces between them. Accordingly, gums develop a crescent-like form. If, however, gums were not healthy, their ridge would no longer be crescent-like and would gradually become straight. Again, it would be best to consult a periodontist for his/her professional advice.

                           Patients with abnormal form gums and smooth


● Smell of your mouth

22-  Are you suffering from bad breath due to gum diseases or tooth decay?

If, despite regular brushing of your teeth and observance of oral health, you still feel an unpleasant odor in your mouth, consulting your dentist would be advisable. Bad breath can be caused by inadequate hygiene, faulty fillings, tooth decay and infection, and gum disease. Sinus problems and digestion complications can also be at work here alongside the above-mentioned causes.

Choosing Your Cosmetic Dentist

To choose your cosmetic dentist, you need to consider the following points:

  1. Refer to those specialists who enjoy adequate skills and experience in cosmetic and restorative dentistry.

  2. Through referring to the cosmetic and restorative dentistry departments of universities, you can become acquainted with such specialists.

  3. You can get a list of cosmetic and restorative dentists practicing in Iran through the Iranian Society of Restorative Dentistry.

  4. Consult those among your acquaintances who have had such previous experience.

  5. Do not prioritize low fees if you are seeking cosmetic dental services.

  6. Ask your dentist to provide you with photographs of previous patients so that you gain a general picture of the results, beforehand. Do of course bear in mind that different individuals have different teeth and oral cavities and you cannot expect your teeth to be restored in exactly the same fashion as those of somebody else.

  7. There is nothing wrong with referring to several cosmetic and restorative dentists and asking for their opinions, particularly when you happen to doubt your dentist’s treatment plan.

Upon deciding to apply for cosmetic dentistry, you may wish to ask the following questions from your dentist:

  1. What are the treatment methods and the cosmetic treatment plan suitable for my case?

  2. What would my teeth look like at the end of the treatment process?

  3. How long would my treatment take?

  4. How should I preserve my restorations once the treatment is over?

  5. How similar would my restorations be with my other teeth?

  6. Would I need to change my eating habits?

  7. How long would the restored teeth last in my mouth?

How much would the treatment plan cost and how would I have to make the payments?


Treatment Expenses

Cosmetic dentistry is employing science and technology together with art and delicacy in creating healthy teeth and a beautiful smile. In order to reach this objective, extra work and a higher level of precision and delicacy is inevitable; naturally, extra work and precision would translate into further expenses and this is of course not exclusive to cosmetic dentistry.

Merely seeking low expenses in cosmetic and restorative dentistry usually fails to pay off since low expenses are almost always simultaneous with using lower quality materials, working with less advanced laboratories, and spending less time on the treatment process.

Last but not least, the prime factor in achieving your desired smile is how you effectively communicate with your dentist. The more clearly s/he understands what your concerns and goals are and the more meticulously you observe his/her recommendations, the greater your satisfaction.

The next chapters elaborate more on cosmetic dentistry anomalies and ways to treat them.