SMILE

 A facial expression characterized by an upward curving of the corners of the

mouth and indicating pleasure, amusement, or derision.

DETERMINANTS OF AN ATTRACTIVE SMILE

TEETH: color, position, and shape

GINGIVA: health, harmony of form, symmetry,

LIPS: lip lines

The gingival line follows the upper lip contour

The incisal line follows the lower lip contour

A PERFECT SMILE

It is characterized by a medium lip line, an incisal line running against the upper
border of the lower lip, an upper lip presenting an upward curvature. the mouth
corners are symmetrically aligned to the papillary line and leave a proportional
bilateral negative space.

SMILE ARC

The smile arc should be defined as the relationship of the curvature of the
incisal edges of the maxillary incisors and canines to the curvature of the lower
lip in the posed smile.

CONSONANT SMILE / IDEAL SMILE ARC / YOUTHFUL SMILE

The ideal smile arc has the maxillary incisal edge curvature parallel to the
curvature of the lower lip upon smile; the term consonant is used to describe
this parallel relationship

NONCONSONANT SMILE / FLAT SMILE ARC

A nonconsonant, or flat, smile arc is characterized by the maxillary incisal
curvature being flatter than the curvature of the lower lip on smile. Good
evidence exists now that a consonant (ideal) smile arc is an important aspect of
smile esthetics.

 In his cosmetic dentistry text, GOLDSTEIN describes

“OLDER SMILE,” in which the incisal edges appear straight across the smile,
“YOUTHFUL SMILE” in which the front teeth are longer and create a line
that comes slightly downward in the middle of the smile, traveling superiorly to
the corners.

 Lay observers significantly prefer an ideal smile arc,

and a flattened smile arc decreases the attractiveness of a male or female
smile.
A flattened smile arc and pose either or both of the two problems: it is
less attractive, and it tends to make the patient look older (because older
individuals often have wear of the incisors that tend to flatten the arc of
the teeth).

HIGH SMILE

Reveals the total cervicoincisal length of the maxillary anterior teeth & a
continuous band of gingiva
AVERAGE SMILE

Reveals 75% to 100% of the maxillary anterior teeth and the interproximal
gingiva

LOW SMILE

Displays less than 75% of the anterior teeth

REVERSE SMILE LINE

The cuspids are lower than the central incisors

GINGIVAL SMILE LINE

Gummy Smile

High Lip Line

Short Upper Lip

Full Denture Smile

SMILE CLASSIFICATION

SOCIAL SMILE

Stage I smile

 Voluntary

 unstrained

 static facial expression

ENJOYMENT SMILE

stage II smile

 Involuntary
 Dynamic
 Natural -expresses authentic human emotion
According to RUBIN there are three smile styles:

COMMISSURE SMILE/ MONA LISA SMILE.

action of the zygomaticus major muscles, drawing the outer commissures

outward and upward, followed by a gradual elevation of the upper lip.
Patients with complex smiles tend to display more teeth and gingiva than
patients with Mona Lisa smile

CUSPID SMILE
Elevators of the upper lip raises it like a window shade to expose the
teeth & gingival scaffold

COMPLEX SMILE / FULL-DENTURE SMILE

 action of the elevators of the upper lip and the depressors of the lower lip
acting simultaneously, raising the upper lip like a window shade and
lowering the lower lip like a window.

EIGHT COMPONENTS OF BALANCED SMILE

1.LIP LINE

2.SMILE ARC

3.UPPER LIP CURVATURE

4.LATERAL NEGATIVE SPACE

5.SMILE SYMMETRY

6.FRONTAL OCCLUSAL PLANE

7.DENTAL COMPONENTS

8.GINGIVAL COMPONENTS
LIP LINE

• Upper Lip Length

• Lip Elevation

• Vertical Maxillary Height

• Crown Height

• Vertical Dental Height

• Incisor Inclination

SMILE ARC

“DENTURE MOUTH APPEARANCE”

• Over Intrusion Of Maxillary Incisors

• Bracket Positioning

• Cant Of The Occlusal Plane

UPPER LIP CURVATURE

• Upward Lip Curvatures

• Straight Lip Curvatures

• Downward Lip Curvatures

LATERAL NEGATIVE SPACE

• Transverse Dental Projection

• Extraction&Non Extraction

• Arch Form

• Maxilla Postion

SMILE SYMMETRY

• Position Of Corners Of Mouth In The Vertical Plane

• Deficiency Of Muscle Tonus

FRONTAL OCCLUSAL PLANE

• Tip Of Right To Left Canine

• Dental & Skeletal

• Asymmetry- Smile

Canted Occlusal Plane

Facial Asymmetry

DENTAL COMPONENTS

Size

Shape

Color

Alignment,

Crown Angulation

Midline

Arch Symmetry

GINGIVAL COMPONENTS

Color

Contour

Texture,

Height Of Gingiva

Inflammation

Blunted Papillae

Open Ginival Embrasures

Uneven Margins
SHAPE OF TEETH

By assessing laypeople’s perceptions of the esthetics of a smile and specifically

the influence of the shapes of the maxillary anterior teeth on this perception, we
concluded the following.

1. Sex and age of laypersons did not affect their esthetic perceptions of the
shapes of the maxillary anterior teeth.

2. Both in men and women, square-round and round incisors seemed more
beautiful than square ones, and round incisors were the most esthetic.

3. The shape of the canines had an unnoticeable effect on laypeople’s esthetic

perceptions.

4. It is recommended to improve smile esthetics by rounding the mesial and

distal corners of square incisors.

BUCCAL CORRIDORS / NEGATIVE SPACE

When the only difference between altered images of a smiling subject was the
broadness of the smile, the presence of broad smile fullness (minimal buccal
corridors) was consistently judged by lay persons to be more attractive than
narrower smile fullness (larger buccal corridors).

● No significant differences were found in judging smile attractiveness with

varying levels of smile fullness between either male and female subjects or
between male and female judges.

● Having minimal buccal corridors is a preferred esthetic feature for both men
and women, and large buccal corridors should be included in the problem
list during orthodontic diagnosis and treatment planning.
Variable Description
Smile arc The curvature formed by an
imaginary line tangent to
the incisal edges of the
teeth, modified in varying
degrees of curvature in
relationship to the lower
lip.
Buccal The amount of dark space
corridor fill displayed between the
facial surfaces of the
posterior teeth and the
corners of the mouth,
calculated as the total dark
space on both sides of the
mouth as a percentage of
the total smile width.
Maxillary The amount of gingival
gingival show above the central
display or incisor crowns and below
gummy smile the center of the upper lip.
Negative numbers indicate
gingival exposure; positive
numbers indicate tooth
overlap by the lip.
Maxillary The relationship of the
midline to face maxillary dental midline
(measured between the
central incisors) to the
midline of the face, defined
by the center of the
philtrum and the facial
midline.By definition, the
Range
From no curvature to an
accentuated curvature. The
degree of curvature was in
relation to the lower lip, so
quantification differed for
each model.
From 6% to 26.5% in
approximately 0.5%
increments.
From 1 mm of gingival
display (–1) to almost 7 mm
of tooth coverage for the
female model, and
approximately 2 mm of
gingival display (–2) to 6
mm tooth coverage for the
male model in approximately
0.25-mm increments. The
variation between models
was due to differences in
sizing and coordinating the
images for different faces.
The maxillary midline was
moved to the left of the face
in approximately 0.25-mm
increments. The right and
left buccal corridors were
maintained throughout the
movement of the
dentition.The maximum
Variable Description
ideal was considered to be
0 for this variable.
Maxillary to The relationship of the
mandibular maxillary central to the
midline central embrasure to the
mandibular central to
central embrasure.By
definition, the ideal was
considered to be 0 for this
variable.
Overbite The vertical overlap of the
central incisors measured in
both millimeters of
coverage and percentage of
coverage of the mandibular
incisor.13 This was
modified by incrementally
altering the mandibular
layer of the image in the
vertical dimension. The
vertical movement of the
mandibular layer produced
an increased or a decreased
overbite.
Central incisor The vertical gingival
gingival margin difference between
margin the central incisors. By
discrepancy definition, the ideal was
considered to be 0 for this
variable.
Maxillary The difference in the
Range
deviation shown was 6 mm.
Maintaining the maxillary
midline, the mandibular
dentition was moved to the
left in approximately 0.25-
mm increments. The right
and left buccal corridors
were maintained throughout
the movement of the
mandibular dentition. The
maximum deviation shown
was 5.5 mm.
The layer was moved in
approximately 0.25-mm
increments. The range was
from 0 to 9 mm of overbite
(or 100%).
The gingival margin of the
left maxillary central incisor
was altered in approximately
0.25-mm increments. The
incisal edges were
maintained at their original
height. The maximum
deviation was 3 mm.
Variations from increased to
Variable Description Range

anterior vertical height of the decreased height were

gingival gingival zenith of the presented in approximately
height central incisor to the lateral 0.25-mm increments.The
discrepancy incisor. A negative value range was −2.6 to almost 1
from central to indicated that the lateral mm.
lateral incisor incisor gingival margin was
incisal to the central incisor
gingival margin; a positive
value indicated that the
lateral incisor gingival
margin was apical to the
central incisor.

Incisal edge The vertical difference Variation was assessed by

discrepancy or between the incisal edges moving both lateral incisors
lateral step of the central and lateral up or down together in
incisors. approximately 0.25-mm
increments. The range was
0.4 to 2.4 mm.

Cant The divergence of the The rotation of the plane

occlusal plane from the occurred in 0.25°
horizontal axis, as seen increments. The range was
when smiling, was altered 0° to 6°.
by gradually rotating the
plane through a point
between the central
incisors. By definition, the
ideal was considered to be
0 for this variable.
PUBLIC AWARENESS:BAD HABITS AFFECTING SMILE
REFERENCES
OVERVIEW
The Eight Components of a Balanced Smile
ROY SABRI,DDS MS(AJODO)

Smile esthetics from patients’ perspectives for

faces of varying attractiveness
Chan A. Chang,a Henry W. Fields, Jr,b Frank Michael Beck,c Nathan C.
Springer,d Allen R. Firestone,e
Stephen Rosenstiel,f and James C. Christenseng
Cupertino, Calif, and Columbus, New Philadelphia, and Dayton, Ohio

Dynamic smile analysis in young adults

Christopher Maulika and Ravindra Nandab
San Diego, Calif and Farmington, Conn

Smile line assessment comparing quantitative

measurement and visual estimation
Pieter Van der Geld,a Paul Oosterveld,b Jan Schols,c and Anne Marie Kuijpers-
Jagtmand
Nijmegen, The Netherlands

Dynamic smile visualization and quantification:

Part 2. Smile analysis and treatment strategies
David M. Sarver, DMD, MS,a and Marc B. Ackerman, DMDb
Vestavia Hills, Ala, and Bryn Mawr, Pa

Hard- and soft-tissue contributions to the

esthetics of the posed smile in growing
patients seeking orthodontic treatment
Laurie McNamara,a James A. McNamara, Jr,b Marc B. Ackerman,c and
Tiziano Baccettid
Ann Arbor, Mich, Jacksonville, Fla, and Florence, Italy

Characterization of posed smile by using visual

analog scale, smile arc, buccal corridor
measures, and modified smile index
Vinod Krishnan,a Sunish T. Daniel,b Don Lazar,c and Abin Asokc
Tamilnadu, India

The importance of incisor positioning in the

esthetic smile: The smile arc
David M. Sarver, DMD, MS
Birmingham, Ala
Dynamic smile visualization and quantification:
Part 1. Evolution of the concept and dynamic
records for smile capture
David M. Sarver, DMD, MS,a and Marc B. Ackerman, DMDb
Vestavia Hills, Ala, and Bryn Mawr, Pa

Smile esthetics from the layperson’s perspective

Nathan C. Springer,a Chan Chang,b Henry W. Fields,c F. Michael Beck,d Allen
R. Firestone,e Stephen Rosenstiel,f
and James C. Christenseng
New Philadelphia, Columbus, and Dayton, Ohio

Goldstein RE. Change your smile. 3rd ed. Carol Stream (Ill):
Quintessence Publishing; 1997