The Five Tenets of Esthetics

In the last decade of the 20th century esthetics changed dentistry, and it continues to be a powerful force today. Esthetics is a branch of philosophy dealing with beauty and taste.

As dentists, when we perform esthetic treatment to patients we create something that evokes a response from others (the people who see the smile).

For a lot of us the developments have made dentistry fun and exciting. Patients who come in desiring esthetic treatment are driven by discretionary motivation – they don't need to have the treatment done; they desire it because they want to look better. These patients are not typically fee-sensitive or insurance-driven.

Art in a Museum

Much like viewing and responding to art in a museum, dental esthetics is subjective. It's important to understand that there are definite aspects that we can be objective about, but conversely realize that there is a high degree of subjectivity involved. One person's pleasant smile might be another’s unattractive one. We can measure the objective areas, such as midline placement. However, areas like tooth brightness, shape and color are highly subjective. Even with the objective areas, there is an acceptable range of error. What dentists consider most attractive is not necessarily what laypeople consider most attractive.

The Five Tenets

No matter what level of treatment plan you present to a patient, always consider the five major tenets of esthetics:

1. Tooth position (How do we position teeth correctly?)

2. Gingival levels

3. Arrangement

4. Contour (What shape do you make the teeth?)

5. Color (What color do you make the teeth?)

Most general practitioners would like to perform more esthetic work. There are several keys to keep in mind as you add more of these treatments to your practice:

• Know how to evaluate each of the five major areas
• Know if correction is necessary
• Know how to treatment plan the correction
• Know how to technically execute the correction

Esthetic treatment is much more than cosmetic changes made to alter appearance. It requires a thorough understanding and systematic implementation of objective and subjective criteria.