In a recent article, I went over the esthetic options available when determining arrangement and contour in our patients. The esthetic outcome is purely subjective and determining contour and arrangement that is ideal for both you and the patient can be difficult at times.

Ultimately, patient preference regarding contour and arrangement is the most important opinion since it is their smile. There are a few ways to help find that common ground of esthetic preference between you and your patient.

1. Photos: I will ask my patients to bring in photos of their friends that have nice smiles or have them flip through magazines and cut out pictures of smiles they find attractive. They don't need to know why they like them, but by having a photographic reference we can get an idea of what is possible and what isn't.

2. Facial form: If we look back on the literature on dentures, teeth were chosen based on facial form. Traditionally there are three types of tooth form: square, triangle and ovaloid. A patient with a square face would receive square teeth, a patient with a triangular face would receive triangular teeth and patients with a round or oval face would receive ovaloid teeth. Matching face shape and tooth shape with help you avoid gingival embrasures in the final result.

3. Gender: With teeth, there are masculine forms and feminine forms. There are certain characteristics that we tend to see with masculine teeth that we don't see in feminine teeth. The incisal edges of the teeth are the true determining factor of whether a tooth looks more feminine or more masculine. Masculine teeth tend to be sharp, angular, bold and defined; feminine teeth are round, smooth and have soft edges.


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