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Advanced Aesthetic and Preventive Dentistry

Smile simulation

Part of the new wave of computerized dental technologies, smile simulator software is offered by different companies and educational institutions, enabling dentists to visualize and communicate a virtual smile design. For patients, the educational value is very high and quite emotional. Like any new technology, it also comes with pitfalls of which patients should be aware of:

  1.  A smile simulation alone has only a cosmetic value. It needs to be further tested to see if the prototype smile can be actually achieved in reality.
  2. “Form follows function”. Any alteration of the teeth shape and position will most definitely have a functional impact: chewing, speaking and even breathing. A digital smile prototype alone cannot provide any information about patient’s functional status.
  3. The color rendering from a computer screen can be slightly different in real life. Tooth structure and dental ceramics possess much more sophisticated optical properties, which cannot be replicated by flat computer screens.

As I outlined in the article “Esthetic and Functional Dental Digital Imaging” published in Contemporary Esthetics in 01.2007, digital imaging should not be used to emotionally manipulate the patients into accepting an aesthetic treatment. Such technology should be used only to confirm an already established comprehensive diagnosis and visualize a treatment that is both medically necessary and functionally possible. The digital smile prototyping is especially useful in proving or disproving if the patient’s expectations can match the medical necessity.

When and how should smile prototyping be done?

… only used in conjunction with other techniques and skills that complement the enumerated pitfalls:

A Smile Simulation +

1.-1   A completely reversible mock-up (composite material temporarily sculpted on the teeth but not bonded) can show if the new tooth form and position can be tolerated by the patient – speaking, chewing, facially-integrated…

2.-2  A functionally-integrated wax design can confirm if the jaw joints geometry and muscle dynamics can be tolerated and accept the new smile design.

3.-3   Computer-designed and manufactured provisionals can provide valuable feedback on the light reflection/refraction with the tooth surface, color depth/distribution, translucency and texture. This way, the new smile design can be evaluated from different light angles and in various environments.

In essence, a digital smile simulation is just the beginning on the path of discovery if a necessary dental treatment can also complement one’s appearance, character and biology.

Costin Marinescu
Dr.-medic stom., D.D.S. (USA)