Tooth Proportions

Tooth Proportions

A key ingredient to excellent smile aesthetics is tooth proportions. I recently had a paper published in Dentistry Today, January 2017 regarding the topic. Teeth need to be in proportion in their width to height, in relation to adjacent teeth and in relation to the overall face. The average front tooth (central incisor) is 1/14.5th the width of the face when measured at the cheek bones (zygomas). This means that if you were to measure the width of that tooth you could fit 14.5 of them across the face. The lateral incisor is 80% the width of the central incisor and the cuspid is 90% the width of the central incisor. Within each tooth the width to height is also important. I like to use 5 parts wide to six parts tall though this proportion can vary depending upon a patient’s personal preference. Whenever I am requested to change the shapes of teeth, I first simulate how I feel the teeth would best look by applying tooth colored acrylics onto the fronts of the teeth and gums. Then I hand the patient a mirror and watch for their expression. In particular I look for what I term “Smiling With the Eyes” which is when a person uses all of their facial muscles to smile and the outer corners of the eyes develop tiny folds. This tells me that the patient truly appreciates the new look in terms of color, contour and proportion. I can then remove the “diagnostic provisional restorations” and make the necessary permanent changes into the teeth. This process can be used when making porcelain veneers, crowns or removeable dentures. The patient in the attached photograph was displeased with his original smile. The teeth were short and had large gaps in between. He underwent a process of first making the original teeth longer followed by placement of six porcelain veneers on the front teeth to close the gaps. The teeth are six parts tall to five parts wide. The lateral incisor is 80% the width of the central incisor, and the cuspid is 90%. The front teeth are 1/14 times the width of the face. The patient was thrilled with the tooth proportions as well as all the other details.

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