Introduction
Dental esthetics is about how teeth look: their colour, shape, size, position and alignment, and how they fit the lips and face. Esthetics is one of the three things prosthetic treatment restores, together with chewing and speech. It mixes science (measurements and rules) with art (the clinician's eye, the technician's skill, the patient's taste).
Tooth colour
Natural colour changes with age (teeth darken and lose translucency), wear (smoother and glossier), sex (women's teeth tend to be lighter), stains and the position in the arch. Canines are the darkest front teeth; premolars and molars are a little lighter than canines.
Prosthetic treatment and esthetics
Choosing artificial front teeth
- Size: pre-extraction photographs and casts are the best guides. The width of the six upper front teeth relates to the distance between the pupils, scaled from a photo.
- Shape: the face outline, seen square, tapering or ovoid, is said to match the inverted outline of the upper central incisor (Leon Williams).
- Colour: match to remaining teeth, age and skin; pick quickly in daylight.
The dentogenic concept (Frush and Fisher)
Teeth are chosen and set to suit three things about the patient, in this order:
- Sex: softer, rounded outlines and smaller, slightly higher laterals for a feminine look; squarer, bolder teeth for a masculine look.
- Personality: wider, darker centrals with sharper angles for a vigorous look; paler, rounded teeth for a delicate one.
- Age: worn incisal edges, some visible "recession" and a darker shade for an older person.
Esthetic options in practice
Prosthetics and orthodontics share this field: prosthetics replaces lost tissue; orthodontics moves malpositioned teeth and jaws.