Studies have been conducted to determine what dentists and other dental professionals see (and what the patients see) when looking at a beautiful smile. While non-dentists typically focus on a single element, cosmetic dentists look at the entire complex — the lips, gums, teeth, bite, face, personality type, hair and skin color, and more. They examine the smile and analyze the length of the teeth, how the teeth line up with other facial features, gum-to-lip distance, and other characteristics.

While it’s important for dentists to listen to their patients to understand what is desired, it’s equally crucial for patients to listen carefully to their dentists to understand what procedures are being suggested and what they entail. It’s this attention to dental details that can create an appealing smile — and great results.

To get the most positive results from your experience with a cosmetic dentist, communicate clearly from the beginning and have a good understanding of what you want from your smile. Ask yourself the following questions:

1. What shade of white do I want my teeth to be: a natural shade or a whiter-than-white shade or somewhere in between?
2. Am I satisfied with the amount of teeth showing when my lips are relaxed and when I smile?
3. Am I looking for perfectly aligned teeth or am I happy with slight variations?
4. Am I happy with the amount of gum that shows when I smile?

As materials and techniques have improved over time, the idealistic “Hollywood smile” has made way for the more naturalistic result. Patients are often pleased with teeth having a sense of regularity and alignment, more like nature intended, and less like a mouthful of “chiclets."

A smile design meeting between you and your cosmetic dental professional will consist of a conventional evaluation and an aesthetic evaluation. The conventional part of the consultation will be a physical examination of your teeth, gums, and bite, and the taking and evaluation of x-rays. The aesthetic part of the consultation will be more subjective, and this is where communication between you and your dentist is important.

A preview of your proposed changes is a great tool and dentists can offer this in a variety of ways. Computer imaging is a wonderful way to see what your teeth can look like after a change and gives you the flexibility to change your mind about almost anything. Other ways require the dentist to make models of your mouth and build mock-ups out of wax or resin to give you a three–dimensional view of the finished product.

A provisional (temporary) restoration is another tool used to give the patient and the dentist a trial period before the final work is done. The first restoration (made from the previously approved mock–up) lets you see how the final restorations will look and feel in your mouth, and how they might affect your gums, your speech, and biting function. Your dentist can make any necessary adjustments before the final restoration is completed. The provisional restoration should look and feel very much like the final desired outcome.

The only way to get what you want in a smile is through open, honest, and clear communication between you and your dental professionals. Realize from the outset that no one is coming from exactly the same place, so work must be done to make sure that everyone knows what procedures will be performed and exactly what the final smile will look like.