AESTHETIC DENTISTRY
Smile Design
Not a treatment, but a plan that starts from the least invasive option
Provided at our clinic in Altunizade, Üsküdar (Istanbul).
IN SHORT
Smile design is not a single treatment; it is a planning process that decides which treatments are needed. The shape, colour and alignment of the teeth, the gum level and their relationship with the facial features are assessed together. Before moving on to a permanent procedure, the result can be tried in the mouth with a temporary trial (mock-up). In planning, the least invasive method that solves the problem is used first; methods that require removing substance from a healthy tooth are only preferred if they are necessary.
Smile design is not a treatment
Patients often ask, “should I have a smile design or veneers?” This is a wrongly framed question.
Smile design is the process that decides whether veneers are needed or not. It is a plan. Zirconia, veneers, bonding, whitening and gum contouring are the tools that carry out that plan.
This distinction matters, because the treatments sold under the name “smile design” are frequently a single method: veneers on twenty teeth. Yet in some cases whitening alone and bonding on two teeth is enough.
What is assessed?
The shape, length and width proportions of the teeth
The colour and light transmission of the teeth
Alignment and gaps between the teeth
The amount of gum visible when smiling and the symmetry of the gum level
The relationship of the upper lip line with the incisal edges
The midline: the harmony between the centre line of the teeth and the centre line of the face
The bite relationship and any teeth-clenching habit
Aesthetic planning is carried out after oral health is established. If there is active gum disease, untreated decay or a serious bite disorder, these are resolved first.
Digital planning and mock-up
Planning begins with photographs, video and an intraoral digital scan. The intended result is prepared in a digital environment.
Next comes the mock-up stage: the planned result is applied over the teeth with a temporary material and tried in the mouth. At this stage the patient sees the result, speaks, smiles and assesses it.
The importance of the mock-up is this: it gives the opportunity to see the result before an irreversible procedure is started. Changes can be requested at this stage. No permanent procedure is begun until the mock-up is approved.
The process step by step
Examination and oral health assessment
Gum disease, decay and the bite are examined.
Preparatory treatments
Any gum treatment, decay treatment and, if needed, orthodontics are completed.
Records
Photographs, video and a digital scan.
Digital planning
The intended result is prepared in a digital environment.
Mock-up
The result is tried temporarily in the mouth; changes can be requested.
Application
The relevant treatments are carried out in line with the approved plan.
Check-up and maintenance
A night guard is planned if needed.
Who is it not suitable for?
Those with active gum disease. Aesthetic applications cannot be carried out on a diseased foundation.
Those with untreated decay.
Those with advanced crowding or a bite disorder. Orthodontics is needed first. An aesthetic crown does not take the place of orthodontics.
Those with a severe teeth-clenching habit. Treatment is not entirely ruled out, but the use of a night guard is mandatory.
Those whose expectation cannot be met clinically. In this case, which result can and cannot be achieved is explained clearly.
Risks and irreversibility
In teeth to which a crown or a prepared veneer is applied, the procedure is irreversible because substance is removed.
Sensitivity after preparation; rarely, the need for root canal treatment.
Fracture. Particularly in patients with a teeth-clenching habit.
The margin of the restoration becoming visible with gum recession.
Temporary sensitivity in cases where whitening is applied.
Knowing these risks also explains why the mock-up stage should not be skipped before deciding.
Start from the least invasive solution
This is the most important section of the page.
The methods in aesthetic dentistry form a ladder according to the amount of tissue removed from the tooth. The correct approach is to start from the lowest step that solves the problem. Removing substance from a healthy tooth is irreversible; a tooth that has once been cut never returns to its former state.
The table below shows which option can be used to start for which problem, and when more is needed. Applying veneers to twenty teeth may genuinely be necessary in some cases; but in a patient who only has a colour problem, this means turning a solvable problem into an irreversible procedure.
Compare the options
| Least invasive option | When more is needed | |
|---|---|---|
| Discolouration | Teeth whitening | For discolouration that does not respond to whitening (tetracycline, advanced fluorosis), veneers or a crown |
| Minor fracture, edge wear | Composite bonding | For extensive substance loss, veneers or a crown |
| Gap between teeth (diastema) | Composite bonding | If the gap is wide or present in many teeth, veneers; if the root position is problematic, orthodontics |
| Mild alignment problem | Orthodontics (clear aligners) | Veneers if camouflage is wanted — but substance is removed from a healthy tooth |
| Advanced crowding | Orthodontics | Veneers do not take the place of orthodontics. Camouflage with crowns requires far too much tissue loss. |
| Extensive substance loss, root-canal-treated tooth | A crown (zirconia or E-max) | — |
| Gum-level irregularity, gummy smile | Gum aesthetics | If there is a skeletal cause, surgical assessment |
Which option is suitable is decided together after an intraoral examination.
Frequently Asked Questions
No. Smile design is a planning process that decides which treatments are needed. Crowns, veneers, bonding, whitening, gum contouring and, where needed, orthodontics are the tools that carry out that plan. Which procedures will be applied is determined after a clinical examination and planning.
It varies according to the number of teeth visible when smiling and the problem. In some cases bonding on two teeth is enough; in others more comprehensive planning is needed. There is no fixed number. When it is applied to only a few teeth, colour harmony with the neighbouring teeth is also assessed separately.
Yes. At the mock-up stage, the planned result is tried in the mouth with a temporary material. At this stage the result is seen and changes can be requested. The permanent procedure is not begun until the mock-up is approved.
It depends on the method applied. Whitening and bonding are less invasive. In teeth to which a crown or a prepared veneer is applied, a return is not possible because substance is removed. This distinction should be discussed in detail before treatment.
In patients with active gum disease, untreated decay or a serious bite disorder, these problems need to be resolved first. Aesthetic planning is carried out after oral health is established.
Mild alignment problems can be camouflaged with crowns or veneers. However, doing this in advanced crowding requires removing far too much tooth tissue. In this case, orthodontics first and then, if needed, an aesthetic application is recommended. A crown does not take the place of orthodontics.
Naturalness depends on the proportion of the tooth dimensions to the facial features, on light transmission and on the symmetry of the gum level. For this reason, planning is done not on a single tooth but over the whole smile and the face. The mock-up stage allows the result to be assessed before the permanent procedure.
Related treatments
The content on this site is for information only and does not replace a clinical examination. The suitability, duration and scope of treatment are determined after a clinical assessment.
This content was prepared by Dt. Mevlüt Yazıcı.
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Altes Diş Kliniği
Altunizade, Üsküdar, İstanbul
- PHONE+90 533 474 43 94
- EMAIL[email protected]
- ADDRESSAlperen İş Merkezi, Valide-i Atik Mahallesi, Altunizade, Nuhkuyusu Cd D:191/B, 34664 Üsküdar/İstanbul
- WORKING HOURSWeekdays 10:00–19:00 · Saturday 10:00–16:00 · Sunday closed