Download e-copy - Smile Dental Journal

The Smile...
Past - Present - Future
If we take a look at the pathway of Dentistry over the past century, we would notice that
The Smile was certainly not the primary focus of the dentist`s awareness and concern until
recently. Dental Aesthetics is one of the revolutions in dentistry since World War II with the
others being the technology and equipment of the 1950s, the emphasis of prevention for
teeth conservation in the 1960s and lately implant dentistry in the 1980s. In fact providing
aesthetic dentistry to patients became an economic necessity for dentists.
In 1989, while chairing the scientific committee at the Lebanese University-School of Dentistry, we organized the 1 st
meeting worldwide on “The Smile” for 2 days that included the contributions of all dental and oro-facial specialties.
Our editorial at the time focused not only on the relationship between health and aesthetics but stressed on the interlink
established between a society of consumption constantly influenced by the mass media, a medical industry catering for
marketing, a dental profession exploring new horizons and a patient constantly seeking for beauty. Such vicious circle
could expose medicine to lose its nobility and with it its true identity.
Today, 22 years later, our opinion has not only not changed but all our apprehension and fear of aesthetic abuses has been
justified specially when considering all the disasters resulting and/or hidden behind the so called “Hollywood Smile”.
Nowadays, the smile still plays a major role in communication and is considered as one of the main tools in advertising.
However, are we really attracted to teeth that are falsely so white and chalky without any natural transparency or
translucency and look so fake? Are we satisfied as dentists to look at magazines covers only to find smiles that all look the
same, in which one size fits everybody and encourage our patients to request copycats because it is the smile of their idols?
Are we not responsible to control and guide the mass media in educating the public and spreading the correct information
rather than adverts not evidence based. Finally shouldn’t we even prepare guidelines about the Ethics of Aesthetics!
With such observations, Aesthetics should be revisited and we would have to pay Mother Nature more respect. Aesthetics
should be viewed in term of rejuvenation with a custom made approach and some consideration to the individual
characteristics. It would have to make people look younger but not cloned to such extent that they loose their personality.
The smile is part of the body and not a wear that changes with years along with fashion.
According to the philosopher Kant, Beauty is defined as “What Attracts Universally and Without any Concept”.
Concerning the smile, we have to go back to our basics:
1. The color is not the only variable in tooth aesthetics, we have to consider position, volume, texture... It is Microaesthetics
2. The tooth is only one variable in the smile components that include the periodontium, lips, smile reveal... It is Macroaesthetics
3. The smile is part of the Facial Harmony that involves the eyes, nose, and chin
The ideal smile team would include an Orthodontist, a Periodontist and a Prosthodontist or a General Dentist in order to
have a multi disciplinary approach and take the best from every specialty. A Maxillo–Facial Surgeon could be consulted in
certain conditions.
Taking all these data into consideration, we have to admit that the time factor plays a major role when a multidisciplinary
approach is indicated for a long lasting result. This time, essential for therapy, that the patient wants to be always shorter
and faster, becomes in fact the only judge for success.
Finally, communication is an issue that we should not overlook if we want to meet our patients’ expectations. Since they
usually pay up front for a series of procedures with an outcome they envision quite differently than we do.
In such circumstances we might fall into Charles Revlon thought:
“In the Factory we Make Cosmetics and in the Store we Sell… Hope”
Prof. Jean-Marie Megarbane DCD, CAGS, FAIDS, FICD
Masters Dental Clinic, Beirut-Lebanon
info@mastersdentalclinic.com
www.mastersdentalclinic.com
| 4 | Smile Dental Journal | Volume 6, Issue 34 - 2011