Understanding Facial Aesthetics

As a dentist, you know that teeth greatly affect your patient’s appearance. Every extraction or crown affects facial aesthetics and it’s your job to give patients the most ideal smile possible.

The lifelong study of dentistry, orthodontics, and facial aesthetics is rewarding but intense.

For example, if a patient asks you about fixing their “gummy smile” or fixing parallelism problems with their teeth and facial midline, are you fully confident in your counsel to them? You can always refer them to a specialist, but increasing your knowledge of orthodontics and how they affect facial aesthetics is a rewarding process — for you, for your patients, and for your production goals.

Here are four things to know about facial aesthetics and orthodontics.

1. How Orthodontics Can Improve Facial Aesthetics

Drastic underbites and overbites obviously have a significant impact on the patient’s looks. However, smaller issues can change the way a person looks as well.

For example, midline deviation, a lack of parallelism between the facial midline and the tooth axes, or uneven gingival margins can impact facial aesthetics.

Proper orthodontics can fix many of these problems by bringing the teeth back into proper alignment.

In some cases, how orthodontic treatment will help is pretty obvious and you can make an educated guess based on your dental knowledge. With others, the effect is more subtle.

If you understand the basics of orthodontics, you can better serve your patients. You still might refer your patient to a specialist for more advanced dental work, but you will have a better idea of when you need to refer them as well as be able to explain to them how orthodontics will likely affect them.

2. Things to Look for and How to Diagnose and Treat

You can diagnose orthodontic conditions through a couple of different methods.

Visual Exam

The first is a visual examination. With the patient’s head in a neutral, relaxed position and the mouth closed to the first tooth contact, you analyze the position of the centric occlusion and the centric relation. Also, take into account the median lines and symmetry of the patient’s face.

From a dental perspective, you’ll want to evaluate whether the dental midline is in line with the facial midline. The teeth should also be appropriately parallel to the facial midline, and gingival margins should be even.

Any of these details being out of alignment can have an effect on the patient’s appearance.

Dental X-Rays

As you know, sometimes more information is required than you can get from a visual inspection. To get a more complete picture, we use dental x-rays to further examine the extent of the misalignment.


Sometimes you might need to make a plaster model of the mouth to further evaluate the patient’s teeth and determine how to correct their issue.

3. Orthodontics and Smiles

Obviously, orthodontics can have a huge impact on a person’s smile. Most people choose orthodontics because they are interested in getting as close to the “ideal smile” as possible. How much and how many of the teeth can be seen when smiling is a big part of facial aesthetics.

For example, when about 70% of young adults smile, you can see between 75% and 100% of the upper incisor’s surface. This is considered ideal.

About 20% of young people will reveal less than 75% of the upper incisor’s surface. And 10% will have a “gummy smile”, exposing the whole surface of the teeth as well as a portion of the gums.

Plus, when the vast majority of young adults smile, you can see the six anterior teeth plus the first or second premolar. Only in 4% of people can you see the smile revealing the first molar.

4. Extractions and Facial Aesthetics

It is also very important to be aware of the impact that a tooth extraction can have on the patient’s face. As you’re already aware, the debate between extraction vs. non-extraction rages on. However, it’s always important to consider what will happen in each individual case.

If it is possible to meet your functional and facial aesthetics goal without extracting the tooth, don’t even entertain the idea of extraction. But sometimes the opposite is true. An extraction will actually help improve the patient’s facial aesthetics.

Knowing the difference between these cases is tricky and something you can learn if you take a general dentist orthodontic course.

Adding Orthodontics to Your Practice

You don’t have to become an expert in orthodontics to add it to your services. You can and should still refer many cases to a specialist (particularly the extreme ones).

However, the basic understanding that you can get from an online orthodontic course will be invaluable to your practice. You’ll be able to better serve your patients as well as create additional revenue for your office.

Dr. Brad Williams, who first joined the American Orthodontics Society in 1983, can teach you what you need to know through his widely known orthodontic courses. Throughout his extensive career, he has studied and used many different techniques in orthodontia. He has developed an expert eye when it comes to how orthodontics will affect a patient’s face and he is ready to pass on what he has learned to you. Check it out today!