various elements to b considered in smile designing

1. Principles of Esthetics

2. CONTENTS
• INTRODUCTION
• NEED
• DEFINITIONS
• CLASSIFICATION
• PRINCIPLES
• COLOR
• SMILE DESIGN ANALYSIS
• STRUCTURAL ESTHETIC ELEMENTS
• CONCLUSION
• REFERENCES

3. Introduction
• Organised & systematic approach ….
• Final result..
• Smile, is a persons ability to express a range of
emotions with the structure and movement of the teeth
and lips can often determine how well a person can
function in society

4. IT IS ESTIMATED THAT 50% OF PERSONS
SEEKING DENTAL TREATMENT ARE ACTUALLY
ESTHETIC IMPROVEMENT.
WANT BASED
NEED FOR ESTHETIC DENTISTRY

5. DEFINITIONS
Esthetic
Concerns with beauty or the appreciation of
beauty. (Oxford Dictionar
Dental Esthetics
The application of the principles of esthetics
to the natural or artificial teeth and restorations. (GPT
1999)

6. Esthetic reshaping
Modification of the surfaces of teeth to improve
appearance
Esthetics (adj. 1798)
1. The branch of philosophy dealing with beauty.
In dentistry, the theory and philosophy that deal with
beauty and beautiful, esp. with respect to the
appearance of a dental restorations, as achieved
through its form and or color. Those subjective and
objective elements and principles underlying the beauty
and attractiveness of an object, design or principle.

7. Esthetic Dentistry
can be defined as the art and science of dentistry
applied to create or enhance beauty of an individual
within functional and physiological limits.
Cosmetic dentistry
Is application of the principles of esthetics and
certain illusionary principles, performed to signify or
enhance beauty of an individual to suit the role he
has to play in his day-to-day life or otherwise.

8. COMPOSITION means the act of combining elements or
parts to form a whole. There are various physical attributes of
the elements of a composition that impart the esthetic value.
Contrast: It is that factor which makes the various elements
of a composition visible. The eye can differentiate the parts of
an object due to contrast of colors, lines, patterns, textures,
etc.
The relationship between the different parts of the face
(facial), the teeth and the gums (dental) made visible by
contrast constitutes the dento-facial composition.
PRINCIPLES

9. Dental FACIAL
DENTAO FACIAL

11. UNITY : Prime requisite for a composition is unity
that will give different part of the composition
the effect of a whole.
STATIC
DYNAMIC

12. Unity between different parts of the face, and
teeth is essential to give the effect of oneness
or wholeness to the dento-facial composition

13. DOMINANCE:
It exists when a strong centralized structure is
surrounded by well-demarcated, characterized structures.
In a dento-facial composition it creates immaculate unity
leading to a harmonious composition. The absence of
dominance makes the composition weak. Color, shape
and size are the factors which can control
dominance.

14. COHESIVE AND SEGREGATE FORCES:
Any element which tends to unify a composition is
a cohesive force. A border is a cohesive force, as well
arrangements of elements in a definite form or according
to a principle. e.g. two parallel objects or an
encircling frame (lips bordering the anterior teeth).

15. Segregative forces are those elements which
break the monotony of the composition. Naturalness
has combination of cohesive and segregative forces. A
proper mix of segregative and cohesive forces adds
variety to the composition making it more dynamic and
interesting.

16. SEGREGATIVE FORCES ARE REPRESENTED BY ELEMENTS ARRANGED IN
AN INTERESTING MANNER ,REMINDER OF AN INTERESTING THING OR
EVENTS, SUCH AS CLASS I ARRANGEMENT.
SEGREGATIVE FORCES ARE THE NECESSARY ELEMENTS THAT ENHANCE THE
ESTHETIC VALUE OF A COMPOSITION.

17. SYMMETRY : Symmetry refers to the regularity
in the arrangement of forms or objects.
HORIZONTAL OR RUNNING SYMMETRY
arrangement of forms either from left to right
RADIATING SYMMETRY
from a central point to either side like a mirror image

18. The horizontal symmetry looks repetitive and
uninteresting while the radiating symmetry looks
dynamic and interesting.
In a dento-facial composition radiating symmetry
of the teeth is more esthetically appealing and is
associated with youthfulness while horizontal
symmetry is less appealing and is associated
with aging.

19. PROPORTION
To be able to give a certain mathematical
representation of beauty for numerically expressing the
relationship of the various units that combine to make a
composition, the term proportion is used.
The relationship of the various units which are
different from each other in a composition but are associated
with each other through a certain repetitive mathematical
factor is the repeated ratio.
The proportion between the various elements of a
harmonious composition, in which the cohesive and
segregative forces are equally balanced and which has its
various units in an esthetically appealing respective
proportion to each other is the golden proportion.

20. Key principle found in nature,art and architecture.
basis of modern theory of dentofacial esthetics
Related to principles of cephalometrics and anthropometrics
GOLDEN PROPORTION RATIO : 1.618 : 1 : 0.618

21. • The dentofacial characteristics determined
from the golden proportion include width
of both centrals to height of centrals .
• 78% is ideal

22. 24

23. • If the ratio is applied to the smile made
up of the central, lateral incisor and the
mesial half of the canine, it shows that
the central incisor is 62% wider than
the lateral incisor which in turn is 62%
wider than the visible portion of the
canine which is the mesial half, when
viewed from the front.

24. Application of sizing the central incisors from certain
facial measurements is known as the 1 to 16 theory,
whereby the height of an ideal maxillary central
incisor from the incisal edge to the gingival crest is
1/16th
of the distance from the inferior border of the
chin to the inter papillary line.
The same tooth width can be measured from the
mesial to distal contact areas and is 1/16th
of the
distance measured from either zygomatic prominence
through an imaginary facial midline.

26. Once the size for the central incisor is determined it is
essential to design its outline form. The facial
harmony method can be applied to relate the tooth
form to the facial form.
Various facial shapes are identified and descriptions
such as
Ovoid, square, tapered and combinations of these are
used . The same shape when inverted can be applied to
the central incisor design. This shape acts as guideline
for the outline forms of other maxillary teeth.

27. BALANCE: It is achieved when there is an exact equilibrium
between the forces present on either side of the fulcrum in a
composition. In dentistry this implies the balance of the
elements in relation to the midline.
Visual tension is the tension brought about by the presence
of certain elements that cause an imbalance in the given
composition.

28. If the presence of these factors is closer to the fulcrum,
the effect of the tension into the fulcrum, the effective
tension induced is more magnified as against their
presence further from the fulcrum.

29. COLOR
Dimensions of color
Color cannot be perceived without light, which
is a form of electoro-magnetic energy visible to the
human eye. The visible spectrum of light lies in a
narrow band of 380nm to 760nm. It has the ability to
stimulate the cells in the retina which is interpreted
by the brain, discerning the sense of color.

30. Clark stated that “Color, like form, has three
dimensions”.
HUE : In Munsell’s words, “It is that quality
by which we distinguish one color family from
another”.
Generally there are six hue families. Violet,
blue, green, yellow, orange and red. For
example, in the Vita shade guide there are four
hues A, B, C and denoting reddish brown,
reddish yellow, grayish and reddish grey
respectively.

31. CHROMA :
In Munsell’s words, “it is the quality
which we distinguish a strong color from a weak one
“Human teeth fall into the yellow to yellow red area of
the Munsell color order system. Pale colors have a
low chroma whereas intense colors have high chroma.

32. VALUE :
Value or brilliance is the relative blackness or
whiteness of color. On a scale of black to white, white
has “high value”, black has “Low value” and Midway
between black and white is the medium grey. Value is
the only dimension of color that can exist by itself.

33. Opacity and Translucency: As light strikes a surface,
it is either totally reflected, totally absorbed or a
combination of both. Opaque objects reflect all or most
of the light that is incident on them whereas transparent
objects transmit all of the light that is incident on them.
When part of the light incident on an object is
transmitted, while the rest is scattered, the property of the
object is known as translucency. It decreases with
increasing scattering within the materials.

34. Translucency, in effect, is the three dimensional spatial
relationship or representation of value.
Highly translucent teeth tend to be lower in value, since
they allow light to transmit through the teeth, while
opaque teeth have higher value.
.

35. There might be inter tooth as well as intra tooth
differences in the translucency. Its extend can vary
according to the age of the patient due to the
degenerative and reparative changes in the enamel
and dentine.
To mimic natural teeth the effective use of restorative
materials should largely depend upon this translucent
effect.

36. METAMERISM
The change in color perception of two objects
under different light sources is called metamerism. For
example , a shade guide tooth matches the natural tooth
under incandescent light but not under fluorescent
light.
This can be attributed to the difference in the radiant
energy of two different wavelengths of light.
The standardization of lighting condition during
shade matching diminishes the effect of metamerism.

37. FLUORESCENCE
The emission of light by an object at a different
wavelength from that of the incident light is called
fluorescence.
The emission stops immediately on removal of incident
light. Teeth with flurosis stimulus in the range of 340nm
to 410nm. This spectrum is in the blue range.
Thus, according to the principles of additive color, the
emitted blue light acts with the yellowness of the tooth to
produce a whiter tooth.

38. Fluorescing pigments incorporated in the
ceramic restorations by the ceramist and in the
composite restorations by the manufactures may
thus be advantageously used in altering the
perception of the final result.

39. The smile analysis/design process begins at the
macro level, examining the patient’s face first,
progressing to an evaluation of the individual
teeth, and finally moving to material selection
considerations.

40. SMILE DESIGNING
Is a process where by the complete oral
hard and soft tissues are studied and
evaluated and certain changes are brought
about which will have a positive influence on
the overall esthetics of the face.

41. “ A well designed smile is a product of consolidated
efforts accomplished by accurate diagnosis,
methodical treatment planning, use of advanced
materials and contemporary techniques rendered
by the skilled dentist”.

42. The esthetic orientation of the dental composition
with the entire facial composition can be achieved by
taking into consideration the references, smile elements,
proportions and symmetry.
These are the factors of esthetic compositions and they
help the dentist in determining tooth display, size,
arrangement and alignment during the diagnosis and
treatment phase.

43. The dento-facial frame constitutes the teeth and gingiva
related to the lips and then to the entire face.
The oral frame is determined by the anatomy and
mobility of the tissues when in function surrounding the
teeth and gingiva .The exposed portion of the oral
elements i.e. teeth and gums within the oral frame
during a smile is called the smile window.
.

44. References can be classified as
Horizontal references,
Vertical references,
Saggital references and
Phonetic references.

45. STRUCTURAL ESTHETIC COMPONENTS
1.Facial components
2. Components of smile
3. Dental components
4. Gingival components
Facial features
Tooth visibility
Lip line
Smile line
Upper lip curvature
Negative space
Smile symmetry
Dental midline
Golden rule
Axial alignment
Dental morphology
Contact points
Gingival morphology
Gingival contour

46. HORIZONTAL REFERENCES:
The horizontal perspective of the face is provided by the
interpupillary line the commissural line.

47. VERTICAL REFERENCES:
The facial midline serves to evaluate the location
and axis of the dental midline and the medio-lateral
discrepancies in tooth position.
The inter-pupillary line and the facial midline
emphasize the ‘T’ effect in a pleasing face. The
dental midline, if perpendicular to the inter-pupillary
line and coinciding with the bridge of the nose and
the philtrum, produces an attractive orientation of
the smile.

50. FACIAL ANALYSIS
Frontal View
Facial analysis is checked at a conversational distance. The clinician uses a series of
horizontal and vertical lines to determine the size and proportion of the face from chin to
hairline and also the relationship of the patient’s face and dentition in space
John R Calamia, DCNA 2011

51. • A profile view allows clinicians to visualize an important imaginary
line called the Rickett’s E-plane. A concave profile may call for a more
prominent position of the maxillary anterior teeth with final restoration
ofthe anterior teeth, whereas a more convex profile may require a
more retruded positionof the final restorations.
• Other imaginary lines form the nasal/labial line angle. In men the
nasal-labial angle is generally 90 to 95, whereas in women it is
generally 100 to105.

52. • Incisal and Occlusal Analysis
John R Calamia, DCNA 2011

53. • Phonetic Analysis

54. • Dental Analysis

56. SMILE ELEMENTS:
The extent of the smile is outlined by the curvature of the upper
and lower lip and the position of the angle of the mouth, and it
determines the degree of exposure, both in the anterior and
posterior teeth, gingiva as well as the width of the buccal corridor
Smiles can be classified as passive, active (moderate) and laugh.
In a passive smile the lips are parted slightly away from the rest
position expressing content, passion, desire, surprise, etc.

57. • In an active smile the lips move to a significant
extent away from the rest position displaying
more teeth and even gums, expressing joy,
welcome, happiness, etc.
• Laugh is an instant fluctuation from an active
smile position where the facial muscles
instantly act leading to maximum exposure of
the teeth and gums. Humorous and funny
situations usually lead to such an expression.

58. SMILES?
 S - size and golden proportion
 M - midline and canting
 I - axial inclination
 L - Lip line vs incisal edge of teeth.
 E - extra hard tissue guidelines, contact points, arch
form.
 S - soft tissue conditions, gingival symmetry
62

59. TOOTH VISIBILITY:
It is more important for females than males as the average
exposure of teeth is twice in females as that of males.
AGE

60. Feminine type of smile line
Masculine type of smile line

61. SMILE COMPONENTS
LIP LINE DENTIST HAVE ARBITARILY CLASSIFIED THREE TYPES OF
SMILES THAT,RELATING THE HEIGHT OF UPPER LIP RELATIVE TO THE
MAXILLARY ANTERIOR CENTRAL INCISORS
High lip line Medium lip line
Low lip line Anterior low lip line

62. Lip and lip lines:
Length, curvature , shape of the lips significantly
influence the amount of tooth exposure during rest and
in function.
A prominent tooth display is associated with a youthful
smile and most patients would like to seek the benefit
of the same. Some researchers demonstrated that the
average maxillary incisor display with the lips at rest is
1.91mm in men and 3.40 mm in Women .Patient’s with
short upper lips and younger patients generally display
more maxillary tooth structure which may be up to
3.65mm.

63. UPPER LIP LINE
Helps to evaluate the length of the maxillary incisor exposed at
rest and during smile and the vertical position of the gingival
margins during smile.
The upper lip line can be classified as low, medium or high
depending upon the amount of tooth or gingival display that is
available at rest of during a moderate smile. The gingival
margins may be displayed in high lip line cases.

64. The most apical position of the gingiva
over the facial aspect of the maxillary
central incisor and canine is slightly distal
to the long axis of the tooth while in the
maxillary lateral incisor it is at the long axis
of the tooth. This is called the gingival
zenith.

65. Whenever a patient displays the gingival margins
easily on smiling or speaking, a definite pattern of
the gingival display can be recorded. This pattern
can be either esthetic or unesthetic .
A smile can be termed “toothy” if more than 6mm of
incisal display is seen at rest position or “gummy” if
more than 3mm of gingival tissues are displayed in
moderate smile.

66. LOWER LIP LINE
Helps to evaluate the buccolingual position of the
incisal edge of the maxillary incisors and the curvature
of the incisal plane

67. SMILE LINE: It is an imaginary line passing through
the incisal edges of the upper anterior teeth. The smile
line usually coincides or runs parallel to the inner
vermilion border of the lower lip.
In a youthful smile the incisal edges of the central
incisors and canines are aligned on a convexity and are
longer than the lateral incisors, incisal embrasures
gradually deepen from central incisor to the canine,
giving the appearance of the wings of a gull.

68. C) UPPER LIP CURVATURE
Directed upwards Straight
Slightly downwards Pronounced downwards

69. D) NEGATIVE SPACE (buccal corridors) : DARK SPACE APPEARS BETWEEN
THE JAWS DURING LAUGHTER
AND MOUTH OPENING

70. The lateral negative space exists between the labial
surface of maxillary teeth and the corner of the mouth
while the buccal negative spaces appear in the buccal
vestibule on either side of the buccal aspect of posterior
teeth.

71. Obliteration of these essential spaces by dental
elements like
bulky canines,
wide arches or
over-contoured restorations can lead to an
unattractive smile.
Excessive negative space seen in cases of
missing premolars or
palatally placed posteriors and a constricted arch also
appear unesthetic.

72. GRADATION : WHEN THE TWO SIMILAR OBJECTS
ARE PLACED AT DIFF.DISTANCE CLOSER
WILL APPER LARGEST.
THIS FRONT-BACK PROGRESSION IS DETERIMED
BY ARCH FORM AND KEY TOOTH THAT ASSESSES
THIS NATURAL TRANSITION.

73. Progressive abating in a dental composition:
When similar structures are aligned in an arch form one
after the other, they appear to progressively abate in size
from the nearest to the farthest. This gives an illusion of
depth.
The essential requirement of the front to back
progression in dental composition is the alignment of the
contour of the labial surface at the incisal third, middle
third and the gingival third of successive teeth in the arch.

74. The incisal mesio-buccal inclines should be well
aligned to give a smooth progression from tooth to
tooth. The buccal and lateral negative space
progressively reduces the illumination on teeth to
enhance the front to back abating effect.
The presence of poorly shaped teeth, differences in
axial inclinations, tooth length discrepancies,
discolorations, gingival disharmonies etc. can lead
to a visual tension resulting in a disruption of the
front to back progression.

75. E) SMILE SYMMETRY
RADIATING SYMMETRY
HORIZONTAL SYMMETRY

76. DENTAL COMPONENTS
A) DENTAL MIDLINE
It is an imaginary vertical line that separates the two central
incisors.
Recommended protocol
a) Placing this midline precisely in accordance with facial midline
or in the middle of the mouth using the incisive papilla or labial
frenum as landmarks.
b) Never establish it in a precise midline because it may
contribute to an artificial appearance.

77. Mesiodistal width and inciso gingival height
Some osseous and dental landmarks
1.Bizygomatic width and maxillary central incisor
width (1/16th
)
2.Bizygomatic width and maxillary anterior teeth
width (1/3rd
)
3.Skull length and maxillary incisor length (1/20th
)
4.Skull circumference and width of the maxillary
incisors
5.Nasal width and maxillary incisor width
6.Angle of the mouth and maxillary anterior teeth

78. AXIAL INCLINATION
Is the direction of the anterior teeth in relation to the
central midline and becomes progressively more
pronounced from the central incisor to the canine.
There is a definite mesial inclination to all the anterior
teeth related to the midline. The axes of the premolars and
the first molar on either side also show mesial inclination in
relation to the midline.

79. The perception of tooth inclination can be viewed
from the frontal aspect around the central vertical
midline, which acts like a fulcrum around which axial
inclination of teeth on either side exhibit a phenomenon
of balance of lines.
Natural smiles show a deviation from these standard
axial inclination. Deviations in axial inclination cause a
visual tension when beyond the point of equilibrium .

80. E-line or esthetic line is an imaginary line connecting
the tip of the nose to the most prominent portion of the
chin on the profile, ideally the upper lip is 1-2 mm
behind and the lower lip 2-3mm behind the E-line. Any
change in the position of the E-line indicates the
abnormality in the upper or lower lip position.

81. The relationship of the maxillary incisal edges to the
lower lip is a guide for the placement of the incisal
edge position and length.
The pronunciation of the ‘F’ and ‘V’ consonants
helps determine the position of the incisal edges.
On pronouncing ‘F’ and ‘V’ the incisal edges should
make a definite contact at the inner vermilion border
of the lower lip. Thus the position of the incisal third
of the maxillary central incisor can be determind.

82. PHONETIC REFERENCES:
Phonetics play a part in determining maxillary central
incisor design and position.
‘F’ and ‘V’ sounds : Tilt of the incisal third of the
maxillary central incisors and their length.
‘M’ sound: To achieve relaxed rest position and repeated
at slow intervals can help evaluate the incisal display at rest
position .
‘S’ or ‘Z’ sounds determine the vertical dimension of
speech.

83. PLEASING SMILE
A naturally attractive smile that evokes a
feeling of beauty or harmony and complements
the personality of the bearer is termed as a
pleasing smile.
The natural pleasing smile may not necessarily
comply with all rules of symmetry or golden
proportion or may not exhibit perfect balance
without irregularity of shape. However, the
composition is esthetically appealing with unity
within its various elements.

84. SMILE DOMINANCE :
Different facial features stand out differently in
the eyes of every beholder. In certain cases, the most
predominantly striking features of a face is the smile;
these are the “Dominant Smiles”.
The distinguishing characteristics observed in
people with pleasant smile dominance that can be
used as a guideline for creating the same are :

85. • The maxillary central incisors exhibit a strong
presence by their size and form reflecting the personality
of the individual.
The maxillary lateral incisors and the canines
complement the central incisor in terms of proper shape
and form.
Although numerically all proportions of the anterior
teeth do not follow the rule of golden proportion, the
teeth are so placed that they appear in suitable
proportions with each other.

86. Well co-ordinated movements of the lips with
the other peri-oral musculature and corresponding
harmonious facial expressions, contribute to the
pleasant
face during smile.
The complexion and texture on the face contrast
with
the lip color, gingival and the teeth leading to a distinct
demarcation between the oral and the facial frame.

87. PERCEPTUAL ASPECTS – THE ART OF ILLUSION
Illusion is a figment of imagination where a
perception of an object is created.
Fundamental and Principles
The art of creating illusions consists of changing
perception, to cause an object to appear different from
what it actually is. Teeth can be made to appear
smaller, larger, wider, narrower, shorter, longer,
younger, older, masculine or feminine.

88. One being subjected to light the most
fundamental objects exhibits two dimensions,
that is, length and width.
‘Principle of Illumination”.

89. The second artistic predilection of great importance in
dentistry is the use of horizontal and vertical lines .
“Principle of Line”.
The artistic predilection exhibited in the principle of
illumination can be maintained to change the size,
shape and the overall form of the tooth through
illusions.

90. Law of the face.
The face of a tooth is that area on the facial surface on
both anterior and posterior teeth, that is bound by the
transitional line angles as viewed from the facial i.e.
labial or buccal aspect.
These transitional line angles mark the transition from
the facial surface to the mesial, distal, cervical and
incisal surfaces.

91. Shadows created as light strikes the facial surface of the
tooth begin at the transitional line angles, these shadows
delineate the boundaries of the facial form.
Thus the apparent face is that portion of the face that is
visible to the observer from any single view. When
maxillary anterior teeth are viewed from the front only
the mesial half of the canine is visible however the entire
incisor face is visible.

92. THE LAW OF THE FACE
Implies making dissimilar teeth appear similar by making the
apparent faces equal.
The apparent face should be manipulated, not the actual face.
This is more important in the canines and the posteriors as the
‘apparent face’.
The transitional line angles are relocated so that the apparent
faces look equal, however this results in dissimilar areas outside
the transitional line angles.

93. Similar faces produced attract light and
appear high lighted while the dissimilar areas that
are in a shadow appear to recede.
When the transitional line angles cannot
be repositioned on a restoration, then the portion
of the tooth can be stained darker to create an
illusion that the transition line angle has been
moved.

94. DENTAL MORPHOLOGY :
TEXTURE :
Characterization of tooth surface is a function of
two types of convexities and concavities.
- Anatomic grooves,facets,and prominence that
exist in various degree on any tooth surface.
- The perikymatae,stipping,and rippling that may affect
the enamel surface.

95. SHAPE OF THE TEETH
Bizyomatic width and maxillary incisor width
Nasal width and maxillary incisors
COLOR AND FACE OF TOOTH CONTOUR.

96. 100

97. Shape or form
101

98. CONTACT POINT
The lip line,incisal line and contact
line represent an ideal in cohesive forces
of dentofacial composition.
From frontal view contacts are situated in
a position that seems to go from incisal to
cervical and from centrals to canines.

99. PHONETICS
M & E SOUND
- FOR INCISAL TOOTH DISPLAY IN REST POSITION
- LENGTHOF THE TEETH AND INCISAL LINE.
F & V SOUND
BUCCOLINGUAL PLACEMENT OF UPPER
MAXILLARY INCISORS.
S SOUND
VERTICAL DIMENSION OF SPEECH IS DETERMINED

100. F & V SOUNDS M - SOUNDS S & Z - SOUNDS

101. EMBRASURES AND INTERDENTAL SPACES
Interdental gingiva follows the contour of bone
GINGIVAL COMPONENTS
GINGIVAL MORPHOLOGY
GINGIVAL TISSUE AND
RACIAL FACTOR
ALVEOLAR MUCOSA
GINGIVAL CONTOUR

102. GLOSS
Gloss is an optical property associated with a
smooth surface that produces lustrous surface
appearance
and thus reduces the effect of color differences.
Increase the brilliance (value of the final result.)
In
dentistry, unlike spectral colors, the restorative
materials
have pigment colors incorporated in them. Predictable
restorative color outcome can only be achieved by

103. PRIMARY COLOR
Are those colors that cannot be formed by mixing of
multiple colors. They occur naturally by themselves. For
example, red, yellow, blue etc.
COMPLEMENTARY COLORS
According to the additive principle of colors,
complementary colors can be used to lower the value of
the restoration and not to complementary color may be
added to the respective hue to decrease the value.

104. PERCEPTION OF COLOR.
The perception of color involves many
physiological , and physiological aspects
THE LIGHT SOURCE.
The light source has the color of the emitted light
and is described in color temperature (Kelvin.). The
lighting environment makes a significant differences in
the perception of color. The teeth and the shade guide
should be sufficiently illuminated. The light reflected
from a glossy surface obscures the viewer’s perception
of light. Shadows should be eliminated as they reduce
the available light and hide details.

105. The dental operator may be illuminated by combination
of natural sunlight and artificial light,
The artificial light may be incandescent
(predominantly) blue. Also the ratio between the task
light (which falls directly on the working area) and the
ambient light (derived from the surroundings), known
as the contrast ratio, should be higher than 3:1, but
lower than 10:1.
This can be attained by regularly measuring the
intensity of light, cleaning the diffusers and the light
sources any by replacing them when their effective life
is over.

106. THE OBSERVER
The stimulus of light travels through cornea, lens,
aqueous and vitreous humors and reaches the cones
and rods of the eye.
The cones function for day light vision and color
perception whereas rods are sensitive to the quantity of
light perceived. These stimuli are then sent to the brain,
where they are computed and interpreted as color. This
complexity of color is further modified by the embryonic
development of the brain, aging process, aberrations of
color vision like color blindness, dichromatism, mental
fatigue and drug intake.

107. THE OBJECT
The quality of the color of an object (the tooth)
depends on its ability to absorb, reflect, transmit or
refract the light energy falling on it. The surrounding
environment greatly influences the color. The ceiling
and the walls reflect light and should not be painted in
bright colors. Neutral colors like grey or white should be
selected.
CONTRAST EFFECTS
The background considerably affects the
perception of color. Different contrasts effects that alter
the color vision, should be understood.

108. SIMULTANEOUS CONTRAST
Is visualized when two objects are viewed at the
same time. The light or dark contrast can be correlated to
the surrounding environment like skin tone, hair color
and brightness of adjacent soft tissues and teeth. Hence,
brighter shades should be chosen for light toned patients
and darker shades for pigment toned patients.
ACTUAL CONTRAST
Is influenced by the size and the chroma of the
tooth. A brighter tooth looks larger while a darker tooth
of the same dimension look smaller.

109. SHADE SELECTION
Shade selection is a complex procedure due to the
variations and differences in the optical properties of
the new generation of cosmetic restoration materials. It
can be well accomplished by understanding the
fundamentals of color and adopting a proper
methodology of matching shades. The effective
communication with the laboratory and precise
fabrication and meticulous finishing of the restoration
will affect the color of the final restoration.

110. SHADE SELECTION SEQUENCE
Any color modification procedures like bleaching or
microabrasion should precede color selection after ensuring
color stabilization.
Make the shade selection at the beginning of the procedure
as well as over different appointments (diagnosis, prophylaxis
etc.)and cross check these observations.
View the patients at eye-level. The operator should stand
between the light source and the patient.
In a contrasting environment, colors look more intense and
brighter. Hence it is wise to ask the patient’s to remove artificial
lip color.

111. Place the tabs as close as possible to the area that
is being checked.
Moisten the tab and eliminate the worst match.
Evaluate the value (upper to lower). Value is the
most important factor in shade matching. If the value
blends, small variation in hue and chroma will not be
noticeable. The value is to be matched with eyes half
closed.
After value, mark the translucency
Match the chroma (more or less saturated) and
finally, hue in that order.

112. To avoid hue sensitivity, rapid observation is made
for 5 seconds (not more than 20 seconds). Look away,
ideally stare at a blue surface, which will readapt the
vision to the orange yellow portion of the spectrum.
Match prior to tooth preparation, since preparation
dehydrates and changes color due to the debris of
preparation.
Match the tab with the opposing tooth also.
Metamerism complicates color matching, as the tabs
look different under different light sources. The best
approach is to use three light sources; cool white
fluorescent light, incandescent operatory lamp and day
light if possible.

113. • When in doubt, always select higher value and
lower chroma, since it is easy to lower value and
increase chroma
Shade tabs of different batches don’t always
match, hence it is wise to sent the actual selected shade
tab to the technician.
Make a decision regarding relative translucency,
area of hypo calcification, increase saturation, crack
lines surface texture and other characterization. Make
a drawing of the facial surface and record all patient
information graphically.

115. It is to be noted that smile design should
always be a multifactorial decision-making
process that allows the clinician to treat
patients with an individualised and
interdisciplinary approach.

116. ESTHETIC DENTISTRY IS ART OF
DENTISTRY IN ITS PUREST FORM.
GOAL IS NOT TO SACRIFICE FUNCTION,
BUT TO USE IT AS FOUNDATION FOR TREATMENT.

117. Goldstein E Ronald. Principles of
esthetic dentistry, 2nd
ed.
Ward H Daniel. Proportional smile design using the
recurring esthetic dental proportion(RED).
DCNA.2001:45(1);143-53
1.YOU ARE NEVER FULLY DRESSED WITHOUT A
SMILE
Journal Of Esthetic Dentistry
vol:18; No 2;2006

118. van Zyl I, Geissberger M. Simulated shape
design. Helping patients decide their
esthetic ideal. J Am Dent Assoc 2001
Aug;132(8):1105-9
fundamentals of esthetics; Claude R.
Refenacth.