Digital Smile Design
What is Digital Smile Design?
Digital Smile Design or ‘DSD’ is a ground breaking development in undertaking cosmetic dental treatment – developed by Dr Christian Coachman, a dual qualified dentist and ceramist hailing from Brazil. Dr Coachman developed this technique as a means of improving three critical areas of communication between:
- Dentist and Patient
- Dentist and other treating clinicians
- Dentist and Ceramist/Laboratory
DSD is a process of record taking and analysis including digital photography, dynamic video recording and computer software analysis that enables the restorative result to be pre-planned and confirmed prior to any interceptive/invasive dental treatment.
This plan of the proposed restorative result is then tested with the patient using a direct ‘mock up’ in the mouth – that is simply placed over their natural teeth for the patient to see and trial – without any tooth preparation whatsoever.
Why is Digital Smile Design important?
Digital Smile Design is becoming ever more important, due to an increase in the aesthetically aware and demanding patient base. This is not to say that patients are seeking unattainable levels of aesthetic excellence, but rather they are seeking a more natural result that is fitting with their facial harmony and appropriate to their age, race and sex when undertaking cosmetic dentistry. Gone are the days of the ‘white picket fence’ –rather the focus is now on natural shaping, shading and arrangement to teeth that is a reflection of natures ‘perfect imperfection’. This may be achieved through slight rotations to teeth, the natural translucency or shade differential over the tooth surface, or a more characterised texture to the ceramic surface.
DSD is thus important as it allows us to ‘test drive’ this new smile – to confirm patient acceptance prior to any tooth preparation. Patients can then go forth comfortable in undertaking this treatment, knowing that they have had the opportunity to view and confirm the proposed aesthetic changes. Many practitioners sadly ask their patients to go into treatment of this nature with ‘blind faith’ and hope that the treatment will be undertaken to the desires of the patient. Sadly, when this isn’t the case, it leads to unhappy patients and a ‘re-do’ of the treatment – a significant compromise to the final result.
The image on the left is pre-treatment, whilst the image on the right shows our patient with the temporary ‘mock up’. Remember – no tooth preparation at this stage!
Perhaps one of the most positive benefits of this treatment is that it allows Dr Dunn to be extremely conservative in tooth preparation. When we have defined the desired outcome prior to any tooth re-shaping, it means we only remove the amount of tooth required to achieve the final restorative result. This is in comparison to the ‘old system’ of cutting teeth first – and then building restorations to fit this! This leads to teeth being aggressively over prepared – to accommodate ‘all options’ for the ceramist in the laboratory. With Digital Smile Design, the ceramist is aware of the final outcome – and thus receives the model of the prepared teeth appropriate to this.
What is the process?
The Digital Smile Design process begins with a thorough examination of your:
- Facial Aesthetics
- Facial Symmetry
- Dental and Facial Midline Positions
- The relation of the dental aesthetics to the facial aesthetics
- The soft tissue (gum) harmony and symmetry
- Phonetic considerations
A series of photographic images are taken, both intra-oral and extra-oral as well as impressions of the upper and lower teeth. Further, we take a dynamic video recording, so that we can see the lips in motion during various emotional expressions – as well as in a natural smile – which is generally a lot ‘broader’ than a posed smile!
The important tools of Digital Smile Design
Using these records, Dr Dunn then designs the changes in the computer using a series of aesthetic considerations (tooth height to width proportions, the length of teeth and display at rest etc). Not only are these aesthetic considerations important – but also designing the tooth shaping relevant to the emotional personality of the patient! For more dominant personalities this can involve a more rectangular tooth shaping, whilst for softer personalities – this translates to a more rounded tooth shaping. Conversely – this can be inverted and those dominant personalities wishing to balance this trait can test a softer tooth shaping.
Tooth shaping and arrangement relates to personality traits which can be highlighted or softened.
This information is then transferred to models of the teeth using wax – to add length, close spaces, de-rotate teeth etc.
Our analysis indicating anticipated ideal height to width proportions and the need for soft tissue augmentation.
It is in undertaking this ‘wax up’ that we are then able to transfer this directly into the mouth – without preparation of a tooth!
The flow chart for the Digital Smile Design process.
Further images and a video recording is taken of this, and given to the patient for them to assess and discuss with friends, partners or family members – to confirm the aesthetic result and begin treatment comfortably and confidently!
We believe, here at The Macquarie Street Centre, that this type of aesthetic analysis and test drive procedure is the gold standard for any type of invasive cosmetic dental treatment today – and can apply this technique from single tooth treatment, right through to complex full mouth rehabilitations.
For further information regarding this procedure, see below to watch our Digital Smile Design video: