Smile Personalization – Visagism

In order to understand Visagism, we must understand what aesthetics is.
The word aesthetics derives from the Greek aisthésis – perception, sensation, sensitivity.
Objectively, it is based on the concept of perception and the sensation of what is considered beauty. It is dedicated to the evaluation of the various ways of feeling art, colors, images, habits. It provides a feeling of pleasure and delight after something is observed through the various senses.
What is beautiful depends on the customs of each time or society. In this context, the media has strongly contributed to the concept of aesthetics, leading to the term Visagism.

Nowadays, we are witnessing, more and more, a greater concern about dental aesthetics. In a society where the smile has become the main business card, it is inconceivable the absence of dental elements, or the so-called “yellow smile”.

With this growing demand for the perfect smile, the knowledge and techniques of dentists have increased in recent years.

The personalization of a smile requires extensive analysis by the dentist, extra or intra-orally.

From an extra-oral point of view, several photographic records of the patient are made, with different planes and perspectives, with static postures and dynamic movements, which allow us to evaluate all the harmony of a smile.

Intra-orally, a photographic sequence is taken to evaluate the entire dental-alveolar structure, as well as the inter-maxillary relationships.

All these photographic records will allow the dentist, after the appointment, with tranquility and the greatest scientific accuracy, to define the best treatment plan for the patient.

Our clinical team at CERO, namely the Department of Oral Aesthetics, having completed part of their training at the International University of Catalonia (UIC) in Barcelona, has, as a basis for their aesthetic analyses, the concepts and guidelines published by Prof. Dr. Mauro Fradeani in the book Esthetic Rehabilitation in Fixed Prosthodontics.

To this end, we give special significance to the aesthetic analysis described in your book, where, from photographs at rest, maximal smile, 45º and 90º lateral angles, we check the facial lines and proportions that characterize each patient. These references will guide us in the construction of each smile, at midline level and in relation to dental exposure at rest or maximal smile.

The intraoral photographic record, in addition to what has been written previously, allows us to analyze all the teeth and the relationship between them more precisely.

Another resource, no less important, is the recording of a short video of the patient interacting/talking with the clinical team, allowing us to evaluate all the dynamism of the smile, and the relationship between the teeth, gums and lips.

In recent years, different techniques have been developed to plan each smile. One of the tools used by the CERO clinical team is the Digital Smile Design, created by Dr. Christian Coachman. This multipurpose protocol has numerous advantages:

– Ease of diagnosis, through an aesthetic and structural evaluation, intra and extra-orally;

– Better communication between team members, which ensures better visual perception, education and motivation on the part of patients;

– More effective case planning and presentation;

– Clinical efficiency and predictability through digital technology.

The Digital Smile Design involves patients in the restorative and aesthetic process, making them one of the main architects of their own treatment, with the possibility to share objectives, express their wishes and expectations alongside the restorative team.

It is important to mention that the Digital Smile Design is first-instance virtual planning. At a later stage, it will allow us to create several mock-ups, which will be placed in the mouth for the patient to ‘test drive’ it. The usage time of this mock-up may vary depending on whether changes or adjustments to the initial project are required. When the patient feels comfortable and satisfied with the shape, size, exposure of their new teeth, we can proceed with the creation of the new teeth.

Regarding the choice and shape of teeth, there are several guidelines for creating new teeth. From the first day that the patient arrives at the CERO clinic, we start a thorough analysis of their personality traits, as well as his wishes and expectations. All of these factors are carefully observed. According to Paulucci et al., the characteristics of each personality are reflected in the shapes of our teeth, as we can see in the following image.

Therefore, taking these characteristics into consideration, we can present this proposal for the oral rehabilitation of each psychological profile:

Nowadays, having an oral cavity without biological and functional problems is no longer enough for most patients. More and more, the goal is to have naturally beautiful smiles, in harmony with their physical characteristics and, more importantly, with their personality.

Our CERO clinical team knows all the factors that contribute to making our patients more satisfied, beyond the conventional techniques. Each customized smile can be easily visualized and improved based on each patient’s ideas.

Visagism is a very important concept for dentistry, as it aims to reconstruct personalized smiles using visual art. The goal is to project a smile in detail that expresses the patient’s identity, lifestyle and personality. In this way, the harmony of the smile will be achieved, reaching or even exceeding the patient’s expectations. This will improve their self-esteem, with incalculable benefits in their personal, family and social life.

Dr. André Furtado

Visiting lecturer of the master degree in dental aesthetics – International University of Catalonia (UIC, Barcelona);
Master in dental aesthetics 2017-2019 – International University of Catalonia (UIC, Barcelona);
Oral rehabilitation training at Centro de Formação Prof. Dr. Fernando Almeida in 2017 – Clínica Dentária Infante Sagres (Lisbon, Portugal);
Modular dentistry course at the OMD Centro de Formação Contínua (Lisbon, Portugal) in 2015;
Participation in several national and international seminars and congresses (WCO Congress; SPEMD; SEPES);
Registered in the Portuguese Dental Association (OMD) with professional card no. 8904;
Monitor at the oral rehabilitation department 2012-2013 – ISCSEM (Almada, Portugal);
Graduated dentist from the Instituto Superior de Ciências da Saúde Egas Moniz (Almada, Portugal).

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