Smile Analysis

Description

Help your patients to smile with confidence. This non-formulaic focus on Smile Design offers a “how-to” approach to patient communication surrounding the art of smile analysis, the treatment planning process, and case presentation. Read it again and again as you master each step of smile creation at your own pace.

• This tried and tested method will transition your dental practice from a single tooth method toward full-mouth care.
• Honed over 30 years in her award-winning dental practice, Dr. Halley brings you her system for Smile Analysis, complemented by an array of case studies that allow you to test your skills before trying them in the clinic.
• Packed with “how-to” checklists, red flags, and decision points, this book will guide you through a step-by-step process, including how to incorporate technology, in the most understandable guide to better smiles available today.

 

Author: Elaine Halley, BDS

• Dr. Halley graduated from the University of Edinburgh in 1992 and achieved membership of the Royal College of General Dental Practitioners in 1995. She is a member of the American Academy of Cosmetic Dentistry and is a director of the UK’s first Seattle Study Club, Pathfinder in Scotland. She is a member and past president of the British Academy of Cosmetic Dentistry and was the first accredited member in Scotland. She is also a member of the International College of Dentists. She is clinical director for the Pain Free Dental Group. In 2018 Dr. Halley was awarded Outstanding Contribution to Dentistry at the Dentistry Scotland Awards.

 

Hardcover

 

Table of Contents

CHAPTER 1

• Why Do We Smile?..............................................................................1

CHAPTER 2

• Who Is the Person Behind the smile?.........................................................................................11
• FIRST... LISTEN.......................................................................................................................................11
• WHO IS THE PERSON BEHIND THE SMILE..............................................................................................11

CHAPTER 3

• The Dental Experience...................................................17
• VULNERABILITY AND TRUST................................................................................................................17
• PATIENT PERCEPTION IS REALITY.....................................................................................................18
• TIMELINES FOR THE PATIENT JOURNEY.............................................................................................. 20
• CHANGE AND THE STAGE OF LEARNING.............................................................................................. 22
• VALUES AND LEADERSHIP................................................................................................................. 23
• HABITS................................................................................................................................................ 24
• PERSONALITY STYLES........................................................................................................................ 26
• LEARNING STYLES...................................................................................................................... 28

 

CHAPTER 4

• Decision Point: Single Tooth or Comprehensive Approach...................................................................31
• DENTIST: DR. SMITH............................................................................................................................. 32
• DENTIST: DR. JONES.............................................................................................................................. 32
• EMOTIONAL INTELLIGENCE .................................................................................................................. 34
• SINGLE-TOOTH PROBLEMS................................................................................................................... 35
• WHEN TO IMPLEMENT A DIFFERENT STRATEGY............................................................................ 36
• APPOINTMENT STRATEGIES FOR TRANSITION TO GUIDED TREATMENT PLANNING.......................... 37
• DIGITAL CAPTURE................................................................................................................................. 40
• SCREENING VERSUS DIAGNOSIS.............................................................................................................41
• RED FLAGS ............................................................................................................................................. 44

CHAPTER 5

• Capture the Data.....................................................................47
• PRECLINICAL............................................................................................................................................ 48
• PHOTOGRAPHY AND VIDEO................................................................................................................... 49
• Technical versus emotional photography................................................................................................ 50
• Full-face smile photograph...................................................................................................................52
• Full-face retracted photograph............................................................................................................ 52
• Profile at rest......................................................................................................................................... 53
• Full-smile profile.................................................................................................................................... 54
• Full face at rest (M-Position)................................................................................................................ 55
• Tooth display at rest............................................................................................................................... 56
• FURTHER IMAGES................................................................................................................................. 58
• INTRA-ORAL IMAGES................................................................................................................................ 59
• The Value of a video capture protocol....................................................................................................... 60
• FREEDOM—THE IMPORTANCE OF VIDEO.......................................................................................... 60
• DIGITAL INTRA-ORAL SCAN......................................................................................................................64
• CLINICAL EXAMINATION.............................................................................................................................65
• RADIOGRAPHS/CBCT................................................................................................................................ 66
• EMERGING TECHNOLOGIES .................................................................................................................... 66
• COMMUNICATION SKILLS TO ENHANCE CASE ACCEPTANCE ............................................... 67
• HOW TO ORGANIZE THE CAPTURED DATA......................................................................................... 68
• CHAPTER 6 Guided Observation..............................................................71
• TIME  MANAGEMENT.....................................................................................................74
• SCREENSHOT OF MULTIPLE SCREENS OPEN IN GOOGLE CHROME ................................. 76
• Keynote storyboard open for the patient................................................................................................ 78
• STEPS FOR ANALYSIS THROUGH GUIDED OBSERVATION........................................................ 79

CHAPTER 7

• Macro Observations.............................................................81
• STEP 1: GLOBAL DIAGNOSIS......................................................................................................................81
• STEP 2: GENERAL RISK FACTORS............................................................................................................. 89
• STEP 3: MACROESTHETIC CONSIDERATIONS.................................................................................. 92

CHAPTER 8

• Mid Observations....................................................................121
• STEP 4: GLOBAL FUNCTION ..................................................................................................................121
• STEP 5: ORTHODONTIC OVERVIEW........................................................................................................122
• STEP 6: MISSING TEETH........................................................................................................................122

CHAPTER 9

• Micro Observations..........................................................123
• STEP 7: TOOTH-BY-TOOTH ANALYSIS...................................................................................................123
• Example of annotated screenshot from MyiTero inserted into storyboard........................126
• Predicting the prognosis....................................................................................................................127
• STEP 8: MICROESTHETIC EVALUATION...............................................................................................128
• Other microesthetic observations.......................................................................................................128
• STEP 9: SUMMARY RISK ASSESSMENT..............................................................................................134
• Example case with storyboard and diagnosis and observations from filled out...............134
• Diagnosis and Observations..........................................................................................................136

 

CHAPTER 10

• Smile Design....................................................................................141
•  SEEING BALANCE AND HARMONY.........................................................................................................142
• SYSTEMATIC SMILE DESIGN......................................................................................................................149
• NON-RESTORATIVE SMILE DESIGN ........................................................................................................161

CHAPTER 11

• Dental Imaging — the Power of a Visual Image.....................................................................................165
• SO HOW DOES DENTAL IMAGING HELP US?.....................................................................................167
• ARTIFICIAL INTELLIGENCE OPTIONS....................................................................................................170
• CHAPTER 12 Trial Smile.............................................................................................173
• TRIAL SMILE..................................................................................................................................179

 

CHAPTER 13

• Outcome Simulation....................................................183

CHAPTER 14

• Risk Assessment..................................................................187
• PATIENT’S ESTHETIC EXPECTATIONS AS A RISK ........................................................................190
• MEDICAL CONDITIONS AS A RISK......................................................................................................193
• Listen to your intuition............................................................................................................................195
• PERIODONTAL STATUS AS A RISK......................................................................................................196
• SMILE LINE AS A RISK..........................................................................................................................196
• High Smile line—No Hiding Place............................................................................................................. 200
• LIP MOBILITY AS A RISK......................................................................................................................201
• GINGIVAL LEVELS AND BIOTYPE AS A RISK.................................................................................201
• SKELETAL PATTERN, BUCCAL CORRIDORS AND ARCH WIDTH AS A RISK............... 202
• Anteroposterior dimension................................................................................................................. 204
• OCCLUSAL PLANES AS A RISK........................................................................................................... 207
• Curves of Spee, Wilson, and Monson...................................................................................................... 207
• TMJ/MUSCLES AS A RISK...................................................................................................................... 208
• OCCLUSION AS A RISK...................................................................................................................... 208
• GUIDANCE IN LATERAL EXCURSIONS AS A RISK.................................................................... 209
• BITE FORCE AS A RISK................................................................................................................... 209
• CHEWING PATTERN AS A RISK............................................................................................................210
• TOOTH ALIGNMENT AS A RISK............................................................................................................210
• Bolton analysis ......................................................................................................................................210
• MISSING TEETH AS A RISK................................................................................................................211
• BIOMECHANICAL RISKS....................................................................................................................212
• CARIES RISK......................................................................................................................................212
• TOOTH SURFACE LOSS AS A RISK.....................................................................................................213
• TOOTH COLOR RISK ASSESSMENT..................................................................................................215

 

CHAPTER 15

• The Pause Before the Patient Presentation..............................................................................................219
• STEP 1: THE CHALLENGE SUMMARY................................................................................................... 220
• Considering integrated treatment planning ....................................................................................... 223
• STEP 2: ASK FOR OPINIONS.......................................................................................................................224
• STEP 3: TREATMENT PLAN OPTIONS .................................................................................................. 226
• STEP 4: PATIENT PRESENTATION TOOLS.......................................................................................... 229

CHAPTER 16

• Case Presentation............................................................231
• CODIAGNOSIS...........................................................................................................................................231
• WHO OWNS THE PROBLEM? ................................................................................................................ 232
• STEPS FOR CASE PRESENTATION......................................................................................................... 234
• STEP 1: THIS IS WHAT I SEE..................................................................................................................... 236
• STEP 2: THIS IS WHERE WE COULD GO............................................................................................... 239
• STEP 3: HERE ARE THE WAYS WE COULD GET THERE............................................................... 240
• STEP 4: HERE ARE MY CONCERNS/OUR LIMITING FACTORS................................................241
• STEP 5: HERE ARE THE RISKS, INCLUDING DOING NOTHING................................................ 242
• BUILDING TRUST.................................................................................................................................. 243
• STEP 6: HERE ARE THE NEXT STEPS, THE FIRST THINGS........................................................ 243
• STEP 7: HERE ARE THE COSTS INVOLVED........................................................................................ 243
• Discussing finance............................................................................................................................. 244
• COACHING OUR PATIENTS THROUGH THE DECISION-MAKING PROCESS................... 244

CHAPTER 17

• Case Studies..............................................................................247
• STUDY 1: PATIENT A........................................................................................................................... 247
• Preclinical information.......................................................................................................................... 247
• CLINICAL EXAMINATION......................................................................................................................... 248
• STORYBOARD CREATION....................................................................................................................... 249
• EDITING A VIDEO IN KEYNOTE ................................................................................................................ 250
• GUIDED OBSERVATION..................................................................................................................250
• FILLING OUT THE DIAGNOSIS AND OBSERVATIONS FORM.....................................................251
• SMILE DESIGN........................................................................................................................................ 255
• RISK ASSESSMENT FORM......................................................................................................................... 257
• PRE-TREATMENT AND POST-TREATMENT PHOTOGRAPHS................................................. 259
• Reflection.............................................................................................................................................. 259
• CASE STUDY 2: PATIENT B..................................................................................................................260
• Preclinical information.......................................................................................................................... 260
• CLINICAL EXAMINATION..........................................................................................................................261
• DIGITAL TOUR OF THE MOUTH................................................................................................................ 262
• GUIDED OBSERVATION......................................................................................................................... 265
• SMILE DESIGN.............................................................................................. 268
• RISK ASSESSMENT.......................................................................................... 270
• REFLECTION................................................................................................... 274
• CASE STUDY 3: PATIENT C............................................................................... 276
• Preclinical information...................................................................................... 276
• CLINICAL EXAMINATION.................................................................................. 277
• GUIDED OBSERVATION.................................................................................... 280
• SMILE DESIGN............................................................................................... 283
• RISK ASSESSMENT......................................................................................... 285
• CASE PRESENTATION...................................................................................... 287
• ETHICS ........................................................................................................ 287
• REFLECTION...................................................................................................291
• APPENDIX Diagnosis and Observations............................. 293
• References.................................................................................................... 297
• To the Reader................................................................................................ 299
• Acknowledgments...........................................................................................301

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