Dr. Eugenio J. Brenes, D.D.S., M.S., M.B.A.


Nowadays, a common tendency has grown in the population to have a more critical perception of what we externally project, and many of the physical characteristics that have been scrutinized, those that people are willing to put time and resources into changing if they are not satisfied with them, are physical features that do not fulfill their expectations.

In my field, which is prosthetic and dental aesthetics, I have seen the rise of “Perfect smiles” requests and have been able to help patients and resolve their requests in a successful and predictable way.

Nowadays, we can rely on an arsenal of instruments, materials and dental procedures that allow us to modify, outline and restore the form of our teeth with complete invisibility. Things that only 15 years ago were not as predictable or even possible.

Understanding the Conformation of a Perfect Smile

To understand the conformation of a perfect smile, we have to take in account several anatomic elements and their condition.

A smile does not depend only on its teeth, but has many more dimensions and elements.

Architecture of the Gums

Amongst them you can find a good architecture of the gums, catalogued as the frame of the teeth; many times we have seen how a beautiful painting can look bad on an ugly frame.

Gums must be healthy, with no swelling, and they must have an adequate shape, so that the tooth can have a protagonist role.

The Lips & The Line of The Smile

Another element of the smile are the lips, and the line of the smile. It must be evaluated in a qualitative way: how many teeth are shown when you smile. It must be done with different smiles, since it is not the same for a tiny smile or for a burst of laughter. This has to be taken into account, so that the teeth look nice in every aspect of our daily lives.

The lips have to be evaluated too when designing a smile. Wide lips will cover the tooth more when compared with thin lips.

Characteristics of The Teeth

Most of the population pays attention only to the color. There is a lot more we have to evaluate: the texture; if the teeth present any kind of wear or restoration, their length, how the tooth looks compared to other pieces present in the mouth, if it is symmetric, the shape and the action it performs when it works together with other teeth.

The Mirror Test – Step One For Obtaining The Perfect Smile

To obtain a perfect smile, the first thing to be done is a self-evaluation. I call it the mirror test, and suggest patients to look in the mirror and ask themselves the following questions:

  • Do I like the color of my teeth?
  • Do I like the position of my teeth?
  • Am I happy with the shape of my teeth?
  • Do I have any visible cavities?
  • Do I have tartar or stains in my teeth?
  • Do my gums look healthy and pink?
  • Do I lack any teeth?
  • Do I have any restoration, crown, or filling that I am not happy with?

If you are happy with the way your teeth look, then you have a perfect smile. As one of my mentors on my residency at Loma Linda University, Los Angeles, Dr. Wayne Campagni, used to say: the best dentistry is non-dentistry.

However, if your oral condition is not ideal, if you have old restorations that have lost their properties or if you simply want a change, there are several ways to improve your smile.

Ways to Improve Your Smile

For example, if the shape, length and relation of the teeth with the other elements we have mentioned are ok, and all that bothers you is the color, that can be solved with prophylaxis and a dental whitening.

If the shape is the issue, resin or porcelain veneers, or even ceramic crowns could be the solution.

If you are lacking a tooth and wish to restore that space, a bridge or a dental implant are very good options to resolve that situation.

Pricing is a Fundamental Factor For Deciding Which Dental Treatment to Choose

In the present, pricing is a fundamental factor when it comes to deciding which dental treatment to choose. The key lies in establishing a plan of goals and being both honest and realistic in both parts. On my practice we have been able to make work plans based on periods of 2 to 3 years and in that period we change in a constant and organized way the dental pieces, so that in the end the patient will achieve the expected result.

There are procedures, such as dental implants, which are done in two phases and between them there is a period of 6 months in which the patient can work out a savings or credit plan so that he can finish the treatment.

Regarding whitening treatments, it is good to have a “pot” or a piggy bank and establish the whitening as a goal. Usually whitening at my practice has a cost of $350, and includes whitening at the office with laser and a treatment to take home. That is, if we save 4 dollars a day for three months that would be enough to get the treatment.

Defining a treatment as expensive is a personal affair, since everyone has their own priorities, according to their needs and reality.

For example, it has been scientifically proven that a person who gets a dental cleaning every six months will have a more favorable health condition, less cardiac problem risks, will have better probabilities of not suffering chronic problems such as diabetes, systemic diseases, and their teeth will be under the care of a professional person who will look after them and make sure there health is the optimum.

This treatment of having 2 cleanings a year costs $170, which is only $0.50 a day to guarantee both physical and oral health. Nevertheless, in many occasions, we may think it is expensive and use that money for other things that does not give such a tangible result.

If you have financial restrictions, the daily use of dental floss and brushing your teeth with a toothbrush that is in a decent state, at least 3 times a day, is a good way to begin. Also putting into our priority list a dental cleaning performed by a professional every six months. That would be a great way of keeping your teeth and health in good control.

It is good to stick to one professional, since he will be able to get familiar with your mouth and will have a more strict control with photographs and x-rays of what is happening and he will notice if there is a change in your mouth.

A smile we feel comfortable with will bring a series of benefits in all aspects. Functionally it will allow us to enjoy different foods that are necessary for our health. It will help us have a better social presence: studies of the American Association of Orthodontics have revealed very interesting things about what our smiles project, for example: 48% of the Americans from 18 to 24 years of age have untagged themselves from Facebook because they don’t like their smile; a third part of the population of the United States is not happy with the way their teeth look. On the same study, of 1000 adults that were interviewed, 78% perceived people with twisted teeth as unsuccessful and 14% said their smile was a factor that kept them from getting a good job.

In the present, the population is looking for different options to be healthier and at the same time looking better. It is never too late to have a nice smile and currently we have so many treatments and materials that help us solve defects in a successful way.


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