What is “the perfect smile?”

There was a time when you could spot a smile makeover almost immediately. Oftentimes, you still can.

The teeth are exceptionally straight, exceptionally white and exceptionally uniform. Technically, they might check certain boxes. Culturally, they created one of cosmetic dentistry’s most enduring stereotypes: the “Chiclet” smile.

Intense criticism has long followed the ultra-perfect smile, typically a combination of too white, too bright, and too bulky. In the early 2000s, much of cosmetic dentistry was built around established rules of proportion. A beautiful smile could be measured, calculated and, theoretically, reproduced. Dr. Apa knew that if the same mathematical ideal is applied to every patient, individuality becomes the first casualty.

The industry was cookie cutter, so Dr. Apa decided to change it. He pioneered Facial Aesthetic Design: a philosophy that considers the entire face, from lips to cheeks to eyes, as the foundation of a smile makeover. 

The premise is deceptively straightforward. Your face is unique, and your smile should be, too.

When Cosmetic Dentistry Became Too Perfect

For decades, one of the foundational concepts in cosmetic dentistry was the golden proportion, a mathematical ratio used to establish an aesthetically pleasing outcome of your smile. 

There is value in understanding proportion. Problems begin when proportion becomes prescription. If you isolate the mouth and evaluate only the teeth, the definition of an “ideal” smile is relatively narrow. There are only so many ways to arrange straight, proportional teeth within that small frame.

The result was an era of cosmetic dentistry in which technically successful smiles could begin to look surprisingly similar.

People noticed. Patients noticed. Providers noticed. 

By the early 2000s, Dr. Apa was hearing a familiar objection: “I want a better smile, but I don’t want veneers.” Why? Potential patients were afraid of ending up with large, straight, conspicuously white teeth. “Natural veneers” were on the horizon. But natural-looking restorations are not the same as a natural smile. 

Dr. Apa asked questions that no one else was paying attention to. Why are we designing smiles, instead of designing smiles for the person? 

Beyond the Mouth

The answer led Dr. Apa outside traditional cosmetic dentistry and into principles more commonly associated with orthodontics.

Orthodontists have historically evaluated teeth as part of a larger anatomical system. A cephalometric X-ray, for example, provides a view of the head that allows the doctor to understand where the teeth sit in relation to the jaws and underlying skeletal structure.

Dr. Apa began combining information about facial and skeletal structure with the aesthetic principles used in cosmetic dentistry. Rather than determining the ideal proportions of the teeth first, he could consider what those proportions should be in relation to a particular face.

Facial Aesthetic Design. The philosophy that changed the starting point of cosmetic dentistry, and uprooted the industry for the better. 

What Is Facial Aesthetic Design?

Facial Aesthetic Design is an approach to smile design that uses the individual architecture of a patient’s face to guide the shape, position and proportions of the teeth.

Despite what before-and-after images may lead you to believe, no one actually experiences your smile in isolation. Zoom out. There’s an entire face around it. 

We see teeth framed by lips. We see the relationship between the smile and the jaw. We register how the teeth sit beneath the nose and between the cheekbones. We see what happens when someone speaks, laughs and moves.

The larger frame is the foundation of Facial Aesthetics Design. A smile can be technically beautiful on its own and still be wrong for the face it belongs to. Your face is part of the diagnosis. Bone structure, facial proportions, tooth position, and existing asymmetries inform the aesthetic decisions that follow.

The teeth still have to be beautiful, but they need to be beautiful in the context of your face. There is a meaningful difference between someone saying, “Nice veneers,” and someone saying, “You have an incredible smile.” The first is a compliment about the dentistry. The second is a compliment about you. 

Perfect Symmetry Can Look Surprisingly Unnatural

We live in a culture of reference images. The benefit of references is their communication to your dentist about what you respond to aesthetically. Now, it’s difficult to find a patient who doesn’t have a saved folder of other people’s features. A nose from one person. Hair from another. A jawline you saw on Instagram. A celebrity smile you have been staring at for six months. Patients start to believe that their aesthetics appointments resemble most closely to build-a-bear. 

Then there’s the downfall of reference images. They cannot tell your dentist what your teeth should look like. The smile you admire is inseparable from the face around it. Those teeth are being read against that person’s lips, skeletal structure, facial proportions, and asymmetries. Move them onto another face and they become something else entirely. A wrong smile. 

Asking for someone’s exact smile is like asking a tailor to recreate a dress based entirely on an inspiration image… without taking your measurements. You can borrow the reference, but you can’t borrow the fit. 

A starting point. Not the blueprint. 

Pulling individual features from different people and forcing them onto your own anatomy rarely creates the same effect. What looks beautiful is often beautiful because of the context around it.