The Facially Driven Smile Design Philosophy — What It Means for Your Smile
Ask ten cosmetic dentists in Chicago what "smile design" means and you'll get ten different answers. Some will show you a tooth-shade guide. Some will pull up a computer program with a stock smile template. Some will just say "we'll make them nice and white" and hand you a consultation form.
None of that is smile design. It's tooth selection.
Real smile design starts one step earlier — at your face. And that shift, from tooth-focused to face-focused, is what separates cosmetic work that looks natural from cosmetic work that looks obviously "done."
I'm Dr. Brittany Dickinson, a cosmetic dentist and member of the American Academy of Cosmetic Dentistry (AACD), and this is the philosophy that guides every case in my practice. Let me walk you through what it actually means.
The core idea
Facially driven smile design means your new teeth are designed based on the proportions, symmetry, and features of your unique face — not based on a template, a trend, or a standard shape catalog.
Your teeth exist in the context of your face. The shape of your lips, the width of your smile at rest, the shape of your jawline, the position of your midline, the way your upper lip lifts when you laugh, even the color of your eyes and skin — all of those inputs matter. When we ignore them and just pick a tooth shape from a book, we get smiles that technically look "correct" but feel subtly wrong in real life.
You've seen it before. That celebrity you couldn't quite place who used to look like themselves, and now looks a little like everyone else with veneers. That's what happens when the teeth were designed in isolation.
Why "tooth-driven" design fails
Traditional cosmetic dentistry works from the inside out: pick a tooth shape, pick a shade, prep the teeth, place the veneers. The teeth might look beautiful sitting on a tray next to the lab — but in a face, they can look:
Too square for a soft, oval face
Too white for a warm skin tone
Too uniform — every tooth the exact same size, giving that "chiclet" look
Too long or short for your lip position at rest
Misaligned with the midline of your face (which almost nobody's midline actually matches their dental midline exactly)
The result: your smile looks technically improved but somehow doesn't quite look like you. Everyone can tell something has changed. That's the opposite of what most patients actually want.
What facially driven means in practice
At a Smile Design Consultation in my office, we start by getting to know your face — not just your teeth. Here's what that looks like:
1. Full facial photography. Front-facing, three-quarter, profile, smiling, at rest, laughing. Not just teeth close-ups. We need to see how your smile lives in your face across expressions.
2. Facial landmarks. We map your interpupillary line (the line between the pupils of your eyes), your midline, your lip line, your smile arc. Your new teeth will be designed to harmonize with those landmarks, not fight them.
3. Personality + lifestyle inputs. A soft-spoken lawyer who wants an understated result gets a different design than a broadcast journalist who wants presence on camera. Both are correct. Both are facially driven. Neither is a template.
4. Digital preview + wax-up. Before we touch a tooth, you see a rendering of your future smile in your own face. You can react to it, refine it, adjust the shape or shade or length. This is the step most practices skip.
5. Trial smile. For most veneer cases, we then create a temporary "trial smile" that you wear in your real life for a week or two — driving, eating, meeting clients, kissing your partner. You come back and tell us what worked and what didn't. Only then do we make the finals.
The elements I’m actually designing for
When cosmetic dentistry is done well, the design is thinking about all of these at once:
Tooth shape — square, oval, tapered, or a mix — matched to your face shape
Tooth proportion — the width-to-length ratio of each tooth, ideally around 75–80% for the front two
Golden ratio spacing — how the widths of the front teeth relate to each other
Incisal edge line — the imaginary curve along the biting edges of your upper teeth, ideally following the curve of your lower lip
Buccal corridor — the dark space between your back teeth and cheek when you smile fully; too much = "narrow smile," too little = "denture smile"
Gum line symmetry — often the invisible detail that makes a smile look "off"
Shade — natural teeth are not one flat color. Great veneers have subtle variation from gum to edge and from tooth to tooth.
Translucency — real enamel has depth. Cheap veneers look like typing paper.
You don't need to memorize any of that. It's my job. But when you see it laid out, you understand why a 60-minute consultation with a real design process is nothing like "pick a shade and let's schedule you."
When facially driven matters most
For a single-tooth repair, it matters less. For anything involving your front teeth — veneers, bonding, a full smile makeover, even Invisalign for cosmetic-driven adults — it matters enormously.
Facially driven design is especially critical if:
You're doing 6+ veneers or a full smile makeover
You're combining Invisalign with veneers (the alignment sets up the design)
You've had cosmetic work before that "looks off" and you can't figure out why
You're a public-facing professional (photographed often, on camera, giving presentations)
You care deeply about looking like a better version of yourself — not like a different person
What this looks like at my practice
Every patient at Chicago Aesthetic Dentistry gets the facially driven treatment as standard. Not an upgrade. Not a premium tier. It's just how we do cosmetic dentistry. Because the alternative — doing it any other way — produces the results I spend most of my week fixing for patients who went somewhere else first.
The best compliment I ever get is: "My friends knew something looked different, but they couldn't figure out what." That's facially driven done right. You should look rested, radiant, more like yourself — not like you had work done.
If you're considering veneers, Invisalign, or a full smile makeover, the first step is a Smile Design Consultation. 90 minutes, full digital preview, a real conversation about what your face, your lifestyle, and your goals ask for.
Ready to book? Call 773-883-1818 or book a Smile Design Consultation online. Chicago Aesthetic Dentistry — 3346 N. Paulina St., Lakeview.
written by Dr. Brittany Dickinson