So much goes into an aesthetic smile. Aspects such as symmetry, the visibility of the gingival and buccal corridors, and malocclusion all come into play. The individual shape of each tooth can also make a big difference, collectively coming together to form a smile that can be judged – subconsciously or otherwise – by those that see it.
Understanding what makes an aesthetic tooth shape, and how clinicians can help deliver this to patients, is important for maximising the potential success of cosmetic and restorative treatment.
What is an aesthetic tooth shape?
Many aspects of restorative dental care, whether completed purely for cosmetic purposes or to remedy functional problems, will interfere with the appearance of the dentition. This influence could be positive or negative, and the clinician should always try to optimise the final result for the patient’s benefit.
When people are highly satisfied with their smile, they are more likely to show their teeth when smiling, and like to see their dentition in the mirror, videos and photographs.[i] Overall the self-perception of dental aesthetics can affect greater social and psychological well-being factors, with a knock-on effect on their self-confidence.[ii] A pleasant smile is also advantageous in job interviews, social interaction, and when finding a romantic partner.[iii]
The making of a perfect smile
Subtle changes can make a significant difference when assessing the perception of smile attractiveness. Though there is no universal agreement on what makes up a “perfect smile”,[iv] studies mostly show agreement amongst dentists, non-dentists, males and females regarding different aesthetic aspects of the dentition.
A 2017 report[v] found a general consensus among different smiles, but dental professionals and non-clinicians differed slightly in just two instances. In one subject, which clinicians were slightly more critical over, aspects such as a poor crown to root ratio and asymmetry in the midline may be identified as of importance to those in the profession. In another subject, which the clinicians preferred, the smile could be commended less highly by the layperson due to minor incisal edge chipping. This suggests that though aesthetics are generally agreed upon in consensus, minor discrepancies can alter opinion based upon knowledge of dental care.
Minimally invasive intervention
Research shows that rounded or semi-rounded incisal embrasures are preferred to rectangular incisal forms, and this may therefore be a common request when patients seek cosmetic treatment.[vi]
When supporting patients who are dissatisfied with the shape of their tooth, there are a variety of effective treatment approaches that can be suitable. A clinician should always ensure the chosen mode of care is in the patient’s best interest, with a holistic approach that collates their physical, psychological, social, and long-term oral health needs, as well as the likelihood of achieving the patient’s targets for treatment.[vii]
If an individual wishes to amend their tooth’s shape, a clinician must consider how changes could impact aspects such as occlusion – unsuitable treatment could create more problems than it solves, causing damage to a restoration and the surrounding dentition. Clinicians could also use a consultation to recommend more long-term treatment, such as orthodontic care, if it is suitable and aligns with the patient’s desired outcomes.
For minimally invasive care, cosmetic bonding can be a useful tool for reshaping individual teeth across the dentition. In cases of tooth wear, additive treatments such as direct composite bonding are preferred, reducing the risk of future complications caused by the removal of too much hard tissue.[viii] Repairs may be needed in future, and technical skill is required to provide an aesthetic and functional finish;viii clinicians should seek out high-quality educational opportunities to learn such techniques before putting them into practice.
Direct composite restoratives may also be suitable when patients want to amend the shape of their teeth even when excessive wear is not present, and therefore can act as an ideal cosmetic solution. Once again, clinicians should only provide such treatment when it is deemed to not impair their long-term health.
Treat with care
To provide restorative care that optimises the aesthetic appearance of the dentition, and individual teeth, clinicians need confidence in their ortho-restorative skills. With these, treatments can be long-lasting and meet patient expectations.
The Ortho-Restorative course from IAS Academy covers key aspects of care, such as aesthetic tooth shaping and simple edge bonding, as well as advanced retention management for cases including orthodontic care. Delegates are supported by leading tutors who also provide life-long mentoring where desired. The course equips clinicians with the ability to deliver complete treatment plans to their patients with confidence.
The shape of a tooth is just a small part of smile aesthetics, and might be included as part of considerations for a wider treatment plan. Understanding how clinicians can support patients is possible when we realise what an “attractive” tooth shape looks like, and how to achieve it safely.
For more information on upcoming IAS Academy training courses, please visit www.iasortho.com or call 01932 336470 (Press 1)
Dr Tif Qureshi – founder and a clinical director of IAS Academy
[i] Afroz, S., Rathi, S., Rajput, G., & Rahman, S. A. (2013). Dental esthetics and its impact on psycho-social well-being and dental self confidence: a campus based survey of north Indian university students. The Journal of Indian Prosthodontic Society, 13(4), 455-460.
[ii] Armalaite, J., Jarutiene, M., Vasiliauskas, A., Sidlauskas, A., Svalkauskiene, V., Sidlauskas, M., & Skarbalius, G. (2018). Smile aesthetics as perceived by dental students: a cross-sectional study. BMC oral health, 18(1), 225.
[iii] Heravi, F., Rashed, R., & Abachizadeh, H. (2011). Esthetic preferences for the shape of anterior teeth in a posed smile. American Journal of Orthodontics and Dentofacial Orthopedics, 139(6), 806-814.
[iv] Soh, J., Wang, Z. D., Zhang, W. B., & Kau, C. H. (2021). Smile attractiveness evaluation of patients selected for a US-Based board certification examination. European Journal of Dentistry, 15(04), 630-638.
[v] Chan, M. Y. S., Mehta, S. B., & Banerji, S. (2017). An evaluation of the influence of teeth and the labial soft tissues on the perceived aesthetics of a smile. British dental journal, 223(4), 272-278.
[vi] Fermeiro, M., Costa, L. G., Manso, M. C., Herrero-Climent, M., Gil, J., Brizuela-Velasco, A., & Ribeiro, P. (2025). Influence of Incisal Embrasures on Smile Aesthetics. Journal of Clinical and Experimental Dentistry, 17(9), e1129.
[vii] General Dental Council, (2019). Standards for the Dental Team. (Online) Available at: https://www.gdc-uk.org/standards-guidance/standards-and-guidance/standards-for-the-dental-team [Accessed October 2025]
[viii] Kreulen, C. M., Crins, L. A., Opdam, N. J., & Loomans, B. A. (2022). Rehabilitation of worn dentition with CAD-CAM restorations: a case report. The Journal of Adhesive Dentistry, 24, b2916447.
