Alexandria Orthodontics Showcase: Reverse Smile Line and the Aesthetics of a Smile

There are many components of an aesthetic smile besides straight teeth. Dental professionals understand that the soft tissues have a very large component of the aesthetics of a smile. Soft tissues the influence the smile include the lips, the cheeks, chin, and nose.

Today, we will focus on the smile arch or smile line which is a line that follows the tips of the upper teeth while smiling. A positive smile line, also called a parallel smile line, is one which the tips of the upper teeth follow the curvature lower lip while smiling. A reverse smile line is the opposite of this where the tips of the upper teeth form a curvature that is opposite of the curvature of the lower lip. A flat smile line may be in between where the tips of the upper teeth form a straight line across from canine to canine when smiling with little or no curvature. Across several dental studies, a positive smile line is the most aesthetic while a reverse smile line has consistently been placed as the most undesirable smile line as it prematurely ages the individual’s smile.

In our weekly case, our patient did not initially notice that she had a reverse smile line until it was pointed out. In many cases for reverse smile lines, the patient had a deep “Curve of Spee.” This concept of Curve of Spee has been described in many of the previous spotlights as a major component of deep overbites or over closures in the in anterior teeth. In our patient of focus, instead of a deep overbite, the lower anterior teeth were pushing the upper anterior teeth up and flaring them out. In addition to the proclination of the teeth, the patient also had a good deal of crowding on the lower teeth.

It was recommended to extract the upper and lower first premolars for proclination, crowding, and to correct the patient’s smile line. About 17 after the extractions were done, the patient finished with a positive smile line, midlines coordinated, and a normal overbite.
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