Digital smile design.
Digital planning relates tooth position to the face rather than only to the adjacent teeth. Its value is in testing a proposal and communicating it, not in guaranteeing an outcome.
What the process does
Facial photographs and video are combined with a scan of the dentition so tooth position can be planned against facial references — the midline, the interpupillary line, the lip line at rest and in a full smile, and the relationship of the incisal edges to the lower lip.
Those references are what make an anterior result read as belonging to the patient's face rather than merely being well made. A restoration designed only against the adjacent teeth can be technically correct and still look wrong in a smile.
The output is a proposal that can be converted into a wax-up, a mock-up, and then provisionals that carry the design into treatment.
The mock-up is where it becomes real
A digital proposal on a screen is persuasive to a clinician and abstract to a patient. Converted to an intraoral mock-up through a silicone matrix, it puts the proposal in the patient's mouth without preparing anything.
That is the point at which the patient can genuinely consent, and the point at which they can object while objecting is free.
It is also diagnostic. Phonetics, incisal display at rest, and whether the proposed contour is achievable within the available space all become visible in a way no rendering shows.
What it does not do
It does not guarantee the result. A proposal designed on a screen still has to be achievable within the space available, tolerable to the patient's function, and reproducible in ceramic by a person.
It also does not replace clinical assessment. Periodontal condition, occlusal scheme, tooth vitality and the amount of sound structure remaining all constrain what can be delivered, and none of them appear in a facial photograph.
Presented as a promise, it creates expectations that treatment then has to meet. Presented as a plan to be tested, it is genuinely useful.
What the laboratory needs
A full photographic series — retracted frontal, close views, incisal edge, unretracted smile, and a facial portrait at rest and smiling. Video where the system uses it.
Scans or impressions of both arches and an accurate bite record. Where the vertical dimension is being altered, that has to be stated rather than inferred.
And a clear statement of what the patient wants changed, in their words if possible. A patient who says their teeth look short is describing something different from one who says they look uneven.
Managing the patient conversation
The risk with any visual proposal is that the patient hears a promise. An image on a screen looks finished, and treatment then has to match it.
Frame it as a plan to be tested. The mock-up is the honest checkpoint — it shows the proposal in the patient's own mouth, in their face, and it is the point at which both of you find out whether the plan works.
Where the mock-up reveals that the proposal is not achievable within the available space or is not tolerated functionally, that is the process working rather than failing.
Carrying the design through treatment
The value is lost if the approved design is not transferred. A reduction guide made from the wax-up ensures preparation is measured against the intended final contour. Provisionals made from the same matrix carry the approved form into the mouth and let it be tested over weeks.
If the provisionals are adjusted to work, those adjustments are the design — record them and instruct the laboratory to reproduce the provisional rather than the original proposal.
A case where the digital design was approved and then quietly abandoned at preparation has spent the planning effort for nothing.
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Digital scans and conventional impressions are both accepted. Cases move by UPS and Purolator, and Fairmont works with practices throughout British Columbia and across Canada.