Facial and smile analysis are important parts of an orthodontist’s everyday clinical practice. To improve dental and facial balance, a deep understanding of facial beauty is required, including the evaluation of facial aesthetics, proportions and symmetry.

Facial Beauty Through History

Facial beauty has always fascinated humans and has been passionately discussed by great philosophers such as Plato, Socrates and Aristotle. Aesthetics, the study of beauty, is derived from the Greek word aesthesis. Beauty is described as a ‘combination of qualities that give pleasure to the senses or to the mind’. From Homer’s Helen of Troy, who was described as having a ‘face that launched a thousand ships,’ to Queen Nefertiti, whose name literally means the ‘Perfect One’, to modern models and actors, facial beauty has always been the most valued aspect of human beauty.

Is Beauty Subjective or Objective?

The Greek philosopher Theocritus stated that; “Beauty is not judged objectively, but according to the beholder’s estimation”. In 1878, Hungerford coined the famous statement that; “Beauty is in the eye of the beholder”. In contrast, the Renaissance artist Alberti defined beauty as; “The summation of the parts working together in such a way that nothing needs to be added, taken away or altered.”

Kant, in 1790, expressed the view that; “The beautiful is that which pleases universally without a concept”. This suggests that there is a universal standard for beauty that transcends across all cultures and biases. The most famous concept for describing beauty objectively is the Golden Proportion, first described by the ancient mathematician Euclid (325-265 BC) and later re-named the Divine Proportion by another mathematician Pacioli in 1509. This proportion is found in nature and is seemingly pleasing to the eye, with the emphasis being upon the proportion of the parts to the whole. Some clinicians have attempted to apply the golden proportion to the human face. Stephen Marquardt, developed the Marquardt Facial Mask based on the golden proportion and proposed it to be a useful guide for plastic surgery.

Despite some famous historical faces (e.g. Queen Nefertiti) and contemporary celebrity faces (e.g. Angelina Jolie) fitting the Marquardt mask, it does not apply to every beautiful face. Scientists are still yet to figure out what exactly makes people beautiful.

A Balanced Perspective

The 16th century artist Albrecht Dürer said; “I know not what beauty is, but I know that it affects many things in life.” Dürer explained that, although the concept of facial beauty is essentially subjective, the assessment of facial proportions could be undertaken objectively. He maintained that disproportionate human faces were unaesthetic, whereas proportionate features were acceptable if not always beautiful. Therefore, the appropriate goal for orthodontists is to detect and where possible, correct dental and facial disproportions. Orthodontists have the clinical skills to diagnose, analyse and improve dental and facial features. The latter is often the reason why patients seek orthodontic treatment. It is a wonderful privilege to help patients improve their appearance, confidence and self-esteem.

The Enigma of Facial Beauty - Part 2

The influence of facial beauty on quality of life and how orthodontics can help.

Beauty and Quality of Life

Many studies have suggested that facial attractiveness has been associated with increased quality of life and inter-personal success. This research suggested that attractive people were perceived to be more intelligent, confident and socially acceptable.

What Constitutes a Beautiful Smile?

A beautiful smile is dependent on teeth features (e.g. tooth position, size, shape and colour) along with the soft tissues which surround the teeth (e.g. how much gum is visible and what the lips look like). A truly pleasing smile will display symmetry and harmony between all these features.

The Link Between Facial and Dental Appearance

Facial attractiveness and smile attractiveness appear to be strongly connected. Eye-tracking research shows that in social interactions, most of the attention is given to the mouth and eyes of the speaker’s face. The mouth forms the centre of communication in the face, therefore the smile plays an important role in both facial expression and appearance. When assessing smile attractiveness, the smile must be evaluated in the whole face because it is a dynamic and expressive feature. Interestingly, many celebrities have attractive smiles that are not technically perfect from a dental perspective (e.g. Tom Cruise, Kirsten Dunst). However, when the smile fits in the face well, the imperfections are not generally viewed as a negative.

Beauty in the Modern World

Social media shows how infatuated modern society remains with the idea of beauty. Many people wish to emulate celebrities, to look “perfect” and take “selfies”. It seems that the pursuit of beauty places heavy pressure on both individuals and health professionals. It would seem unrealistic to expect the media’s obsession with appearance to significantly change, however, greater responsibility on the media’s part would be commendable.

The Synergy Between Art and Science

Naini stated that; “Nowhere in medicine is the fusion of art and science more important than in the clinical assessment of facial aesthetics.” Throughout history there has been a close link between art and science, with the greatest artists of the past also being the master scientists of their age. Similarly, orthodontic treatment combines the science of dentistry and tooth movement with the artistic aspects of the smile and face.

Can Orthodontic Treatment Help?

The World Health Organisation defines oral health as “a comfortable and functional dentition which allows individuals to continue in their desired social role”. It is clear that not every person has a great need for orthodontic treatment and some are not bothered at all by how their teeth look. Research has shown that following orthodontic treatment, many teenagers reported fewer negative social issues (e.g. teasing and/or embarrassed by smiling). Such changes can be hugely important for some patients. Even if orthodontic treatment can potentially improve a patient’s quality of life, it is still ultimately the individual patient’s decision whether having treatment is the correct way forward for them.

References are available upon request

Dr Desmond Ong, Orthodontist
Townsville Orthodontic Specialists