Why is planning a separate stage of a smile makeover?
A smile makeover is not a single procedure: it brings treatments such as whitening, orthodontics, crowns or veneers together in one plan. Which treatments can be combined is explained on our smile makeover page.
Some of these treatments cannot be undone. According to the American Dental Association (ADA), veneers involve removing some of the tooth enamel, so the treatment cannot be reversed. Cleveland Clinic also says that most veneers are irreversible, and that only some types that need little or no tooth reduction can be reversed. In its 2023 warning, the Dental Board of Australia points out that porcelain veneers can be an irreversible treatment that needs ongoing maintenance.
The purpose of planning is to make sure that you and your dentist are aiming for the same result before any irreversible step is taken. A 2025 systematic review by Reviansyah and colleagues reports that digital smile design lets patients see the expected smile before irreversible procedures. A study included in the 2024 review by Jain and colleagues also found that digital planning made communication with patients easier.
What happens at the planning appointment?
The ADA recommends discussing your dental history, your expectations and your concerns with your dentist before treatment. Planning usually follows these steps:
- Examination: The teeth, gums, existing fillings and crowns, and your bite are assessed. According to the ADA, any decay or gum disease is treated first, and clenching, grinding or a deep overbite, where the upper teeth cover the lower teeth a long way, can make veneers an unsuitable option.
- Photos: Photos of your face and smile are taken. In the digital workflow described in a 2020 study by Lo Giudice and colleagues, two face photos were used: one while smiling and one with the lips held apart by a retractor.
- Recording the teeth: Impressions of the teeth are taken, or the teeth are scanned with an intraoral scanner. In the same study, the scan of the teeth was superimposed on the face photos, so that the design could be made to suit the face.
- Design: The new tooth shape is planned on these records and modelled, either in wax on a model or digitally.
- Mock-up and discussion: If you wish, the design is tried in your mouth, the changes you want are discussed and the treatment plan is finalised.
If you live abroad, the first part of this can begin before you travel: you can send photos of your smile and any recent X-rays for a preliminary assessment. This helps you plan, but the treatment plan itself is only made after the in-person examination.
What does digital smile design show, and what does it not show?
Digital design lets you see the planned tooth shape on your own face and teeth. According to Reviansyah and colleagues, interactive digital design supports a more transparent, shared decision-making process between dentist and patient.
However, a design on screen is not a promise of the result. The review by Jain and colleagues analysed 10 studies with a total of 344 participants. Most of the studies had few participants, and the authors rated their quality as mostly moderate. According to the review, patients generally preferred digital and three-dimensional methods, but this finding rests on a small number of studies. In short, digital design is a tool that makes communication easier; it does not show that the result will match the design exactly.
How is a mock-up made?
A mock-up is the planned tooth shape applied directly onto your teeth in a temporary material. Kovacs and colleagues (2011) describe it as a reversible technique carried out at the dental chair with composite resin. According to the authors, a mock-up lets dentist and patient see roughly what is possible in terms of appearance and function, and allows the patient to contribute their own view of the result.
A mock-up can be prepared in two ways. In a small pilot study published in 2023, a silicone mould was made from a wax model in the conventional method, while in the digital method the mock-up was designed on a computer and milled. Mock-ups made with both methods were assessed against aesthetic criteria in five patients, and no significant difference was found between them.
A mock-up is reversible: once the assessment is over, the material is removed from the teeth. Whether to go ahead with final treatment, and what to change in the design, is discussed after this assessment.
What should I look at during the mock-up?
In the studies described in the review by Reviansyah and colleagues, mock-ups were used to test appearance, function and speech before final treatment. During a mock-up, you can pay attention to the following:
- Do the length, width and proportions of the teeth suit your face?
- How much of your teeth and gums shows when you smile?
- Do you find any sound hard to say, or notice a different feeling in your lips when you speak?
- When you close your teeth together, does any point touch first?
- Look closely in a mirror, but also from a few steps away and in different light; taking photos or a short video can help you judge the result.
Say straight away if there is anything you do not like or are unsure about. The mock-up is there so that changes like these can be discussed before final treatment begins.
Why can the final result differ from the design or the mock-up?
The design, the mock-up and the final restorations are made at different stages and from different materials, and small differences can arise at each stage:
- Size differences: In the study by Lo Giudice and colleagues, mock-ups milled or 3D-printed from the digital design were slightly larger than the design.
- Material: The mock-up is made from a temporary material, while final crowns or veneers are made in a laboratory from other materials. In the words of Kovacs and colleagues, a mock-up only shows the result roughly.
- Colour: According to the NHS, whitening only lightens natural teeth; it does not change the colour of crowns or veneers. If whitening is also planned, the shade of the restorations is usually chosen after whitening.
- Tooth and gum structure: The level of the gums, the position of the teeth and existing fillings or crowns all affect the result.
The Dental Board of Australia suggests that, before a cosmetic procedure, people ask themselves whether they accept that they might not be satisfied with the result. The design and the mock-up should therefore be seen as a road map, not as an exact copy of the result.
What should I ask before deciding?
Questions the Dental Board of Australia suggests for people considering cosmetic dental treatment include:
- Why do I want this treatment?
- What are the health risks and other risks of the treatment?
- Is this an irreversible change that will need maintenance, repair or replacement in the future?
- What can I realistically expect, and what are the alternatives?
- Has the procedure been explained to me, and do I understand it?
- Should I get a second opinion?
- Do I need time to think before I decide?
The Board stresses that practitioners should also give patients enough time to think, set realistic expectations and obtain informed consent. If you are travelling for treatment, it is worth discussing the schedule in advance so that you are not deciding under time pressure, for example how much time there will be between the mock-up and the start of any treatment that cannot be reversed. What preparing a tooth for a crown involves, and when less invasive options may be enough, is explained on our page about zirconia crowns.
How is a smile makeover planned at Rönesans?
At our clinic, a smile makeover is planned as part of aesthetic dentistry. The process starts with an examination in which your teeth, your gums and your expectations are discussed. We use digital smile design: your new smile is planned digitally before treatment starts. The current state of your teeth can be recorded with an intraoral scanner, without impression paste. If you would like, the planned tooth shape is tried on your teeth in a temporary material before final treatment (mock-up). The digital plan and the mock-up are preliminary work; the final result can differ from the design, depending on the material used and the structure of your teeth and gums.
We decide together at the examination which treatments the plan will include. Aesthetic dentistry, orthodontics, prosthetic treatment, implants and root canal treatment are among our clinic’s fields; zirconia crowns and clear aligner treatment are provided at our clinic. Crowns and prostheses are made with CAD/CAM at the dental laboratory we work with. Whether veneers or composite work are suitable for you is assessed at the examination.
Before treatment starts, you know which dentist will treat you, and you receive a written treatment and cost plan showing the procedures and the unit and total costs; the cost is confirmed after the examination. Follow-up after treatment follows a defined process. If you live abroad, you can send photos of your smile and any recent X-rays on WhatsApp for a preliminary assessment, or write to us through our contact page; we communicate in English and German. How long you need to stay depends on the treatments combined, and we plan the appointments around your travel dates; practical points are covered in planning your visit.