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How We Design a Smile


Patients always ask me how they will know they'll like their new smile, and it's a wonderful question! My mentor, Dr. LuBovich, first developed a technique decades ago that involved building a prototype out of an acrylic framework with hand sculpted wax. This prototype could be tried in the mouth so that a patient could evaluate the shape and critique it, with adjustments made by a technician or the doctor in real time. Understandably though, the patient had to be very careful when evaluating the wax, as it is very fragile, and he cannot leave with the wax prototype for the same reason. 

While I was trained in this classic technique and consider myself to be as good a wax sculptor as any, this process has evolved to use more modern materials. PMMA is a very strong polymer similar to plexiglass, and has taken the place of wax. These incredibly strong, beautiful prototypes are custom milled in the lab, often designed with the patient's direct input, and then tried in the patient's mouth. Not only can the patient critique the prototype, they're cemented or screwed in (depending on the case) so that the patient can take them on a test drive! Once the bite and esthetics are perfected, the final smile will be made as an exact replica of the prototype out of beautiful zirconia. 

As I design most complex cases myself, I enjoy bringing patients back to the dental lab to sit with me, and help virtually sculpt their new smile. Sometimes it takes multiple prototypes before we find the perfect one, but that's ok! It has been said that, "Perfection is no trifle; trifles are perfection" and those words truly summarize the art of cosmetic dentistry. Our society has become so inundated with the tidal wave of instant gratification that it's easy to forget that most great things aren't realized on the first attempt or in one day. More than that, between my own cases and the multitudes I've seen of Dr. LuBovich, I can't count the times that patients have fondly recollected on their ability to actively participate in designing their smile--it is their smile, after all! 

So, as is often the case, we might get things perfectly to your liking on the first prototype, but if not, do not worry. My lab and I share the same goal of making your smile just as you always dreamed it to be, and think nothing of taking all the time necessary to accomplish that goal. Some cases take longer than others, but every case is worth whatever the time required. Ours is a labor of love, and we hope that you give us the opportunity to help you in any way we can. Click here to see our smile gallery.


Dr. Adam Cottrill


Nashville Cosmetic & Implant Dentistry: Adam Cottrill, DMD
2828 Bransford Avenue
Nashville, TN 37204
Phone: 615-297-5577

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