Digital Smile Design that follows a well-defined digital workflow can help dentists visualise, plan, and refine veneers and aesthetic cases before treatment begins.
About the Author: Dr Lawrence Neville
Dr Lawrence Neville runs two SPA Dental Sydney practices in the Sydney CBD and Ryde. His clinical work focuses on aesthetic and ortho-restorative dentistry, including clear aligner therapy, whitening, bonding, and veneers. He is a member of Invisalign’s global faculty and ANZ faculty, and the founder of Clearly Aligned and Clearly Select; education programs supporting dentists with clear aligner treatment, restorative integration, and practice systems.
Aesthetic dentistry is a competitive part of general practice. Patients arrive with strong expectations and extensive access to treatment information, before-and-after images, and treatment options.
In a crowded cosmetic dentistry market, technology alone is not the differentiator. The strongest aesthetic practices build a repeatable digital workflow that connects diagnosis, patient communication, tooth positioning, laboratory planning, and restorative treatment.
The final veneers are only one part of a result shaped much earlier in the process by the questions asked, the records gathered, and the information sent to the laboratory.
A clear workflow also gives the practice a practical competitive advantage. It can improve case flow by reducing stalled decisions, repeated consultations, avoidable revisions, and late design changes. Patients receive a more coherent experience, while dentists and team members have clearer responsibilities at each stage.
Consistent aesthetic treatment depends on planning the entire journey: establishing the patient’s goals, collecting records, assessing position and function, testing the design, and involving the laboratory before irreversible treatment. For the practice, that structure can reduce repeated appointments, simplify team handovers, and create a more efficient path from consultation to delivery.
Avant Dental’s Digital Smile Design service helps dentists connect those stages through a digital workflow built around structured planning, visualisation, and clinical trialling.
Start with the patient, not the solution
A patient may dislike their smile without understanding the source of the problem. Describing teeth as crooked, short, dark, worn, or uneven does not amount to a diagnosis.
An aesthetic consultation may require around 45 minutes. The first step is to explore what the patient dislikes, what they hope to change, and how they want the result to feel, and how they want to feel.
This conversation also clarifies expectations. For example, a patient may request four or six veneers although their full smile displays eight or ten teeth. With a significant shade change, a limited plan may create an obvious transition between restored and unrestored teeth.
The consultation may also identify gingival inflammation, active disease, unstable occlusion, or significant wear that requires attention before cosmetic treatment progresses.
A clear consultation helps the patient understand both the destination and the steps required to reach it.
Collect records that show the whole smile
Reliable smile design requires more than digital scanning. The dentist needs records that show how the teeth relate to the lips, gingivae, face, speech, and natural smile.
The record set should capture the patient at rest, in a full smile, and in retracted and occlusal views. Including video can reveal details a posed photograph misses, such as lip movement, speech, and the smile in motion.
| Clinical record | What it helps assess |
| Facial photographs | Facial proportions, midline, and horizontal references |
| Resting-lip photographs | Incisor display and tooth position |
| Full-smile photographs | Smile line, gingival display, and buccal corridors |
| Retracted and occlusal photographs | Tooth proportions, wear, crowding, and existing restorations |
| Video | Natural lip movement, speech, and dynamic smile behaviour |
| Intraoral scan | Tooth position, occlusion, and the digital model used for planning |
Align teeth before removing tooth structure
Pre-restorative alignment can be central to an aesthetic workflow. Many restorative cases benefit when tooth position is improved before preparation.
Alignment can create restorative space, reduce crowding, improve overjet or a deep bite, and place gingival margins more favourably. It may also reduce enamel removal or the number of restorations.
Not every patient needs comprehensive orthodontics. Rather, patients may accept six to 12 weeks, or even several months, of targeted clear aligner therapy when the restorative benefit is explained.
The goal may be a realistic improvement that creates enough horizontal or vertical space to protect tooth structure and improve the restorative starting point.
Moving a small lateral incisor into a more favourable position, for example, may allow a minimal-preparation or non-preparation veneer.
It is therefore important to distinguish minimal preparation from minimal restorative burden: one describes a procedure, while the other considers how much dentistry the patient may require across the case and over time.
Make digital scanning clinically useful
A predominantly digital restorative workflow can still include conventional impressions for selected cases.
A scan can reach the laboratory immediately, but it can only capture what the dentist exposes.
Tissue retraction and haemostasis remain essential. A double-cord technique with retraction paste can help expose the margins clearly.
Calibration also matters. Occlusal relationships may change between scanner platforms and design software, so a scan should not be the only reference.
A complete laboratory submission may include:
- Calibrated upper and lower intraoral scans.
- A bite scan.
- Facial, full-smile, retracted, and occlusal photographs.
- Video where lip movement or phonetics are relevant.
- Photographs of occlusal marking paper contacts.
- The approved digital design.
- Trial-smile photographs and scans.
- Clear material, shade, and characterisation instructions.
- Notes on any accepted clinical compromise.
Use Digital Smile Design as a planning tool
Digital Smile Design sits between diagnosis and treatment. It brings the clinical records together and allows the dentist, patient, and laboratory to review the proposed result before the teeth are prepared.
The proposed teeth should be assessed against the interpupillary line, facial and dental midlines, horizontal plane, smile arc, tooth proportions, gingival levels, and tooth display.
These references help determine whether the plan requires alignment, gingival correction, restorative treatment, or a combination. They also show where a sensible compromise could avoid unnecessary tooth reduction.
A digital design gives the patient a concrete way to review tooth length, width, shape, and overall balance. The laboratory can then use the approved references to prepare the proposal, mock-up, trial model, and final restorations.
Avant Dental’s five-step Digital Smile Design workflow connects the initial consultation and intraoral scan with design approval, a physical 3D trial, and final manufacture.
| Stage | What happens |
| 1. Patient consultation | The dentist assesses the existing dentition, discusses the patient’s goals, and takes an intraoral scan. |
| 2. Design proposal | Avant Dental develops a personalised digital design from the clinical records and treatment objectives. |
| 3. Design approval | The dentist and patient review the proposal and request any required revisions. |
| 4. 3D model trial | Avant Dental produces a 3D model and trial template so the proposed design can be tested in the mouth. |
| 5. Treatment begins | The approved temporaries are scanned to guide the manufacture and colour matching of the final restorations. |
Separate simulation from clinical design
Chairside simulations help patients visualise a possible outcome and understand why treatment may include alignment, whitening, gingival treatment, bonding, or veneers.
However, an initial simulation is a communication tool, not a clinically planned design. The patient journey should therefore move through four clear stages:
- Initial visual simulation, which helps the patient understand the opportunity.
- Clinically planned Digital Smile Design that applies facial, dental, and restorative references.
- Physical trial smile, which allows the design to be assessed in the mouth.
- Final restoration manufactured from the approved clinical plan.
Test the design before preparation
Patients should trial the proposed smile before the preparation appointment. The laboratory can produce a custom 3D model and trial template to allow the dentist to transfer the design into the mouth with temporary material.
A trial smile allows the dentist to review:
- Tooth length and width.
- Smile arc and gingival relationship.
- Lip support and facial integration.
- Speech and phonetics.
- The patient’s response to the proposed shape and scale.
- Any changes required before preparation.
The practice can photograph and scan the trial, then send agreed changes to the laboratory. This creates an inverted triangle: more planning at the beginning means fewer changes at preparation and delivery.
Avant Dental’s custom 3D trial model gives patients the opportunity to see and feel the proposed result before irreversible treatment begins.
Assess whether veneers are the right endpoint
Veneers should be one possible endpoint, not the starting assumption. Dentists must first decide whether alignment, whitening, bonding, gingival treatment, or another option could reduce the restorative burden.
Before progressing to veneers, dentists should consider:
- Gingival and periodontal health.
- Tooth position, crowding, and rotation.
- Overjet, deep bite, and available restorative space.
- Existing wear, fractures, or failed composite restorations.
- Tooth size and shape discrepancies.
- Smile line and gingival levels.
- The number of teeth visible in the full smile.
- The patient’s desired shade and aesthetic expectations.
- Willingness to accept pre-restorative alignment where it offers a clear benefit.
- Capacity to follow retention and maintenance requirements.
Some patients may need only alignment and whitening. Others may require minimally prepared veneers or a broader plan. Aim for the minimum treatment that can deliver a stable, agreed result.
Prepare through the approved design
Once approved, the mock-up becomes a preparation guide. Preparation is completed through the mock-up rather than using the existing tooth alone as the reference.
A double mock-up technique accounts for the several facial planes of an anterior tooth. The first set of depth cuts guides the initial reduction. The mock-up is then removed, the preparation is assessed, and pencil markings help the dentist see where material remains.
The mock-up is replaced and the depth cuts repeated to confirm the facial planes and restorative space. Preparation guides and putty indices provide another check before the patient leaves with provisionals.
Enamel should be preserved wherever possible, but minimal preparation must not become under-preparation. Without adequate space, the technician may be unable to reproduce the approved contour, thickness, or shade.
Common workflow errors include:
- Preparing before the tooth position has been fully assessed.
- Skipping the physical trial smile.
- Preparing in one facial plane only.
- Under-preparing in an attempt to remain conservative.
- Failing to verify restorative space with guides or indices.
- Sending incomplete records to the laboratory.
Treat the laboratory as part of the planning team
Aesthetic dentistry depends on the dentist–laboratory relationship. The dental technician needs more than a scan and a short prescription. The laboratory should receive photographs, video, digital files, occlusal records, the approved trial smile, and the patient’s aesthetic preferences.
This is especially important in complex cases, where colour, texture, and integration are critical. An in-person laboratory appointment may still add value. Good laboratory communication should reduce chair time at delivery. The final appointment should not be the first time a major aesthetic question is addressed.
Avant Dental supports planning through design proposals, revisions, 3D trial models, and trial templates, while the dentist retains control of diagnosis, consent, and treatment.
Predictability at delivery starts earlier
Predictable delivery depends on earlier planning. The design should be approved, restorative space confirmed, and complete clinical records supplied before the delivery appointment.
This does not remove the need for careful try-in, isolation, bonding, and occlusal assessment. It reduces the likelihood that the delivery appointment becomes a late design meeting.
Plan retention from the beginning
Maintenance is part of treatment. Teeth continue to move after veneers are placed, so a stable result requires retention. Routine veneer cases should include upper and lower retainers, with their fit and condition reviewed at hygiene appointments.
Retaining both arches helps avoid an upper retainer wearing against the lower natural teeth. Retainers may also provide some protection for patients with a history of tooth wear. A heavy bruxer may need a different appliance, but the strategy should reflect the patient’s risks, symptoms, occlusion, and likely compliance.
Retention, hygiene attendance, and maintenance should be discussed during consent.
Three building blocks for a modern aesthetic practice
Practices do not need to introduce every available technology at once. The more important step is to create a digital workflow that every team member can follow consistently.
A shared process makes it easier to collect complete records, explain treatment, track laboratory communication, and identify where a case has stalled.
It can begin with three practical systems:
| 1. Create a repeatable consultation and records protocol
Standardise consultation, photography, video, scanning, and occlusal records. 2. Consider moving teeth before removing tooth structure Assess whether limited alignment could improve space, gingival position, or preparation requirements. 3. Involve the laboratory before preparation begins Agree on the records, design files, trial process, and material information required before preparation. |
Make the journey clear
Patients are more likely to feel confident when treatment is clear, visual, and personalised. That confidence should come from diagnosis and shared planning, not a promise of an instant result.
A modern smile design workflow connects consultation, records, tooth positioning, digital planning, trialling, preparation, laboratory communication, and maintenance.
The goal is not simply to deliver veneers. It is to help the patient understand and test the proposed result before irreversible treatment, while protecting tooth structure and giving the laboratory the information it needs.
Learn how Avant Dental’s Digital Smile Design workflow can support treatment planning, patient communication, and trial smiles in aesthetic cases.
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From Smile Design to Veneers: Clinical Workflow with Dr Lawrence Neville
Avant Dental is a full-service dental laboratory. To find out more about working with us, please email [email protected] or phone 1800 287 336.