The first step in facial evaluation is to make sure you are viewing your patient at an appropriate angle. Have your patient stand or sit up in the chair with his or her gaze parallel to the floor. Then you can evaluate if a part of the face is out of proportion. Later, computer imaging can confirm this for you. Note any facial deformities or parts of the face that stand out disproportionately.

Visualize your intended changes, such as increasing the interincisal distance, or shortening, widening, or narrowing the teeth. Then confirm your ideas via computer imaging. Try to see how your patient’s appearance could be improved. To do this you need to visualize an ideal facial form and identify what is lacking to make that face ideal. You may not be able to accomplish this—nor does every patient wish to be “perfect”—but for those that do, your careful evaluation can be extremely helpful. The more you do this the better you will become at helping your patients see what is needed to improve their appearance (see Esthetics in Dentistry 1st ed., Vol. II, Chapter 28: Facial Considerations).
A video camera and monitor also allow both you and your patient to see the face in two-dimensional silhouette form. By recording your patient while speaking, various facial positions can be seen, thus making it easier to identify the extent of the esthetic problems.

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