Jennifer Garner, Megan Fox, Tom Cruise, Morgan Freeman, George Clooney – it is not difficult to identify an American celebrity on TV, as they all have the flawless Hollywood smile! The Americans are known to be obsessed with straight and pearly white teeth. According to a survey conducted by the New York magazine, 39% of the Americans are prepared to sacrifice dessert if that will give them a better smile. The question here is: Why are they so fanatical about perfect looking teeth?

The American perception towards the 'perfect' smile is greatly influenced by their history. During the time of the Great Depression, Charles Pincus the dentist opened his practice in Hollywood and Vine. He then began advertising to the movie studios. He used veneers to cover up teeth imperfections and created great smiles for famous actors like James Dean, Judy Garland and Shirley Temple to match their symmetrical faces. Since then, symmetrical and aesthetically pleasing smile has become conspicuous with wealth and fame. Americans believe having a Hollywood smile can boost self-esteem, confidence and give a better first impression. In fact, this may be true! As studies suggest that people with white and straight teeth are 38% more likely to be perceived as smart and are 62% more likely to get a date. In addition, it is a social norm to receive orthodontic treatment in America. 80% of North American teenager visits the orthodontist and the average age of first visit is 7. Straightened teeth means it will be easier to maintain good oral hygiene which leads to reduce risk of gum disease, dental decay, chewing problems and uneven enamel wear. Patients have also shown an increase desire to whiten their teeth after orthodontic treatment. With a wide variety of easily accessible teeth whitening products, approximately 39.09 million Americans used tooth whiteners in 2017. Among all the products, teeth whitening strips are the most popular. Based on the US Census data and Simmons National Consumer Survey, 21.32 million Americans have used it in 2017.

Different components are taken into account to create the ideal American standard smile. We are going to discuss the extra-oral and intra-oral criteria in the following sections.

Extra-oral components – Facial Proportion, The Jawline and Lips:
In America's present culture, facial proportions that coincides with the golden ratio is thought to be beautiful. The golden ratio is a standard method of measuring different parts of the face. The distance between certain facial features are compared to other facial distances. The closer the measurements is to the ratio 1.618, the more attractive the person is.

Men and women with prominent, chiselled jaw are thought to be more attractive. A strong jawline helps evoke a confident and powerful look. A chin implant and buccal fat pad removal, are common procedures to create a more pronounced and sleek facial profile. On the other hand, BOTOX® cosmetic injection is quite popular among the patients to help create a less squared, more feminine appearance. Fat injections are used to reinforcement cheekbones. To remove wrinkle, excess skin and double chin, facelift or neck life is often a treatment option.

Thick lips can enhance the smile by hiding imperfections. A full, symmetrical lip can optimize the smile. Lip augmentation using BOTOX® or filler is not an uncommon treatment choice.

Intra-oral components – White aesthetics, the teeth:
Typically, an aligned, medium smile line that follows the curve of the lower lip and runs parallel to the horizontal line joining the pupils is desirable. The smile is thought to be the most aesthetically pleasing when only a third of the upper teeth (from upper right second pre-molar to upper left second pre-molar) are shown and without the presence of black corridors. Symmetry around the central line is usually aimed by the dentist when contouring the teeth. Typically, the incisal edges of the front teeth are not at the same level, lateral incisors are often 1mm shorter than the central incisors.

Overall, females prefer oval, slender and slightly tall teeth. In contrast, males think square shaped, round, bulky teeth give them a more masculine look. To ensure a natural look, embrasures should be created.

Intra-oral components – Pink aesthetics, the gums:
Healthy looking gum should be bright pink in color, stippled and follows the contour of the teeth. Minimal gum exposure is favored. Americans are willing to contour the gum or move the teeth to get rid of the gummy smile.

In the United States, cosmetic dentistry is the '' largest non-surgical beauty industry after makeup ''. Americans are willing to achieve a perfect smile by getting dental treatments eg veneers, crowns, bridges, dental implants etc. done. According to statistics, 600,000 people had veneers in 2006. A significant growth in number in recent years has been predicted. In 2016, the teeth whitening industry alone is approximately $ 11 billion per year business. As United States GDP Growth Rate is steadily rising at an average of 3.21% and people are becoming more aware of their appearance, we can foresee that the cosmetic dentistry market will expand dramatically in the future.