special _ smile design I of general dentistry. The aesthetic outcome of any dental treatment plays a vital role in the patient’s treatment satisfaction criteria. _MI dentistry currently focuses on prevention, remineralisation and minimal dental intervention in the management of dental carious lesions. It has failed to give the necessary attention to the problems that negatively affect smile aesthetics, for example non-carious dental lesions, or developmental defects and malocclusion. _The treatment modalities of contemporary cosmetic dentistry are trending towards more invasive procedures with an over-utilisation of crowns, bridges, thick full veneers, and invasive periodontal aesthetic surgeries, while neglecting long-term oral health, actual aesthetic needs and the characteristics of the patient. _Social trust in dentistry is degrading, owing to the trend of fulfilling the cosmetic demands of patients without ethical consideration and sufficient scientific background (the more you replace, the more you earn; more is more mentality). In this article, I introduce a concept and TP for minimally invasive cosmetic dentistry (MICD), in order to address these facts properly and integrate the evidence-based MI philosophy and its application into aesthetic dentistry. 3. adoption of the do-no-harm strategy in the selection of treatment procedures and the maximum possible preservation of healthy oral tissues; 4. selection of dental materials and equipment that support MI treatment options in an evidence-based approach; 5. encouragement of the keep-in-touch relationship with the patient to facilitate regular maintenance, timely repair and strict evaluation of the aesthetic work performed. The main MICD benefits include: 1. promotion of health, function and aesthetics of the oral tissues and positive impact on the quality of life of the patient; 2. preservation of sound tooth structures (banking the tooth structure), while achieving the desired aesthetic result; 3. reduction of treatment fear and increased patient confidence; 4. promotion of trust and enhancement of professional image. _The MICD treatment protocol In my experience, the TPs that are currently in use in aesthetic dentistry are mostly based on more invasive techniques and procedures. _Defining MICD As the perception of aesthetics and beauty is extremely subjective and largely influenced by personal beliefs, trends, fashion, and input from the media, a universally applicable definition is not available. Hence, smile aesthetics is a multifactorial issue that needs to be adequately addressed during aesthetic treatment.17 MICD deals both with subjective and objective issues. Therefore, in this article I define MICD as “a holistic approach that explores the smile defects and aesthetic desires of a patient at an early stage and treats them using the least intervention options in diagnosis and treatment technology by considering the psychology, health, function and aesthetics of the patient.”18 The core MICD principles are: 1. application of the-sooner-the-better approach and exploration of the patient’s smile defects and aesthetics desires at an early stage in order to minimise invasive treatments in the future; 2. smile design in consideration of the psychology, health, function and aesthetics (Smile Design Wheel18) of the patient; MICD treatment options NI TREATMENT OPTIONS SMILE TRAINING TOOTH WHITENING RE-MINERALISATION OF WHITE SPOTS SHORT ORTHODONTICS (SECTIONAL) NON-PREPARATION VENEERS ENAMEL AUGMENTATION ADHESIVE PONTIC (LONG-TERM TEMPORARY RESTORATION) ORAL APPLIANCE MI TREATMENT OPTIONS MICRO- AND MACRO-ABRASION SELECTIVE CONTOURING (GUMS/TEETH) DIRECT RESTORATIONS WITH MINIMAL TOOTH PREPARATION MINIMAL PREPARATION ADHESIVE BRIGDES VENEERS, INLAYS AND ONLAYS MI IMPLANTS With the use of such protocols, cosmetic dentists are knowingly, or unknowingly, heading towards the over-utilisation of invasive technologies in their practices, which is becoming a professional and ethical concern. The basic aim of the MICD TP is to guide practitioners in achieving optimum results with as little intervention as possible. The intervention level of the treatment in MICD depends on the type of smile defects and the aesthetic needs (objective measurement and subjective perception) of the patient. Table 1 cosmetic dentistry 4 _ 2009 I 29