Dr. Trevor Nichols, an Arizona orthodontist, developed the Nichols Smile Score, a 10-feature framework that expands orthodontics beyond teeth straightening to include facial profile, lip volume, smile arc, gum display, and airway health. His comprehensive diagnostic approach helps patients achieve natural-looking results by addressing multiple smile components and screening for breathing issues that affect roughly 40% of his practice.
- The Nichols Smile Score evaluates 10 features including facial profile, lip volume, smile width, smile arc, occlusion, gum display, and tooth color
- Approximately 40% of Dr. Nichols' practice focuses on airway treatment, with all new patients screened using an airway questionnaire
- His diagnostic process uses full records and CT scans, then shows patients before-and-after photos tied to specific features for personalized treatment planning
- The practice employs daily morning training sessions on biomechanics, anatomy, and physiology, plus full clinical training every Thursday
- Dr. Nichols credits his general dentistry and cosmetic dentistry background with enabling him to handle interdisciplinary cases involving restorative work and implants
Most patients think of orthodontics as a way to straighten teeth. Dr. Trevor Nichols, a board-certified orthodontist in Queen Creek, AZ, built his diagnostic approach around a different question: What else can orthodontics offer?
In this episode of The DrBicuspid.com Podcast, host Kevin Henry talks with Nichols about the "Nichols Smile Score," a 10-feature framework he developed and now lectures on internationally. The features range from an individual's facial profile and lip volume to smile width, smile arc, occlusion, gum display, and tooth color, all aimed at what Nichols calls creating a "natural veneer" for patients who want results without cosmetic dentistry.
Nichols walks through how he uses the framework in consultations, starting with full records and computed tomography scans, then showing patients before-and-after photos tied to the specific features where they stand to benefit most. From there, he works backward with the patient to build a plan that accounts for what they're actually willing to do, whether that entails exploring jaw surgery or finding a nonsurgical path instead.
The conversation also covers how Nichols trains his team to keep everyone, staff and patients alike, on the same page throughout treatment. His assistants are called "treatment specialists" rather than assistants, a distinction he says changes how they show up to work.
The team holds daily morning training sessions covering biomechanics, anatomy and physiology, plus a full clinical training afternoon every Thursday. Nichols credits his own general dentistry background, including cosmetic dentistry work before he became an orthodontist, with giving him a broader view of interdisciplinary cases involving restorative work or implants.
Airway health is another major focus. Roughly 40% of Nichols' practice involves airway treatment, and every new patient is screened with an airway questionnaire. He discusses how patients often respond with relief when a screening surfaces an explanation for symptoms like snoring, teeth grinding, or worn dentition they didn't previously connect to breathing issues.
Nichols closes with advice for practices looking to grow heading into 2027: Stay humble, stay curious, and resist the urge to assume your current approach is the only right one.
Nichols can be reached through his website, nicholsortho.com, on Instagram @dr.trevornichols, or by email at [email protected].
Listen to the full conversation in the player below.
