Gummy Smile An Esthetic Problem or Something More?

gummy-smile

 

When you smile, do you feel the appearance of your upper teeth is overshadowed by excessive gum tissue? Are you of the opinion that your upper teeth appear too short compared to the amount of gingival tissue displayed when you smile? If you answered “yes” to either of these questions, you may have a condition that is commonly called a “gummy smile” or excessive gingival display.

A gummy smile can have a negative effect on the esthetics of your smile. The good news is that a gummy smile can be corrected through various treatment options.

What Are the Causes of Gummy Smile?

Gummy smiles may be caused by one or more factors relating to the gums themselves, the teeth, or even the lip or jaw. Each of these areas will require a different approach to solving the problem. Let’s look at some of the ways a gummy smile can be corrected:

Gums. If your teeth appear too short in relation to your gums, it could be that they are being covered up by too much gum tissue. This problem can be solved with a periodontal plastic surgery technique called “crown lengthening,” which involves removing and reshaping the excess tissue to expose the full length of teeth.

Teeth. There are natural variations in the tooth-eruption process that can result in shorter than normal teeth and gumminess of the smile. If that’s the case, your teeth can be made to appear longer by capping (crowning) them or covering them with thin porcelain veneers. It’s also possible that your teeth have become worn down over time, especially if you have a grinding habit. When this happens, it can cause what is known as compensatory eruption. To compensate for the wear and maintain a functional bite, the teeth actually begin to move (or erupt) very slowly outward from the gum. This makes the smile appear gummier because the gums, which are attached to the teeth, move with them as they erupt. In some cases, orthodontic treatment can be used to move the affected teeth back up into the correct position. Afterward, the worn-down teeth would usually be restored with porcelain crowns or veneers.

Lip. On average, the upper lip moves 6 to 8 millimeters from its normal resting position to a full smile. If the lip is hypermobile, meaning it rises much farther up, more gum tissue will be revealed. Here the action of the muscles that control the lip will need to be modified so they don’t raise it quite so high. Treatment can range from Botox shots that temporarily paralyze the muscles (for about six months), to surgery that permanently restricts how high the lip can move, referred to as a lip stabilization procedure.

Jaw. Sometimes the upper jaw (maxilla) is too long for the face, a condition referred to as Vertical Maxillary Excess. If this is the case, the jaw would need to be repositioned with orthognathic surgery (“ortho” – straighten; “gnathos” – jaw). Of all the treatment listed here, this one is the most complex — but it can achieve dramatic results

What Are Treatment options?

  • Braces or Invisalign – If the positioning of the teeth and jaw are making your gums stick out and look more prominent, such as in the case of an overbite, braces or Invisalign can be helpful. By bringing your teeth and jaw into alignment, we can help reduce the number of gums showing when smiling.
  • Laser Treatment – Diode laser treatment for a gummy smile is precise, fast and completely painless. It’s quickly replacing some of the more invasive options you’ll see on this list. The doctor numbs your gum tissue with a topical anesthetic and uses the laser to remove the excess gum tissue around your teeth and then reshape what’s left, creating more balance and helping to fix a gummy smile. The only thing you’ll feel during the procedure is the movement of the laser tip and there aren’t even any needles involved. Gum tissue removal with the diode laser is safe and effective for patients of all ages. We usually do it after your braces or Invisalign treatment is complete to put the finishing touches on your new smile. A gingivectomy used to be a surgical procedure but these days, we can often do it with the laser.
  • Botox – Gummy smile Botox treatment involves injecting the muscles of the upper lip with onabotulinumtoxinA. The botulinum toxin temporarily paralyzes the muscle so that it can’t contract and lift up as far when you smile. Less gum shows and it has proven to be effective when the upper lip is the cause of a gummy smile. However, the results only last for about three to four months.
  • Veneers or Crowns – If your gummy smile is due to really short teeth, cosmetic restorations like crowns and veneers can be used to make teeth look longer and give you a better tooth-to-gum ratio.
  • Lip Repositioning Surgery – For a gummy smile that is the result of a short or overactive upper lip, surgery can be performed where the “elevator” muscles of the lip are severed so that it can’t lift as high when you smile. However, this can be pretty costly and there are downtime and discomfort associated with it, which is why a less invasive option could be a better choice depending on the underlying cause. However, in severe cases that are due to the upper lip, the surgery combined with orthodontic treatment can be helpful.
  • Crown Lengthening – Crown lengthening surgery involves gum tissue removal and recontouring of gums and, occasionally, bone to let more of the tooth’s surface show. This is often performed if the teeth aren’t fully erupted and are obscured by gum tissue.
  •  Jaw Surgery – Jaw surgery, technically called orthognathic surgery, is only reserved for extreme cases when the jaw is overdeveloped or there’s severe jaw protrusion. An oral and maxillofacial surgeon recontours the upper jaw so that it’s proportionate to the lower jaw. They then reposition it so it’s in its proper place. This is done in a hospital under general anesthesia.

Sources:

https://www.yourdentistryguide.com

https://www.sturgillorthodontics.com

http://www.dentalimplantperio.com

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