Gummy Smile

REGAIN YOUR CONFIDENCE BY REINFORCING YOUR SMILE

Does your gummy smile make you feel self-conscious or does it make your smile less attractive? Do not worry! We can fix your smile by establishing the right cause and plan right treatment.

What is a gummy smile?

The architecture of the smile is made up of lip framework, gum tissue and teeth.Lip length measures from base of the nose to edge of the upper lip. It ranges from 10 to 36mm. Average lip length is 20 to 22mm.A normal gum display between lower border of upper lip and gingival (gum) margin of upper front teeth during a smile is 1-2mm. If it exceeds 2mm you are said to have a gummy smile.Ideally an aesthetic smile line should reveal least amount of gum tissue possible.

Gummy smile is a condition when more of the gum structure is visible when a person smiles or opens the mouth. It can dwindle the charm of your smile as it looks unnatural, making the teeth look abnormally small compared to visible gum tissue. Females are more prone to gummy smile than males as women display higher smiles than men.

What are the causes of a gummy smile?

Various factors independently or in combination lead to gummy smile. Common anatomical and functional factors that cause your smile to display excess gum tissue are:

  • Short upper lip– Due to short upper lip, more amounts of teeth and gum tissue may be visible which looks out of line. This brings about high smile line and a gummy smile.
  • Smaller size of the teeth– smaller size of the teeth leads to more display of gums.
  • Hyperactive upper lip– The act of smiling involves many of the muscles used in facial expression, especially those that retract the lips to reveal the teeth and gums. The average lip moves 6-8 mm from its normal resting position to a full smile. The muscle that controls the movement of your upper lip could be hyper active, causing your upper lip to rise up higher than the normal. When excessive contraction of the elevators of upper lip occurs, more of your gum tissue is revealed when you smile.
  • Protruding upper jaw/ excessive upper jaw- Vertical maxillary (upper jaw) excess is manifested by gummy smile, exposure of upper front teeth, incompetent lips, and increased length of lower facial height. It is a facial skeletal deformity. When the upper jaw is too long for the face, excessively long relative to the base of the skull to which it is attached, too much gum tissue is showed. You also have a gummy appearance when there is an excessive bulging of the upper jaw within the gum tissue. When there is protrusion of upper teeth due to vertical maxillary excess, more of the gum tissue is exhibited.
  • Over eruption of upper front teeth-when there is excessive vertical eruption of upper front teeth, excess gum tissue is visible because of the migration of the gums downwards.
  • Improper eruption of the teeth- If the teeth don’t erupt fully or gums do not come to their proper position, the teeth appear shorter and the gums become more prominent.

 

What are the possible treatment options to correct a gummy smile?

A gummy smile can be the combination of more than one factors listed above. Treatment of the gummy smile varies according to etiological factors, perception and expectations of the patient. Correct diagnosis is the key to solving any complex cosmetic concern.

Treatment options include:

  • Correction by orthodontics– When there is over eruption of upper teeth (when there is no skeletal deformity), intrusion of upper teeth is done using orthodontic appliances. In vertically normal gummy smile, intrusion of upper front teeth is the treatment of choice. There are advanced orthodontic appliances like mini screw bone anchors to improve the relation between upper lip and teeth, reducing gum exposure. When gummy smile is basically due to strong vertical alveolar growth at the incisors, isolated orthodontic treatment can provide satisfactory results,especially with the development of bone anchorages, extending the potential of classic orthodontics.
  • Surgical correction– In some cases, isolated orthodontic treatment will not be enough to correct large excess anterior gum exposure, especially when it is of skeletal origin.Surgery can improve the relation between the upper jaw and the upper lip. In case of a short upper lip, lip repositioning/lengthening techniques like V-Y lip closure surgery can minimize gum exposure.
  • Crown lengthening– Sometimes your teeth may actually be the proper length, but they are covered with too much gum tissue. To correct this, crown lengthening procedure is done. It is a surgical procedure to expose a greater amount of tooth structure. During this procedure, excess gum and bone tissue is reshaped to expose more of the natural tooth.
  • Botox injections– These injections are given to the lip to reduce the hyper activity of the lip which lessens the excessive lifting of the upper lip and thereby minimizing the exposure of gums.