A patient’s smile is affected by the size and shape of her lips and teeth, the facial muscles and the patient’s gum tissue. An ideal smile is balanced and shows a very small amount of gum tissue above the teeth. A gummy smile refers to a smile where too much of the gum tissue can be seen. Though this is not always due to a medical condition that can affect their health, many patients feel uncomfortable with their smiles, finding that their teeth seem too small or their gums too large, and seek a way to correct it.
Causes of “Gummy” Smile
There are different dental treatments available to allow a patient to alter her smile so that it becomes one that she is comfortable with and likes to show off. One dental condition that can cause this type of smile is bad oral hygiene that leads to an overgrowth of the gums. Breathing through the mouth can also result in overgrown gums. When this happens, the teeth seem too small, even if they are normal sized, and when the patient smiles, too much of the gum tissue shows. Another dental condition is excessive wear on the teeth, which causes the upper teeth to move further downward, pulling the gums in the same direction. Extreme tooth eruption also leads to the gums being pulled down.
Facially-related origins include a short upper lip, an upper lip that moves too easily, and a longer than average upper jaw bone. In patients suffering from facially related conditions, the teeth look small but are actually normal-sized and normal-shaped teeth. Though this type of smile is usually a cosmetic problem, rather than a dental one, some of the conditions that cause it can also affect the teeth negatively if not treated in time. Teeth that erupt in incorrect form, for example, can result in a severely misaligned bite.
The treatment for a gummy smile depends on the cause. Oftentimes, treatment will involve a few of the options at the same time. For some minor cases, a gingivectomy is performed. This treatment is limited to one visit to remove a small amount of extra gum tissue through the use of laser treatment or a radio surgery technique. However, most patients will need other types of treatment to address the problem. To correct excessively large gums, a dentist, periodontist or oral surgeon can perform gum-contouring surgery, crown lengthening surgery or flap surgery.
Crown lengthening surgery, sometimes with bone removal, offers an aggressive approach to treating a gummy smile. Performed under local anesthesia, this treatment molds the gums around the individual teeth. Gum tissue is removed from the bone and moved to the desired position. It is then sutured in place and given about seven to 10 days to heal. The sutures are removed after this time. The healing continues for another five to seven weeks. In some cases, bone needs to be removed from the front part of a tooth’s roots to complete the procedure. Crown lengthening is also used in conjunction with veneers or crowns. These are placed after the healing is completed. This procedure is more complicated than a gingivectomy, and patients can expect to experience some pain and discomfort after the procedure is completed.
If the abnormal jaw bone is the culprit, maxillofacial surgery can be performed to change the position of the bone. Orthognathic surgery, which is a jaw surgery, was a popular method in the past. It is not as commonplace anymore. This surgery involves breaking the upper jaw to remove parts of the bone. It is a complex, invasive procedure that includes an extended recovery period, with the patient having his jaw wired shut, as well as other normal issues and risks involved with major surgery.
Treatment can also include orthodontic braces to align the teeth in a better position. For facially related conditions of the upper lip, the patient can undergo hypermobile lip surgery to limit the unnecessary movement of the upper lip. During this procedure, an oral surgeon reattaches gum tissue under the top lip, so that it is closer to the teeth. This limits the constant upward movement of the lip.
A client does not have to suffer through this type of smile anymore if the smile makes him feel uncomfortable. The treatments available make it easy for a patient to choose the right treatment, considering time, location and finances.