A gummy smile is a smile showing an excessive amount of gingival (gum) tissue above the front teeth when smiling. Large gums or short teeth can give your mouth an imbalanced "gummy" look. Fortunately, various treatment options are available depending on the cause for gumminess.
A number of factors can lead to gummy smile:
teeth erupt (grow out of the gums), the gums recede upwards—most of the time. In some cases, the gums remain and cover part of the teeth, making normal- sized teeth look short.
At the time of orthodontic treatment, the gums can become irritated by the braces and overgrow.
Nasal or adenoid problems can lead a patient to breathe through the mouth, especially at night. This habit dries out the gum tissue, leaving it susceptible to disease and overgrowth.
Medicine such as Dilantin and Cyclosporine can lead to gum tissue overgrowth.
High lip lines :The shape of the patient's mouth can sometimes bare more of the gum tissue than is visible in the average person's mouth.
Gummy smiles can also be caused by attrition, a condition where the teeth have been severely worn down. This case is one where the teeth seriously are too short. Bad habits such as teeth grinding can cause this wear.
If you suffer from a severe gummy smile, your dentist may refer you to a specialist, like a periodontist, orthodontist or an oral surgeon. Depending on the nature of your specific clinical condition.
The crown lengthening process involves a surgical treatment to remove some of the bone around the root of the teeth, hence increasing the height of the tooth crown and repositioning the gum level to show less gum. The outcome of this option can be predicted with more certainty especially with the gum final position. But to complete treatment it may take several months and it is contraindicated in smokers, patients with thin gum and poor oral hygiene. It also involves all the complications associated with any form of surgery such as pain, bleeding, swelling etc.
With mild cases, laser gum reshaping can be used to provide a very painless, bloodless, quick and effective way of reducing the amount of gum tissue on display without removing any underlying bone tissue. The advantage of this technique is its simplicity and being minimally invasive. Its disadvantage is that the final outcome may not be as predictable as surgical bone removal and the gum may re- grow. However it has a good success rate and in combination with some other treatments can be very effective and in many situations is the best treatment option. The position of the gum is maintained by the porcelain veneers and if any gum re-growing takes place it can be removed again.
In situations where the gummy smile is caused by a short or hyperactive upper lip muscle, the gummy smile can be treated with plastic surgery repositioning the upper lip or with Botox reducing the activity of the upper lip elevator muscle. The disadvantage of repositioning the lip is the need for surgery but the advantages is that it is more of a permanent solution. With Botox, it is a much less invasive and simpler solution but need repeating every 3-6 month.
If the gummy smile is cause by small sized teeth or excessively worn down teeth, we usually build-up the worn down teeth with porcelain or composite veneers to restore the teeth back to their former length and height. The patients may also be required to wear an NTi splint at night to stop tooth wear damaging their new veneers.
In cases where the gummy smile is caused by a genetically determined skeletal deformity, where the middle third of the face presents with excessive vertical length, we treat the mild and moderate cases with orthodontic intrusion using Invisalign and the severe cases are treated with Orthognathic jaw surgery and orthodontics.