People around the world have different cultures, traditions, and habits. For this reason, they tend to have different tastes and preferences.
However, regardless of these differences, almost everyone agrees on what makes a smile attractive.
People tend to find a smile attractive when the teeth are white, shiny, and perfectly aligned. However, a smile is more than just the teeth. The shape of the lips and the gums are equally important when determining whether a smile is attractive.
When people smile, a bit of gum on the upper area tends to show between the teeth and the upper lip. This is entirely normal and part of what is considered an attractive smile. However, some people tend to show more gum than expected, which is not attractive to everyone.
In this article, we’ll talk about gummy smiles and explain how to improve this condition.
What is a gummy smile?
A gummy smile is a common dental condition. Its main characteristic is an excessive display of gum above the upper teeth when someone smiles.
However, there isn’t a standard notation that determines whether a smile is gummy or conventional. For this reason, the term might be slightly subjective to many people and dentists.
What a person may identify as a gummy smile could be a normal smile to another person.
Nonetheless, most people call it a gummy smile when more than 3-4 mm of gum is displayed. As a result, many people find a smile attractive when only 2-3 mm of gum is shown.
This condition can affect anyone and tends to appear while growing up. Also, it is more common in females than in males.
Lastly, depending on the severity, a gummy smile can affect a person’s self-esteem and socializing ability. It can even cause people to smile less or cover their mouths while smiling.
How to diagnose gummy smiles?
A gummy smile can be self-diagnosed. There are no special tests or exams to indicate it. Therefore, all it takes to diagnose it is to see the patient smile and understand some specific anatomic proportions.
However, a dentist can make some measurements to determine the precise length of the gummy smile. To do it, they can ask the patient to smile. Afterward, the dentist measures the gum from the lower portion of the lips to the neck of the incisor teeth.
This measurement can be taken in different ways. The dentist usually uses the periodontal probe. This is an instrument that has different marks on the tip. It acts as a ruler since every line is 1 mm from the next.
Another measuring method is placing the mirror handle on the gum’s top. The dentist then proceeds to mark where the neck of the incisor teeth is located. Afterward, the mirror’s handle is measured up to the mark with a regular ruler.
Nonetheless, a dentist can make a thorough evaluation through a clinical exam, x-rays, and medical history to determine the cause of the gummy smile. This also helps decide the best treatment option for each case.
6 main causes of gummy smiles
A gummy smile can develop for different reasons. It may even have a hereditary component to it in some cases. The most common causes for gummy smiles include the following:
1. Passive eruption
The passive eruption is a normal dental condition caused by excessive gum. It is not harmful or painful but can cause aesthetic defects.
This condition happens when the gum over the bone is too thick. As a result, when the permanent teeth erupt, the thick layer of gum covers a large portion of the tooth’s crown. This makes them look shorter than they are, causing more gum to show while smiling.
2. Dentoalveolar extrusion
Dentoalveolar extrusion happens when the frontal teeth overextend while erupting. This causes them to be located more forward than they should. The bone also moves forward as the teeth erupt. The result is a gummy smile.
3. Vertical maxillary excess
In some cases, the maxillary bone, also known as the upper jaw bone, grows longer than it should. As a result, the upper lip cannot cover it efficiently while smiling.
4. Short lip
In other cases, the issue is not the maxillary bone but the lip. If the upper lip is too short, it causes the same visual effect caused by vertical maxillary excess.
This means that the lip is unable to cover the gum as intended. Therefore, it displays excessive gums.
5. Overactive lip
Bone structure is not the only significant factor. A gummy smile can develop if the lip is overactive, even when the maxillary bone and the upper lip have the appropriate size.
An overactive lip means the lip muscles are highly movable and stretch further than they would usually while smiling.
6. Gingival hyperplasia
Gingival hyperplasia is a condition that causes the gum to overgrow. This causes it to cover some portions of the teeth.
Gingival hyperplasia occurs due to different reasons. It can develop as part of a genetic condition that causes the gum to overgrow slowly and steadily.
In this case, there is an overproduction of collagen, which results in enlarged gums.
Nonetheless, it usually develops due to poor oral hygiene, systemic causes, and medications.
Poor oral hygiene can cause the gum to swell and grow. Fortunately, a dental cleaning is often enough to reverse the condition. However, on some occasions, the overgrowth is caused by systemic diseases, such as hormonal changes, diabetes, leukemia, and pregnancy.
Lastly, certain types of medications can trigger gingival hyperplasia. The most frequent medications include the following:
- Immunosuppressants
- Antiseizure medications
- Calcium channel blockers.
Treatment options for gummy smiles
Gingivoplasty
Since there are several causes for a gummy smile, a wide variety of treatment options are available. The type of treatment is determined by its causes and triggering factors.
However, periodontal and maxillary surgery is the most common gummy smile treatment available. It is called gingivoplasty or recontouring gums. It is a periodontal surgery involving cutting and reshaping the gums.
In this procedure, the dentist measures the amount of gum excess around the teeth. This helps to determine how much gum can be safely removed without compromising the integrity of the teeth and bone.
Afterward, the dentist trims and removes the gum using a scalper, electro-scalper, or laser.
The reshaping is done following the tooth contour to achieve a natural result. However, the dentist can make a few minor adjustments to the outline to make it more aesthetically pleasing.
The procedure is done under local anesthesia to avoid pain or discomfort during the surgery.
Orthognathic surgery
The dentist might need to perform orthognathic surgery or jaw surgery when a gummy smile is caused by the overgrown maxillary bone.
This procedure consists of cutting the maxillary bone to reduce its length. Afterward, the bone is repositioned and fixed in place through plates and screws.
This surgery is highly invasive and must be performed under general anesthesia. Moreover, it usually takes around 6-12 weeks to heal due to the nature of the procedure.
Lip repositioning surgery
As the name suggests, this procedure consists of repositioning the upper lip. This is done by removing a portion of the connective tissue from the underside of the lip. This means that the dentist cuts a small part of the tissue located between the gum and lip.
This restricts the movement of the muscle while smiling. As a result, the lip doesn’t stretch and pulls up as much as before the surgery, thus displaying less gum while smiling.
Botox
Botox injections are an excellent alternative for people who don’t want surgery.
The procedure consists of simply injecting botox directly into the upper lip. Botox is a substance that paralyzes and restrains the lip’s movement. Once done, the lip doesn’t stretch as much while smiling, which reduces the amount of gum that shows through.
The dentist might apply topical anesthesia to prevent all discomfort while injecting the botox.
Nonetheless, it is essential to understand that not everyone’s gummy smile can benefit from botox.
Also, the results are not permanent. Therefore, the patient needs to be constantly getting botox injections.
Gummy Smile: FAQs
Anyone who has a gummy smile can qualify as a patient for treatment. However, since most treatment options involve surgery, the patient must be healthy and free of any uncontrolled systemic disease, such as hypertension, other heart-related conditions, and diabetes. Furthermore, in the case of orthognathic surgery, the bone must have finished growing and developing. Therefore, teenagers usually have to wait until reaching their early 20s before being able to opt for this procedure.
References:
Narayan, S. et al. Correction of gummy smile: A report of two cases. Journal of Indian Society of Periodontolgy. 2011 Oct-Dec; 15(4): 421–424.
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