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What can we do for your gummy smile? We’re glad you asked.

We’re noticing that more and more people wish they could do something about their gummy smiles, or gumlines that are uneven.  This seems to be a hot topic, and makes us pleased that more and more people are paying attention to more than just their teeth.  The secret’s out: the look of a smile depends as much on the gums as it does on the teeth.

There are different reasons for a gummy smile, and it is important to distinguish between them in order to find the correct treatment.  If one applies an across-the-board treatment for all smiles, one will encounter catastrophic failure. Just because one has a laser, does not always mean that it should be used.

In general, gummy smiles can be due to three factors: an upper jaw that is placed too far down in the face, an upper lip that is very mobile, or (simplest of all), there is just too much gum tissue.  Of course, there can be combinations of the three, but it is very important to determine the cause.  The treatment must address the cause.  If treatment is undertaken that does not address the cause, it will not be totally successful.  Diagnosis is key here.

Here are two examples from our office:

 

Mouth with an excess of gum tissue
This case of “gummy smile” is truly an excess of gum tissue and not a problem of “small teeth” or an underlying skeletal anomaly.

The treatment for this should be simple: removal of excess gum tissue (or if necessary), some of the underlying bone as well.  There are well-established parameters that need to be followed in order to achieve predictable healing, but it appears to be quite straightforward.  If you haven’t guessed, yes, this is our own Keshia.  She has not had this treatment because of a major health issue that has plagued her for about 8 months now.  At the time of writing, we figure she should be cured in about one more month.

 

Mouth with exposed teeth
When you inspect the amount of visible tooth structure, you will see that the teeth are totally exposed. The problem here is not with the gums, it is with the placement of the entire upper jaw bone, where it sits too low for the upper lip to cover the teeth.

This is an altogether different case.  Here, the treatment actually needs to involve surgical repositioning of the upper jaw (maxilla) to a more upwards position.   There is nothing wrong with the amount of gum tissue, nor is there any excess lip movement.  For some reason (hereditary, likely), the jaws developed in this way, and trying to mask it by trimming gums would end up with a disastrous, or at least odd-looking result.  Treatment needs to be targeted at the problem area, and this would warrant a trip to the local friendly oral and maxillofacial surgeon in conjunction with an orthodontist.

The final basic reason for a gummy smile would be a lip that just rides higher than normal when smiling.  On average, one should expect something in the range of 6-9mm of lip movement when going from rest to full smile.  If it is more than normal, it can be corrected in one of two ways: Botox (easiest, but needs refreshing every 6 months or so) in the lip to reduce the amount of lip rise, or surgery by a specialized practitioner to permanently alter the mobility.

What about cases where gum levels are just a bit uneven from one tooth to the next?  In the case of excess gums, it is easy to just remove the offending portion.  A laser can make quick painless work of that, with great long-term stability.

If there is insufficient gums on a tooth, it will be necessary to attempt to add some gum tissue, by way of grafting.  This can be evaluated and done at your local friendly periodontist’s office.

Contact us if you would like an assessment of your gummy smile or uneven gumlines!  There may be a solution to your problems beyond “not smiling too much”.  We’d love to be your dentist in Barrie.

 

Dr. Elston Wong Portrait

About Dr. Elston Wong

Dr. Elston Wong completed his dental degree at The University of Toronto in 1999 before arriving in Barrie in 2002. After graduating, he continued to learn everything he could about dentistry. Now he has taken the time to share important information for anyone to read.

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