Published on Jun 05, 2021 and last reviewed on Nov 30, 2022 - 4 min read
Abstract
A smile that shows more of the gum line is a gummy smile, making the person conscious while smiling. This excessive gingival display hides his or her smile, resulting in a dent in self-confidence. Please read the article to know the reasons for gummy smiles and the treatment options needed to correct them.
An excessive display of gum while smiling is termed a gummy smile. A normal smile can display one-third of the teeth to entire teeth, with a bit of the gum visible. A gum display of more than 4 mm is usually considered a gummy smile. Sometimes there might be even 10 mm of gum displayed while smiling, making the person conscious while smiling. This makes the person hide his or her smile, resulting in a dent in self-confidence. This can also cause certain gum-related problems.
1) Short Upper Lip - Inadequate growth of the upper lip can make the smile appear gummy even though the teeth and gums are normal. Sometimes overactive lips which move more than the normal range of 6 to 8 mm can also cause such a condition. Overgrowth of the upper jaw or excessive growth of the upper jaw in the vertical direction or its such position can cause this condition. Even with normal lips and teeth, this can make the smile appear gummy.
2) Short Upper Teeth - Short upper teeth can also appear like a gummy smile even though the other factors may be normal. Excessive gum growth, intake of certain drugs, and certain conditions cause an overgrowth of gums making the teeth appear shorter and thereby giving the look of a gummy smile. Sometimes the gums may be naturally dark and pigmented, making the smile even more obvious.
It is needless to say that the treatment should be directed towards the cause. Typically, there will be more than one causative factor, which prompts a combination of multiple treatments.
1) Orthodontic Treatment: Displaced teeth can be pushed back to their original position by means of orthodontic treatment. Often, it is used with jaw surgery to correct the teeth in position before and after the surgery.
2) Oral Prophylaxis: Simple teeth cleaning would be effective in shrinking the gums if they had enlarged due to the presence of tartar. Deep cleaning below the gums can be added in stages if the inflammation associated is very high. And oral hygiene methods must be practiced consistently.
3) Lip Surgery: Lengthening of the upper lip by a surgical procedure can cover up a significant portion of the gums that are displayed during the smile. Frequently, it is done by a plastic surgeon in combination with an oral surgeon. A hyperactive lip can also be corrected with a similar procedure.
4) Gum Lift Surgery: Excessive gum growth can be removed by means of gum lift surgery and thereby restoring the gums to their original position. In case of jaw overgrowth, and sometimes, when jaw surgery is not feasible, camouflage gum surgery is performed to make the gums appear shorter. The gums are reshaped according to the requirement, and the recovery can be within a week. Of course, the procedure has its limitation that a maximum of only 2 to 3 mm correction is possible.
5) Jaw Surgery: Overgrowth of the upper jaw can only be amended by means of corrective surgery. The vertical height of the upper jaw has to be reduced in the procedure leading to upward displacement of the entire jaw. The surgical procedure will always be carried out by an oral and maxillofacial surgeon after careful planning, and it is done in combination with pre-surgical and post-surgical orthodontic treatment. This procedure is highly effective in that even defects of up to 10 to 12 mm can be corrected, resulting in a whole new appearance of the person. If adequate vertical displacement is not achieved using jaw surgery, then it can be combined with gum lift surgery to get rid of the gummy smile.
6) Muscle Relaxant Injections for Overactive Lips: Anti-wrinkle injections like Botulinum toxin (Botox) can be injected in and around the upper lip area to make it less flabby and seem longer. This is a temporary treatment and might have to be repeated every few months.
7) Crowns or Veneers: Short teeth can be compensated by placing crowns or veneers on the upper front teeth, which are longer and thereby restoring the normal height of the teeth. This type of treatment is done when orthodontic treatment is not possible, and also it is a time concern, but this type of treatment can be finished within a week.
It indeed depends on the causative factor for such a smile. Camouflage treatment can be done using gum lift surgery and crowns, but if there is a jaw defect, surgery is the only option.
Without correction, there is a chance that the person may not smile freely with confidence. They may cover the mouth while smiling or restrict the smile to minimize the show of their gums. This may cause low self-esteem, insecurity, poor relationship skills, and overall poor personality.
With the current technology and with the use of three-dimensional planning software, it is possible to plan the surgery accurately and predict the result beforehand.
LASERs are used in gum lift surgeries and can provide accurate shape to the gums after surgery. This technique is also bloodless, and recovery is quite fast. It can also be used for depigmentation of the gums and making them appear pink rather than a blackish shade.
The gums in the upper front teeth area can easily get inflamed and cause bleeding or discomfort while brushing. Sometimes it can be the first indication of gum overgrowth due to intake of certain drugs.
With the advent of so many treatment options, there is no need to carry the burden of a gummy smile throughout your life. Correction can result in shifting the focus from the gums to the teeth while smiling. Facial harmony can be achieved after the correction resulting in a balance between the smile and the rest of the face. This can allow the person to smile freely without any inhibition and improves their confidence. The dentist will decide treatment based on the causative factors, and most frequently, it will be a combination of one or more treatments to get an optimal result.
A gummy smile can be corrected with the help of various methods like gingivectomy. In gingivectomy, the crown portion of the tooth is exposed so that when an individual smiles, the gum line is in a higher position than the teeth. This helps restore confidence in an individual.
The following methods can be used in the treatment of a gummy smile:
- Orthodontic treatment.
- Veneers.
- Lip surgery.
- Gingivectomy.
- Laser gum contouring.
Orthodontists use braces to fix a gummy smile which helps to move the teeth to achieve an aesthetic smile. Braces may take a duration of 10 months to 1 year during the severity of the condition. During the treatment, the dentist may recommend avoiding hard food substances to prevent damage to the braces.
The treatment cost for a gummy smile may vary depending on the severity of the treatment. If the treatment involves a surgical procedure, the dentist may charge according to the complexity of the surgery performed. Most aesthetic treatments are expensive due to the complex procedure.
No, gummy smiles do not disappear on their own. First, a gum lift procedure is performed to expose the tooth structure, which helps eliminate the gummy smile. After the procedure, it may take a week for the gums to start healing.
If an individual maintains a healthy oral cavity, the chances of a gummy smile are rare. Usually, with aging, the gum lines recede, which may result in a gummy smile. So it is possible to have a gummy smile with age due to poor oral hygiene.
Gummy smiles may occur due to various reasons, specifically based on ethnicity. In addition, there are chances an individual may have a gummy smile due to genetic factors. It is more prevalent in women than men.
Gummy smiles are quite common in women and have about 14% of prevalence, while men have about 7% prevalence. If an individual’s family member has a gummy smile, there is a higher chance it may be hereditary. However, with treatment, gummy smiles can be corrected.
Orbecularis oris is the major muscle of the mouth that is responsible for the opening and closing of the mouth. Other muscles of facial expression are also responsible for a gummy smile. Botox injections are injected above the upper lip if an individual prefers a gummy smile.
If a smile is more than 3 mm of gingival tissue exposure, it is considered a gummy smile. Generally, if the distance between the gum and the lip is 4mm or more, it is declared unattractive by the dentist. However, gummy smiles are not harmful, so it is not mandatory to undergo treatment.
The insurance coverage for gummy smiles depends on the type of policy. If the gummy smile is deemed medically necessary, the insurance may approve it. However, surgery done for cosmetic reasons is unlikely to be approved by the insurance provider. Various financing options like medical credit cards may help manage the cost.
A low lip line or a toothy smile is the opposite of a gummy smile. A large portion of the teeth is visible when an individual smiles with relaxed lips. Moreover, the gum tissue is exposed, which creates a more youthful and pleasing smile with teeth more prominent.
Last reviewed at:
30 Nov 2022 - 4 min read
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