A “gummy smile,” also known as excessive gingival display, is a common dental complaint that is seen more often in women than in men. It is the result of a disproportionate ratio of gum tissue to teeth. When someone with excessive gingival display smiles, an above average amount of gum tissue is seen above the teeth. While this is not medically dangerous, a gummy smile can often bring about feelings of self-consciousness.
What Causes a Gummy Smile?
There are multiple causes of excessive gingival display. Genetics can play a role. If multiple family members have gummy smiles, for example, the cause is likely genetics. Other common causes are teeth that did not fully erupt (altered active eruption), an upper lip that is too short, long gums (also known as gingival hypertrophy), altered pass eruption (gums that do not recede as one ages), or an overgrowth of the upper jaw (also known as vertical maxillary excess). There is little one can do to prevent a gummy smile. However, there are non-surgical and surgical treatment options available to reduce the appearance of excessive gingival display.
Because there are multiple causes of a gummy smile, it is important to establish cause before researching treatment options. Once you have been given an accurate diagnosis from your dentist, ask if you qualify for non-surgical treatments. Sometimes, the fix is as simple as a round of orthodontic care. If a patient’s excessive gingival display is mild and is caused by something like overall wear or genetics, a round of orthodontics can be used to shift the patient’s bite into a more natural position; this will reduce the overall effect of excessive gingival display.
Veneers and Botox are two additional non-surgical, cosmetic options worth consideration. Applying veneers or crowns to the patient’s teeth will lengthen the teeth in a way that the disproportionate ratio of gums to teeth becomes proportional. Botox is another non-surgical treatment, however, it is not permanent. The doctor will inject a serum into the patient’s upper lip. This results in temporary (around three months) paralysis of the muscle and prevents the upper lip from rising too high whenever the patient smiles.
Finally, laser gum contouring is an additional procedure that is slightly more complex than the non-surgical treatments aforementioned, but it does not require general anesthesia and can be done at a dental office. The process involves removing excess gum tissue in order to produce an aesthetically-pleasing result. Recovery takes anywhere from a couple of days to a couple of weeks.
If you have exhausted all non-surgical treatments and cannot utilize any of them due to a more complex cause of excessive gingival display, there are a few surgical treatments that have been shown to produce optimal results. Perhaps the most complex in regards to the overall procedure and recovery time is orthognathic surgery. In layman’s terms, orthognathic surgery is surgery of the jaw. If the jaw is what is causing a gummy smile, orthognathic surgery involves re-contouring and relocating the patient’s maxilla before
securing it with plates and screws. Before going under the knife, most patients with jaw protrusions that are moderate to severe will undergo a year of orthodontic treatment. The surgery requires a hospital stay and boasts a long recovery time, but those who have opted for orthognathic surgery to rid themselves of a gummy smile report very noticeable results.
Other surgical treatments that are not as extensive as orthognathic surgery include lip repositioning surgery and a gingivectomy. The latter is performed by a periodontist and involves the removal and reshaping of gum tissue in an attempt to expose more teeth and less gum. Lip repositioning surgery is utilized when the upper lip is the cause of a gummy smile. The muscles in the lip are severed so that the lip cannot excessively lift and expose too much gum tissue.
The best treatment for a gummy smile depends on the cause of a gummy smile. Because the procedure is not a medical necessity, it is wise to “shop” around and to get a second opinion if you have been told that surgery is your only option. If a gummy smile has you feeling self-conscious, ask your dentist to get to the bottom of why you have excessive gingival display and what the best treatment route is to take based on your overall diagnosis.