The Definitive Guide for A Gummy Smile
I am confident this is the most comprehensive guide you will find on the internet regarding a gummy smile and crown lengthening.
In this guide, I will share with you my knowledge, life-changing stories, and experiences around crown lengthening and the treatment for a gummy smile.
My name is Dr. Rana Shahi, DDS, MS, MSD, and owner of LA Periodontics & Implant Specialists --- which is one of the leading periodontal centers in Los Angeles and Brentwood, California.
So if you're troubled by a gummy smile, I hope that you will find value in this guide.
DR. RANA G. SHAHI
Diplomate, American Board of Periodontology
DDS, MS, MSD
Gums Got You Down?
Your gums play an important and crucial role in the health of your teeth. They surround and protect your teeth, forming a pink cradle for your teeth to comfortably sit in.
Unfortunately, many people suffer from what can only be described as a “gummy smile”.
What this means is that in relation to the size and length of their teeth and lips, the relative proportion of their gums is disproportionately large. There is simply too much of the gums showing resulting in visually unappealing aesthetics. In cosmetic parlance, patients are said to be exhibiting “excessive gingival display”.
CHAPTER 1
What Is A Gummy Smile?
A gummy smile is a smile where the gums take up an unusually large amount of the visible space around the teeth. In the world of dentistry, this is called an “excessive gingival display.” While excessive gingival displays do not often interfere with essential functions like speaking or eating, they can nonetheless be frustrating to those who have them.
This frustration has resulted in a demand for corrective treatments, and thanks to some of the latest in dental technology, there are several treatments that are available. The treatment that works best for you will be the one that best addresses the cause of your gummy smile. There are several to consider.
Signs of A Gummy Smile
Many patients and doctors find that about a 2 millimeters of exposed gums are an ideal rule of thumb for the amount of gums that should be exposed in a perfect smile. Of course, the exact amount and proportion of exposed gums to teeth will vary from one patient to the next. In many ways, what constitutes a “gummy smile” may be somewhat subjective. What one person may see as too gummy may be barely noticeable for another person. If you suspect that you may have an unnaturally gummy smile, look for these basic signs:
Ribbon of exposed gums above the teeth
More gums than teeth are showing when smiling
Upper teeth appear too short or too small
More than 2 millimeters of exposed gums
Gummy Smile: Before and After
CHAPTER 2
What Causes A Gummy Smile?
Gummy smiles may be the result of several underlying conditions, including developmental issues involving the teeth and jaws, high lip lines and the overproduction of gum tissue.
Causes for A Gummy Smile
Oversized gums may be the result of problems that first occurred when your baby teeth began to be replaced by adult teeth. If adult teeth don’t come in at the right speed or angle, the gum tissue around them may expand in unwanted ways, covering more of the tooth than is necessary.
Problems with the development of the jaw during childhood and adolescence can also lead to gummy smiles. An overbite occurs when the upper jaw extends out farther than the lower jaw. This condition partially conceals the lower teeth and results in a smile where the gums are overly prominent.
High lip lines are often genetic and can result in gummy smiles. When you have a high lip line, it means that your upper lip rises higher than average when you smile. Instead of centering the place where your teeth meet, your smile will center your upper teeth and expose a significant amount of your upper gums.
The muscle that controls the lip can also become overactive. When this happens, the lip will behave differently and rise a higher distance when you smile.
Sometimes, excessive gum tissue develops without a clear underlying cause. The teeth may be of average size, but the gums grow until more of the surface of the tooth is covered than is necessary to protect them. This may be the result of genetics or a response to a one-time or persistent stressor.
In addition to these causes, there are a variety of different oral conditions that can result in the teeth becoming ground down so that they appear smaller. You should consult your dentist to find out what is causing your excessive gingival displays. Once you’ve settled on a cause, you may benefit from one of the following treatments.
Treatments for A Gummy Smile
Braces are a low-impact treatment that can reduce the prominence of gums by bringing the teeth and the jaws into proper alignment. When implemented by a dentist, braces can reposition the teeth so that they are correctly centered in the mouth. Naturally, this treatment is only useful in cases where the cause is related to misaligned teeth or bones.
Dental lasers are one of the most effective treatment options in cases where there is excessive gum tissue without other underlying causes. Lasers can cut away excess tissue while sealing blood vessels as it goes—resulting in more of each tooth being visible without a lengthy recovery period.
There are a variety of surgical procedures that apply to gummy smiles. Surgery is available to contour gums so that they are the ideal size where they reveal the teeth without exposing any sensitive areas. Surgery is only necessary for gums in cases where there are significant amounts of excessive tissue.
Jaw surgery is another option that may address gummy smiles. The jaw may be implicated in cases where the upper teeth are gummy because the maxillary bone is pushing down on the upper teeth and causing the gums there to expand.
Surgical Solutions for A Gummy Smile
Orthognathic surgery
Orthodontics
Lip repositioning surgery
Botox
Crown lengthening surgery (Gum Recontouring)
Orthognathic surgery, or corrective jaw surgery, is primarily reserved for patients with severe jaw deformities. In these cases, gum recontouring may be included as a part of a more considerable effort to correct jaw misalignments, bite issues, and other serious structural problems.
Orthodontics can also be a potential solution to a gummy smile for patients suffering from malocclusion or misaligned teeth.
Some cases a gummy smile are the result of defects with either the structure or shape of the lip or the lip muscles. Short lips can result in a gummy smile as well as a condition known as hyperactive upper lip in which the upper lip muscles move too far up, exposing too much of the gums when smiling. In most cases, the most straightforward and lasting solution is to have a lip repositioning surgery done. However, in some cases, it is also possible to use Botox to temporarily disable a hyperactive muscle.
However, in most cases and for the vast majority of our patients, we recommend a procedure known as “crown lengthening.”
CHAPTER 4
What Is Crown Lengthening?
There are many names for a crown lengthening procedure including a gingivectomy, crown exposure, gum lift, and gum recontouring. These all broadly refer to the same cosmetic procedure and have the same end goal: to reduce or eliminate some of the gingival tissue in order to minimize their visual impact.
By strategically removing, reducing, and reshaping the gums, a skilled periodontist can give a patient’s teeth the appearance of increased length.
This is important for rebalancing a person’s smile. The goal is to visually reduce the proportion of the gums to the teeth in order to create a more appealing whole.
How Does Crown Lengthening Work?
A crown lengthening procedure can be executed to simply expose more the tooth and thus lengthen the look of the tooth, or it can be a precursor for the placement of an actual cosmetic crown.
In both situations, the goal is to remove some of the gum tissues or underlying bone tissues in order to expose more of the tooth.
The Crown Lengthening Process
The entire crown lengthening process will often take no more than one hour to a few hours depending on the extent and scope of the lengthening process and whether underlying bone structure may be affected. If the removal of bone is necessary, the process becomes much more complex and may necessitate the use of various different tools.
Otherwise, a typically lengthening process can be done in relatively little time and with simple incision tools. The entire operation is incredibly straightforward:
Every crown lengthening procedure starts with an initial consultation with Dr. Shahi or Dr. Pattison. This allows us to align our goals and expectations with those of our patients. This also allows us to make proper medical recommendations and identify potential challenges.
Before any surgery can proceed, the first step is to identify, treat, and eliminate any oral diseases and infections. It is especially important to take care of periodontal disease, infections, or gum issues prior to a crown lengthening procedure.
On the day of the procedure, patients will receive local anesthetics to make the entire operations a pain-free experience.
The first step of the surgical portion of a crown lengthening procedure is to make small incisions in the gums in order to make a flap. This allows the periodontist to access underlying soft tissues or, if necessary, bone tissues.
Once an access incision has been made, the periodontist or maxillofacial surgeon may remove as much or as little of the underlying tissues as necessary to properly expose more of the targeted tooth.
After enough tissues have been removed, the flap of tissue made with the initial incision is sutured back in place. The entire area is treated and bandaged in order to encourage healing and reduce the chance of infection or sepsis.
After suturing and bandaging, the surgical portion of the procedure is complete. However, the crown lengthening process itself still isn’t done. The patient’s gums must be allowed to heal - a process that will take a few months to as long as six months to fully heal.
During this healing process, patients may be on a limited diet and require additional follow-up appointments with Dr. Shahi or Dr. Pattison for monitoring and corrective action should any problems arise.
Don't Let Your Gums Get In The Way of A Beautiful Smile!
Don’t let your gums get you down. With a simple and straightforward crown lengthening procedure at LA Periodontics and Implant Specialists, you can have the perfect smile you’ve always dreamed about. You can have a smile that isn’t gummed up by excessive gingival tissue and is instead characterized by dazzling white teeth. Instead of a gummy smile, you can have a beautiful smile - all it takes is one appointment at LA Periodontics and Implant Specialists.