Understanding and Treating a Gummy Smile

When you smile, ideally, your teeth should be the star of the show. However, for some, an excess of gum tissue can overshadow their pearly whites. This condition, often referred to as a gummy smile or excessive gingival display, is more common than you might think, affecting 10.5% to 29% of the population, with a higher prevalence in females. According to the International Journal of Surgery Case Reports (IJSCR), a smile is classified as "gummy" if more than 2 millimeters of gum is exposed. Several factors can contribute to a gummy smile: Altered Tooth Eruption: Sometimes, teeth don't fully emerge during childhood, leaving more gum tissue visible. Vertical Maxillary Excess: This occurs when the upper jawbone grows excessively or the upper teeth move too far downward. Hyperactive Lip Muscles: Muscles in the upper lip, such as the levator labii superioris and levator anguli oris, can be overactive, lifting the lip higher than normal when smiling. Fortunately, if you have a gummy smile, there are various treatment options available. Consulting with your dental professional is the first step, as they can accurately diagnose the cause and recommend the most suitable treatment plan. Common Treatments for a Gummy Smile Here are three primary approaches to addressing a gummy smile: Crown Lengthening This procedure is performed by a periodontist, a specialist in gum health. As described by the American Academy of Periodontology, crown lengthening involves precisely removing excess gum tissue to expose more of the tooth's crown and reshaping the gumline to a more aesthetic position. The IJSCR article clarifies that this procedure can involve two parts: Gingivectomy: The direct removal of surplus gum tissue. Osseous Surgery: The removal of excess bone and reshaping of the jawbone, if necessary. The extent of the procedure depends on the individual's specific needs and the amount of excess gum tissue and bone. Botulinum Toxin (BT) Injections While commonly associated with smoothing facial wrinkles, Botulinum Toxin (BT) has diverse medical applications, including the treatment of gummy smiles caused by overactive upper lip muscles. An article in the Journal of Clinical & Diagnostic Research notes that small, precise doses of BT can be injected to limit the over-contraction of these muscles, which helps the lip to sit lower when smiling. The effects of BT injections typically last for three to six months, requiring repeat treatments every six months to one year to maintain the desired outcome. This procedure can be performed by dentists or medical doctors with appropriate training. Orthodontic Treatment or Surgery If a gummy smile stems from the downward positioning of the upper teeth or excessive growth of the upper jawbone, an orthodontist, who specializes in teeth and jaw alignment, may be able to help. The IJSCR explains that orthodontic appliances might be used to gently push the teeth upward. In more complex cases, the orthodontist may collaborate with oral surgeons to surgically reposition the teeth and jaw to achieve a balanced smile. Ultimately, if you are concerned about a gummy smile, discussing it with your dentist is crucial. They will guide you toward the most appropriate treatment option based on the underlying cause of your condition.