What makes a smile gummy is a matter of perception, but studies have shown that a smile will usually be perceived as gummy when 4 millimetres or more of gum tissue shows.
There are four major causes of a gummy smile and many different treatment options available.
Why do I have a gummy smile?
There are 4 major causes of a gummy smile.
Tooth problems
Compensatory eruption
If wear occurs relatively slowly the teeth will try to maintain proper biting relations to those they oppose by erupting slightly to compensate for this wear.
As a result of the tooth moving downwards, the gums (which are attached to the teeth) will also move downwards giving the appearance of short stout teeth with a gummy smile. The biting edges of the teeth however will appear in a relatively normal position.
Supereruption from poor anterior coupling
At times the upper teeth sit further forward relative to the lower teeth than they should. As thy erupt into position, they do not come into contact with each other and effectively slide past each other.
As the tooth moves down too far, it brings the gum that’s attached to it along for the ride.
Gum problems
Gums can become overgrown from mouth breathing, certain medications or poor oral hygiene
Lip problems
Your upper lip is too mobile
In most people the lip will travel 6 – 8 mm from its normal resting position to its full smile position.
A “hypermobile” lip travels further than this and reveals more gum tissue
Your upper lip is too short
The jaw bone and teeth size can be correct, while the lip is just too short thus displaying more gum than desired.
Jaw problems
Your upper jaw bone is longer than normal
The cause of almost all gummy smiles is the upper jaw being too vertically long for the face and the amount of lip tissue.
An even amount of excess gum tissue can be seen over the front and back teeth.
What is the treatment for a gummy smile?
The treatment for a gummy smile depends on the cause and includes:
Orthodontic braces
Braces are the ideal treatment choice if teeth have erupted further than they should have (due to compensatory eruption or from poor anterior coupling).
The teeth would be pushed towards the gum, back into their correct position.
After they are correctly placed, the lost tooth structure is restored with porcelain veneers or crowns, or composite veneers
Gum treatment
Professional teeth cleaning.
One of the responses to gum disease, or certain medications is swelling. A thorough professional clean of the tooth and root surfaces should reduce gum swelling Medical advice could be sought to assess if an effective medication can be found that does not have this side effect.
Gum lift
Excess gum tissues and underlying bone are reshaped to expose more of the crown or the root of the tooth.
Jaw surgery
Bone shortening (Orthognathic surgery) is often not done unless there is over 7mm of gums showing.
It is a procedure whereby the whole upper jaw is surgically positioned upward.
A specialist Orthodontist and Oral Surgeon are involved in the process.
Botox injection
Botox injected into the right area can temporarily “paralyze” the muscles involved in lifting the lip.
This is an extremely simple procedure but it needs to be repeated every 6 months as the effects wear off.
Lip Surgery
Lip mobility
Surgery can be performed to restrict the movement of the upper lip and can make a dramatic difference.
Such a procedure is usually carried out by an oral surgeon, or a plastic surgeon.
It may be carried out to correct a hypermobile lip rather than using Botox.
The major advantage of this treatment is that it is permanent.
Lip lengthening
A surgical procedure may be performed to lengthen the upper lip.
This procedure is more difficult than restricting its movement as the effects of smiling and contracting scar tissue will work against any lengthening effort.
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