What is a Gummy smile? A person’s smile can be called a gummy smile if a significant amount of gingival (gums) tissue can be seen by others when that person smiles. A gummy smile by itself is not considered to be unhealthy or abnormal. It has been long considered by dentists a normal variation of human anatomy. Many people with a gummy smile tend to be very self conscious of how they smile, and tend to not smile as broadly.
A gummy smile tends to make the teeth look short and unhealthy. The gingival tissue should be at or just above the neck of the tooth, called the cementoenamel junction. In cases of a gummy smile, the tissue may cover 50% or more of the teeth. The gummy smile can be caused by a variety of things. These can include higher than normal bone tissue, possible incomplete eruption of the tooth, excess gum tissue, or abnormally thick gingival fibers. The presence of excess gum tissue makes maintenance of oral hygiene very difficult or at least more difficult than for patients without a gummy smile. This can lead to unhealthy tissue that can bleed easily as well as increased risk for tooth decay. The excessive tissue will allow food and bacteria to get lodged underneath, causing red, swollen gums and bleeding. This early situation is called gingivitis. Gingivitis is the earliest form of periodontal disease. If this goes untreated the gingivitis
leads to periodontal disease with progression toward tooth loss. Most people notice this just on the front teeth but it can also happen in the back teeth as well.
Cosmetic dentistry is a great way to fix the gummy smile problem and can be quite rewarding for patient and doctor alike. Upon final completion of a case the results are usually quite dramatic. The completed result is usually noticed by everyone around the patient increasing their self esteem almost immediately. Changing the way you smile can positively change your outlook on life. Patients tend to smile more, and feel more confidence and pride in appearance. When patients return for follow up visits they almost always report they should never have waited so long to have this treatment done. It is that dramatic.
Using cosmetic dentistry to correct a gummy smile is very straightforward. There are two separate procedures to fix a gummy smile. The type of procedure needed depends on the cause of the gummy smile. Whether it is removal of excess gum tissue or, removal of excess bone, or a combination of the two.
Cosmetic Dentistry Procedures to fix a Gummy Smile
1) Gingivectomy. A gingivectomy is simply the removal of excess gum tissue. By removing the excess tissue and reshaping the gums, you end up with a very cosmetic result. During this procedure a very small amount of gum tissue needs to be removed. The Dentist will generally use a laser, an electrical cautery unit, or periodontal incisions to complete the reshaping and removal of gum tissue. Although the procedure is generally quite painless, local anesthetic is necessary. The treatment requires no sutures and typically the gingival tissue heals within 1-2 weeks. A gingivectomy is usually the prescribed procedure when only a few teeth are affected by the gummy smile. Sometimes, the bone must also be remodeled to correct the problem. Which leads us to #2…
2) Crown Lengthening. During this procedure, excess gum and bone tissue is removed and reshaped to expose more of the natural tooth. This can be done to one or more teeth to expose a natural, even, wide smile. This procedure is a bit more advanced but still relatively easy to perform by a trained dentist or specialist. The gum tissue is removed in the same way as in a gingivectomy, the bone removal requires rotary instrumentation.
There is a very low risk of complications for both procedures. Any discomfort following the procedures can usually be handled by over the counter medications. Patients will see results immediately. But over the next few weeks following the procedure it will look even better. This is because the gingival and bone tissues need time to fully heal. Once fully healed they will see the full effect of a beautiful and healthy smile and can say goodbye to their old gummy smile!