Ever heard the expression, “He/she was all gums?” It means that someone’s gums feature heavily in their smile. This “gummy smile,” as it’s known– is it really a problem? Not always. An issue that causes discomfort for one person may not phase another. The gummy smile is one such issue.
Definitions of the gummy smile vary depending on who you talk to. The condition occurs when some combination of gum tissue, tooth size, lip size/mobility and jaw structure isn’t in harmony. In a technical sense a gummy smile is anywhere between 2-4 mm or more of gum tissue that shows when someone smiles. It doesn’t sound like much, but I know the problem when I see it.
What Causes a Gummy Smile?
There are multiple factors causing a gummy smile:
1. A Short and/or Hypermobile Upper Lip
The size of the upper lip ranges between 20-22 mm in females and 22-24 mm in males. Typical lip mobility – the amount by which the upper lip moves when you smile – is between 6-8 mm. When the upper lip is smaller than these averages a person’s gums will show more when they smile. And if the lip draws upward more than the average amount the gums will again show more. Refer to Example A.
EXAMPLE A. SHORT AND/OR HYPERMOBILE UPPER LIP
Typical Treatments: Botox injections or cosmetic alteration of the lip by a plastic surgeon.
2. Overgrown Gum Tissue
In adolescence our permanent teeth slowly erupt through the gum tissue and develop into our adult bites. Some people’s gums don’t fully shrink back to normal levels once this happens, and remain higher up on the surfaces of the teeth. This makes teeth appear shorter and smaller, and the gums look much bigger. This “altered eruption” of the teeth leaves many young adults uncomfortable with their smiles. Refer to Example B.
EXAMPLE B. OVERGROWN GUM TISSUE
Typical treatments: Gum lifts, done either surgically or with lasers.
3. Unusually Long Upper jaw (Maxillary Excess)
When gums and teeth are in proportion, and the upper lip is of normal size, the smile may still show too much gum tissue. When this happens it is often because the upper jaw (maxilla) is too long compared to the rest of the face. Refer to Example C.
EXAMPLE C. UNUSUALLY LONG UPPER JAW (MAXILLARY EXCESS)
Typical treatments: Botox injections can address this issue to a certain extent, but it only really gets better with jaw surgery
4. Teeth Worn Down From Grinding and Bite Problems
Severe grinding and bite problems can cause substantial wear to the teeth. When this happens the jaw bone that holds teeth in place will grow to prevent the tooth biting against the opposite arch. With no space between the upper and lower teeth the gum part of the jaw (pink part) gets bigger and the tooth part of the jaw (white part) gets smaller. This is a difficult problem that is avoided with a proper diagnosis at an early age. Refer to Example D.
EXAMPLE D. TEETH WORN DOWN FROM GRINDING AND BITE PROBLEMS
Typical treatments: Orthodontics
Treating a Gummy Smile
There are many safe and affordable treatment options for correcting or altering the issues causing a gummy smile. It could be any of the treatments listed above, though the final decision depends on the specifics of the case and the dentist’s recommendation. If the issue truly affects one’s self confidence there is an argument to be made for correcting things to improve quality of life.
As mentioned, treatment for the symptoms above may include gum lifts, botox injections, orthodontics and complicated surgery. There is no single approach to each issue, and each issue rarely exists in isolation.
Proper diagnosis based on a patient’s dental history is the only sure way to ensure a treatment treatment plan is put in place. At my practice I ensure that patients have a full cosmetic record, including models of the teeth, photos, videos and facial measurement before making a diagnosis. Studying the situation ensures that the patient gets the treatment that’s right for them.
If you’re not happy with the way your smile looks, please get in touch with my office or speak to me when you’re next in.