Causes of a Gummy Smile and How to Fix It

A smile that shows much gums can be subjective. Some would say it affects the facial aesthetics negatively, while others claim it to be attractive.

A pleasant smile is considered a symbol of beauty and well-being in the modern society. A variety of factors including teeth form/position and gingival tissue levels may influence the overall smile aesthetics.In the last decade, a keen interest was focused on periodontal plastic surgery as a reliable tool to enhance aesthetic. Now since we know the perceived value of a smile, what causes gummy smiles?

Women smiling

What causes a Gummy Smile?

One of the commonest factors is an abnormal eruption of the teeth. Teeth covered by excessive gum tissue appear short, even though they may be the proper length.

Secondly, the muscle that controls the movement of your upper lip could be hyperactive causing your upper lip to rise higher than normal. When this occurs, more of your gum tissue is exposed when you smile.

Also, the manner in which your upper jaw bone grew and developed could cause the appearance of a gummy smile. For example, if there were an excessive bulging protrusion of the upper jaw within the gum tissue, you would experience an obvious gummy appearance when you smile.

Along with gingival recessions (receding gums), the excessive gingival display during smiling is a common condition impairing smile aesthetics. This condition is frequently related to an altered passive eruption (APE) of teeth mostly due to developmental or genetic factors that may lead to the persistence of excessive soft tissue amount over the enamel surface.

In fact, after the completion of active eruption phase, a passive eruption with an apical migration of soft tissue occurs. During this process the epithelial junction apically shifts to the cementoenamel junction (CEJ) level, thus reaching a final position of the gingival margin slightly coronal to the CEJ. This basically means a loss of gum tissue and/or retraction of the gingival margin from the crown of the teeth, which exposes more gum in your smile.

More severe cases may also be associated with the hyperplastic growth of maxillary skeletal base. The prevalence of altered passive eruption (APE) is reported to be approximately 12%. This condition may create aesthetic concerns due to the display of excessive quantity of gingival tissue at upper anterior teeth when smiling (gummy smile).

How to improve the look of a gummy smile?

There are a few ways to go about fixing the gummy smile, including gummy smile surgery – though not all cases require surgery. Here’s some of the ways gummy smile can be fixed:

1) Lip Lowering – The upper lip is re-positioned to make the gum line less exposed.

2) BOTOX – To reduce high pulling effect and lets the upper lip better rest over the gum tissue. Studies have shown gummy smile treatment with on botulinum toxin into the levator labii superioris alaeque nasi muscle is an efficient method, with minimum risk of complications and very high patient satisfaction.

3) Gum Contouring/Gum Leveling – Removes excess gum tissue around the teeth.

4) Crown Lengthening – Gum tissue is removed, the bone is modified, and the gum line is re-contoured to establish a longer crown appearance.

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