7 Causes of Gummy Smile
There are many reasons for a gummy smile, and for each one there is a different treatment modality.
1.The Height, Shape, and Size of theTeeth
The Teeth may appear short because they have not erupted properly and remain partially covered by gum tissue. The Teeth are small in comparison to the gums due to wear attrition or genetically small teeth
2.Too Short Upper Lip
The average length of the upper lip and the philtrum is about 20 to 24 millimetres and the average movement between a lip at rest and a lip at a smile is 6 to 8 millimetres
When the upper lip is normal in length at rest but lifts too high when smiling displaying a lot of gum tissue is called Hypermobile Lips
3.Gums Hypertrophy
Gum hypertrophy or enlargement can occur due to several reasons such as hormonal changes in pregnancy or puberty, use of certain medications such as phenytoin or cyclosporins, certain gum tumours, or bony tumours arising from jaw bone which can, in turn, show up excess gum tissue.
4.Vertical Maxillary Excess
Vertical maxillary excess can be simplified as excessive growth of the upper jaw that makes the gums bulge out. These patients usually exhibit lip incompetence (Inability to join upper and lower lip at rest) and present with a long face.
In over eruption of the maxillary anterior a gummy smile is caused by excessive vertical growth of the maxillary anterior Dental alveolar complex.
5.Mouth Breathing
If the person has the habit of breathing from the mouth due to enlarged tonsils, adenoids, or any other breathing issues they usually present with an open mouth and inflamed gums and cause gums to show up and lead to a gummy smile
6.Medications
The use of certain medicines such as Phenytoin to treat epilepsy, Cyclosporins for immunosuppressants, or some anti-hypertensive drugs can lead to gum enlargement and excessive display of gums
Treatment of Gummy Smile is based on its cause.
- Gum Surgery ( Crown Lengthening )
- Lip Lengthening.
- Orthodontic Treatment.
- Orthognathic Surgery.
- Botox injections for upper lip.
- Lip Fillers.
- Treatment of Systemic Causes.
Crown Lengthening
Crown lengthening is a surgical procedure that removes excess gum tissue to expose more of a tooth's structure. It is a procedure to address an excessive gingival display, otherwise known as a gummy smile.
A person with a gummy smile appears to have short teeth. Their teeth are actually the typical size, but excess gum tissue partially covers them. The crown is the part of the tooth that is visible above the gumline. Some people request crown lengthening for cosmetic purposes, while others need the procedure to expose decayed or broken areas of teeth.
Our periodontist may perform crown lengthening procedures to address cosmetic concerns, expose cavities beneath the gumline, expose fractured areas of tooth, expose more tooth structure before they can fit a device such as a bridge. Our periodontist, a gum specialist may perform a crown lengthening to expose more tooth structure before they can fit a bridge or perform another restorative dental procedure.
The following are different crown lengthening techniques: gingivectomy apically repositioned flap surgery surgical extrusion. Dr. Abhishek Verma will choose the most appropriate technique based on the cause of the excess gum tissue and the condition of the person’s mouth.
Some factors that can influence the choice of technique include: aesthetic considerations the length of the tooth’s root, compared with its crown, called the crown to root ratio the proximity of the root the appearance of the root the presence of bone loss the position of the affected tooth or teeth the need for a filling or cap Gingivectomy A gingivectomy is the removal of gum tissue — using a scalpel, a laser, or electrocautery.
lasers may produce better results than scalpels: People who undergo laser gingivectomy may have less pain, heal more quickly, and experience less bleeding. Meanwhile, electrocautery Trusted Source may be as effective as lasers. This approach involves using an electrically heated instrument.
The gums can heal from a gingivectomy quickly. Any pain usually goes away within a few days to 1 week, and complete tissue healing typically occurs in 4–6 weeks if the surgery only involves the removal of gum tissue.
Apically repositioned flap surgery
This involves making an incision in the gums to create a flap of tissue. The periodontist then lifts the flap to remove extra tissue and possibly bone, depending on how much of the tooth they intend to expose.
Next, they reposition the flap toward the root of the tooth and use stitches to keep it in place as it heals. They may also place a dental dressing or bandage over the area.
Surgical extrusion
Surgical extrusion involves moving the tooth to the desired location on the gumline. A periodontist may utilize this method when a tooth is fractured beneath the gum. When restabilizing the tooth, they may use stitches. These may dissolve over time or require removal. The dentist may also use wire or a splint to anchor the tooth to the surrounding teeth.
Recovery after crown lengthning
Recovery can depend on the type of procedure, and the dentist who performed it will give detailed instructions. The area is numbed during the procedure so that the person does not experience pain. However, the person may experience discomfort or pain as the anesthesia wears off.
Some people require anti-inflammatory medication, such as acetaminophen or ibuprofen, to relieve pain and inflammation after the procedure. Minor swelling and bleeding can be expected for the first few days after a crown lengthening.
Our Periodontist Dr. Abhishek Verma may recommend applying a cold compress to the area to help with pain and swelling. During recovery, consume a soft diet and rinse the mouth with water after meals. The dentist may also prescribe a chlorhexidine mouthwash for use twice a day after the surgery.
After the initial healing phase, the pain and swelling will fade and the gums will continue to shrink. If the dentist is going to fit a device, such as a bridge, they may wait for healing to complete. Full healing in the back of the mouth may take 6–12 weeks
