Different Treatment Methods for a Gummy Smile Depending on Its Cause?

Hello.

Today, I would like to introduce gummy smiles, which are a source of self-consciousness for many people.

The term “gummy smile” means a smile in which a lot of gum is visible.

As people age, the skin on their faces sags, causing less of the upper teeth and increasingly less of the lower teeth to show.

This is one of the changes associated with aging.

If you look closely at older people when they speak or smile, you will often see that their upper teeth are barely visible and only their lower teeth can be seen.

In that sense, a gummy smile can be considered a symbol of youth.

When an older person shows a great deal of their upper teeth, they look energetic and youthful when they smile.

This is because the amount of upper-tooth exposure when a person speaks or smiles is a very important factor in whether they look young or old.

It is somewhat different from static features such as nasolabial folds or the length of the philtrum when the face is expressionless.

The aesthetics of movement when smiling are called “dynamic esthetics.”

BLACKPINK’s Jennie, whom I personally like and mention often, is also a representative celebrity whose gums are highly visible when she smiles, and her gummy smile is part of her cute appeal.

However, aesthetics are highly subjective, so although a gummy smile may be an attractive feature for Jennie and an advantage that makes an older person look youthful, it can be a major source of self-consciousness for someone else.

Even for the same person, a gummy smile that feels like a source of self-consciousness when they are young can become a feature that makes them look youthful 30 years later.

In any case, today’s topic is gummy smiles, so I will explain how they can be addressed with orthodontic treatment.

When the front teeth and gums have descended too far?

On a side-view X-ray, the vertical distance between the upper lip and the edges of the front teeth is called the amount of anterior tooth exposure, and 2 mm is considered normal.

If this distance is more than 2 mm,

the upper front teeth and gums are diagnosed as having descended overall.

A gummy smile can be addressed through orthodontic intrusion, which moves the front teeth upward into the jawbone.

(Mini-screws are needed to move the front teeth upward into the jawbone. When the front teeth are moved upward into the bone, the gums rise along with them.)

But what happens if you leave the molars as they are and move only the front teeth upward?

The smile line will be disrupted.

Just like in this photo.

The smile line is the curve formed by the upper teeth when you smile.

If only the front teeth are moved upward among the upper teeth, this smile line becomes inverted.

If you look at the photo below, the yellow line representing the upper lip forms a curve that descends in the center, while the line connecting the white front teeth rises in the center.

It looks awkward and unattractive.

If orthodontic treatment is being performed to move the upper teeth into the bone because of a gummy smile caused by excessive front-tooth exposure, the entire dentition—not just the front teeth—must be moved upward, including the molars.

That is the only way to address the gummy smile while maintaining the smile line.

This includes orthodontic intrusion of the entire upper dentition, often described as orthodontic treatment that makes the face look smaller and shortens a long face.

When the gums cover too much of the teeth

The ideal height-to-width ratio of a tooth is 1:0.8.

If the vertical height looks too short and cramped compared with the tooth’s horizontal width,

it can be addressed simply with gum contouring without orthodontic treatment.

Gum contouring is a procedure in which the gums are trimmed using an electrocautery device after applying only a small amount of anesthesia. You can think of it as being similar to removing a mole from facial skin. The slightly burnt smell is similar as well.

Many people are frightened by the term “gum contouring,” but, like mole removal, there is no bleeding immediately after the procedure and you can return to your daily activities right away, so there is actually no need to be afraid.

When the philtrum is short, or the upper-lip muscles are highly active when smiling, causing the corners of the mouth or lips to rise excessively

A gummy smile can be addressed in the simplest way in these cases.

Botox is injected into the muscles that lift the upper lip when smiling to reduce muscle activity.

The photo below shows an example of a gummy smile addressed with Botox.

Addressing a gummy smile with Botox

What about cases involving a short philtrum?

I am sorry, but this concerns soft tissue, so it is appropriate to consult a plastic surgeon.

I do not know whether plastic surgery clinics offer an operation to lengthen the philtrum.

(There is an operation that shortens a long philtrum by making an incision beneath the nose.)

In fact, aside from these causes, there are also many cases in which the lips lift when smiling because the front teeth are protruded or angled outward, making a lot of gum visible.

In these cases, simply moving the front teeth significantly backward through orthodontic treatment for protruding teeth can often improve the gummy smile considerably.

Ultimately, the most important thing is an accurate diagnosis.

After analyzing X-ray images, carefully assessing the activity of the muscles around the lips when smiling, and considering the horizontal-to-vertical proportions of the teeth, the exact cause of the gummy smile must be identified through a thorough examination and addressed using the appropriate method.

That concludes this information about treatments for gummy smiles.

I hope you are able to address your concerns with the treatment method that is right for you.