What If Your Gums Show a Lot When You Smile? Causes and Orthodontic Treatment for a Gummy Smile

Q. Can a gummy smile, where a lot of gum shows when smiling, be improved with Invisalign?

Hello.

This is Yonsei Baro Dental Clinic, a Gangnam orthodontic clinic.

When a lot of gum shows when smiling, it is commonly called a “gummy smile” or a “gum smile.”

More people than you might think are concerned about gummy smiles, but many do not know exactly what causes them.

Today, I will explain the causes and treatment methods for gummy smiles and introduce an actual case in which a gummy smile and protruding lips were improved together using Invisalign.

There are various causes of a gum smile, or gummy smile.

If the gums are the cause, a simple gum-contouring procedure at a dental clinic may be sufficient.

If the teeth have descended too far, they can be moved upward through orthodontic treatment at an orthodontic clinic.

If the muscles are pulling the corners of the mouth upward too strongly, the issue may be addressed with Botox at a dermatology clinic.

A difficult case to address is when the philtrum is short.

There is a reason plastic surgeons often perform philtrum-shortening procedures but rarely perform philtrum-lengthening procedures.

After people reach their 40s, the philtrum naturally becomes longer, so most people want a shorter philtrum.

As aging begins, the muscles around the mouth lose elasticity and volume decreases, making the philtrum appear longer and the lips thinner.

Even when smiling naturally, less of the upper teeth gradually shows, while more of the lower teeth becomes visible.

Having a short philtrum and showing a lot of gum may be considered a concern at the moment, but in middle and old age, it can become a feature that makes you look younger.

Today’s post shows how a patient with a gummy smile caused by the teeth and gums being positioned too low improved the gummy smile during Invisalign treatment.

This patient visited us hoping to resolve the appearance of protruding lips and a gummy smile through Invisalign orthodontic treatment.

22.08

A slight “walnut chin” and protrusion can be seen.

22.08

Looking inside the mouth, the angle of the front teeth already shows that they are tilted inward.

This was a case that required particularly careful treatment by the orthodontist.

If the front teeth are protruding forward as part of a protruding mouth, treatment is relatively easy.

Whether by extracting teeth or using the space from the wisdom teeth, moving the front teeth backward reduces their angle, resolves their forward inclination, and naturally improves the protruding mouth.

If the front teeth are moved too far backward, however, they can become excessively inwardly tilted.

In this case, the front teeth needed to be moved backward because of the protruding lips, but they were already tilted backward like inwardly tilted teeth.

That made the treatment more challenging.

To improve the gummy smile as well, the front teeth needed to be moved upward without tilting farther backward.

We decided to extract the two small upper premolars and began Invisalign treatment.

2022/09 Gummy Smile

The Invisalign aligners arrived after a month and a half, immediately after the extraction of the two small premolars.

The gum smile, or gummy smile, was quite pronounced.

There was also a period during treatment when the patient did not wear the aligners properly, so they had to be remade once.

23.07

Mini-screws were placed near the front teeth, and elastic bands were attached to the Invisalign aligners.

The goals were to improve the inward tilt of the front teeth and the gummy smile.

This was not part of the treatment plan established at the beginning.

Some patients experience improvement in their gum smile without these additional appliances.

Because this patient had both inwardly tilted front teeth and a gummy smile, improvement would have been slow with the aligners alone, so mini-screws and elastic bands were added.

The more difficult the orthodontic treatment, the less likely it is that good results can be achieved using Invisalign aligners alone.

When mini-screws and additional anchorage are needed, elastic bands that the patient can remove and put back on are also necessary.

23.11

The patient diligently wore the elastic bands for four months, and when we took the following photographs,

23.11

The gummy smile had improved significantly.

22.09~23.11

22.09~23.11

About one-third of the extraction space remained.

22.09~23.11

As the protruding appearance was improved, the muscles around the mouth became more natural.

The walnut chin also relaxed.

The remaining process is to eliminate the remaining extraction space while maintaining the angle of the front teeth.

Treatment methods for a gummy smile vary depending on its cause.

With an approach based on an accurate diagnosis, both a gum smile and protruding lips can be improved through Invisalign orthodontic treatment alone.

I hope this case is helpful to those who are concerned about a gummy smile or excessive gum exposure.

I will also post the patient’s final photographs in a future post.