What Causes a Gummy Smile?

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Do you show too much gum tissue when you smile? Why is this and can it be fixed?

The official term for a “gummy smile” is excessive gingival display. Excessive gingival display can be the result of several different conditions and the best way to correct it depends on the underlying cause. There are three primary components of the smile that determine how much gum tissue is visible, 1) lips, 2) teeth & supporting bone and 3) the gums themselves.

If all other factors are normal, the upper lip may be responsible for a gummy smile if its to short or active. It is not hard to imagine that if your upper lip is too short to cover the teeth and gums at rest, your gummy smile may be a result of the inadequate lip length. If your lip length is normal at rest but lifts up too high when you smile, you may have a hyperactive or “hypertonic” lip. It is important to consider the length of the upper lip before moving the teeth or jaws to match it. If the rest of the face is normal, changing it to match a short lip may make the face look too short. There are now surgical procedures that can be done to both lengthen the lip and reduce its tonicity (usually by relaxing associated muscles).

If your lip length and muscle activity are normal then it may the position of your teeth or jaws. Sometimes, the jaws are in a normal position but the teeth are just too long. Alternatively, the teeth may be the right length but the entire upper jaw is overdeveloped. If the teeth or jaws are only slightly long, braces alone or braces with TADS (temporary anchorage devices) may be enough to intrude the long teeth and “tuck” the attached gum tissue back under your upper lip. It is very important that the teeth or jaws are only repositioned if it has been determined that the lips and amount of gum tissue are normal.

Lastly, if your lips, tooth length, and upper jaw size are all normal, it may be that the gums themselves are just too long (gingival hypertrophy or teeth that just haven’t fully erupted). This can be determined by an orthodontist. The specialist can tell where your gums lie on the teeth and if they really are too long. If so, the remedy is to have a periodontist surgically remove the excessive gum tissue or gingivectomy.

Since there are so many variables that come into play, it is important that your gummy smile be diagnosed by a specialist (an orthodontist) before any fix is prescribed. If you show too much gum tissue because your upper lip is too short or overly active, the treatment should address your lips and not the teeth or jaws. If, however, the problem lies with your teeth or jaws, you should correct those and not try to fix the problem by changing the lip or gum position. Orthodontic specialists are experts in evaluating the lips, teeth and jaws, gums, and how they all work together to create an attractive smile.

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