Gummy Smile Treatment Vancouver, Kitsilano, Point Grey
Gummy Smile: Causes and Treatments
Gummy smile or excessive gingival display is a condition when a significant undesirable amount of pink gum shows during a smile.
Most people during smile, display some part or the full length of their upper front teeth with a small portion of gum attached above the teeth. However, the amount of gum showing can be so much in others that can affect their smile aesthetics and confident.
There are several reasons for a gummy smile, and treatment of this condition depends on the etiology of the excessive gingival display. This requires a detailed comprehensive extra and intraoral examinations and measurements which is in the scope of the expertise of Prosthodontists.
Most common reasons for gummy smile:
Sometimes short upper lips result in a gummy smile; in other cases, a normal length but hyperactive lips can result in gingival display, meaning excessive elevation of upper lip during smile or speech.
When teeth are worn, they appear shorter, and the proportion of tooth and gun showing is altered. This is often followed by an overgrowth of gingival tissues and supporting alveolar bone, which worsens the situation.
Altered passive eruption
When teeth erupt and emerge from inside bone and gums, a physiologic natural phenomenon occurs, and the surrounding gum moves in the opposite direction. This is called “passive eruption”. Gum’s apical migration sometimes fails to happen, which leads to short clinical crowns and excessive gingival show. The condition is called “Altered Passive Eruption”.
Some medicines have chemicals that can cause gum inflammation and gingival hypertrophy as their side effects. The most common medications are anti-epileptic, anti-depressants, and anti-hypertension medicines. .
In many cases, the underlying factor is positioning and proportion of facial bones, particularly upper jaw or Maxilla.
In cases with hyperactive lip function, Botox injection may improve lip’s posture and reduce gingival display. This treatment modality does not have a long term outcome.
This is a surgical technique to reposition short lips to cover excessive gingival display. The result of this approach might be unpredictable.
Gingival/Gum re-contouring (gingivoplasty)
Maybe the treatment of choice in mild cases with gingival overgrowth and altered passive eruption. This can be done with a laser or minimal surgical incision.
Surgical jaw bone repositioning
It is recommended in advanced cases in which significant correction required.
Crown lengthening/Gum reduction surgery
This is a very common and conservative procedure in improving the gum display. In this approach, a very careful analysis of the smile and a mock diagnostic up is used to define the amount of gum reduction. The procedure needs to be planned by a prosthodontist, while a periodontist will perform the gum reduction.