A smile can be a cover letter and one of the most common ways to express happiness, satisfaction or pleasure. However, for some it may be uncomfortable because doing so reveals more gingiva than they would like.
This fairly common condition is known as excessive gingival display or gummy smile. Let’s see what this is about.
Experts say that there is no exact definition to decide what a gummy smile is, since it is largely determined by self-perception or the impression of the other. That is, what for someone is excessive gum exposure, for another it may be normal.
Generally, 3-4 millimeters of exposed gum line is considered disproportionate, resulting in a gummy smile. The height and shape of the teeth, movement of the lips when smiling and the angle of the jaw are also considered.
According to different research, several factors can contribute to a gummy smile:
- Lip changes: the gummy smile can occur when there are abnormalities in the development of the upper lip or when you have hypermobile lips, that is, they move dramatically when one smiles, exposing the gum line.
- Altered passive eruption– In many cases the way permanent teeth grow can result in a gummy smile. For example, if the gums covered more of the surface of the teeth when they erupted, a condition called altered passive eruption could lead to a gummy smile.
- Dentoalveolar extrusion: occurs when the teeth in the front area grow too large, also triggering a growth of the gums.
- Vertical maxillary excess– Occurs when the bones of the upper jaw grow larger than normal.
- Gingival hyperplasia: occurs when the gums grow too large around the teeth. This can occur as a result of taking certain medications, such as those used to prevent seizures or treat blood pressure.
- Even age, sex (predominantly in women), or genetic inheritance can be responsible for the development of a gummy smile.
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How to treat a gummy smile
If you have a gummy smile and it causes you discomfort, you can consult a health professional to evaluate you, make a diagnosis and determine the best treatment. Among the most common options are:
Hyaluronic acid is usually given in injections to treat a gummy smile when it is caused by hypermobile lips. Fillers restrict the movement of the muscle fibers of the lip for up to 8 months.
Experts warn that, although rarely, it is possible to suffer some complications, such as loss of tissue, blindness, or stroke. It can also happen that the immune system reacts to hyaluronic acid and forms a nodule.
Botulinum toxin injections, better known as Botox, can help camouflage the gummy smile when it occurs due to excessive displacement of the upper lip when smiling.
This treatment involves some problems, such as the need to repeat the injections every 3 or 4 months, or the risk of affecting the smile due to an excess of Botox.
When the origin of the gummy smile is in the disposition of the jaw, the health professional may recommend orthognathic surgery.
It is a procedure that seeks to balance the length of the upper and lower jaw by removing a section of bone from the upper jaw. The jaw will then be reattached with tiny plates and screws. If necessary, adjustments can also be made to the lower jaw.
Recovery usually takes between one and a half to three months, and elastics may be needed to keep the jaw in proper position while it heals.
Before performing this surgery, it may be necessary to wear braces or other orthodontic devices to ensure that the teeth and arches of the mouth are properly aligned.
Temporary anchoring devices
Temporary anchor devices are small screws that are implanted into the bone of the mouth. It is a good option to place the teeth in a position that reduces the gummy smile without the need to undergo surgery.
Another surgery that is usually recommended to treat a gummy smile is gingivectomy, which consists of removing the excess upper gum. It is performed under local anesthesia and is also performed to correct the jawbone.
After surgery, your gums will likely bleed and hurt for about a week, and more than one session may even be necessary. However, the results can be permanent.
As its name implies, lip repositioning is a surgery that is used when the position of the lips causes a gummy smile. It seeks to change the position of the lip in relation to the teeth.
In this operation the surgeon makes two incisions in the lower part of the upper lip and removes a section of connective tissue from the area, and then sews the incisions. It is a procedure that takes no more than an hour.
After the operation, analgesics and antibiotics can be prescribed, and recovery is expected after a week. The results are usually permanent.
The smile or gingival display is a condition that is characterized by revealing more gums than is intended when smiling.
It is quite common and its diagnosis often depends on the self-perception or impression of a third party. It can be due to musculoskeletal or lip alterations, age, sex or genetic inheritance.
To treat it, you can resort to Botox or hyaluronic acid injections, temporary anchoring devices or surgeries such as orthognathic, gingivectomy or lip repositioning.
Sources consulted: US National Library of Medicine, Mayo Clinic, National Institute for Dental and Craniofacial Research.