You may have noticed that you or someone you know shows what seems to be an excess of gums when smiling. There are many reasons why this condition may exist, but before this is understood it’s important to know that there is a range of what is considered ideal and that the assessment of what is beautiful on an individual is ultimately subjective. Studies across many fields of study have found that the common features are what are considered to be beautiful. For orthodontists, the determining the appropriate amount of gums showing (called “gingival display”) is age dependent because our upper lip thins and moves lower as we age. It has also been found that more gingival display is more attractive on women than men.
If you and your orthodontist agree that you have an excess of gingival display, the following treatments may be recommended:
Gingivectomy or Crown Lengthening
These procedures are done by a periodontist (a gum specialist) to reduce the amount of gum tissue covering the teeth. This would be indicated if the cause of the gummy smile is an overgrowth of gums.
Your orthodontist is able to move your upper front teeth up, thereby reducing the amount of gums showing when smiling. However, there are limits to moving the teeth in this way with braces and it is a challenging movement to perform. Sometimes the use of mini-screws placed in the bone between the teeth are able to be used to perform this movement.
Sometimes the cause of excessive gingival display is the excessive height of bone in the upper jaw (known as Vertical Maxillary Excess). The only way to correct this is to remove this extra bone in the upper jaw. Depending on the skeletal relationship of the upper and lower jaws, the lower jaw may have to be surgically advanced or set back in order to accommodate to the new and ideal vertical position of the upper jaw.
If you show too much gums when smiling, it can be because the muscles in your upper lip are “overactive”, which raise and thin your upper lip too much. Botox can be selectively placed along the smile muscles to slightly reduce their activity, resulting in the ideal amount of gingival display.
Plastic Upper Lip Surgery
Lastly, some people have a shorter than average upper lip height (while having normal upper jaw bone height). Therefore, your lips may also be unable to close while relaxed. A facial plastic surgeon can allow your upper lip to be more moveable (downward), thereby decreasing gingival display. This should be done with caution because you may end up regretting it when you’re older after your lip covers more of your teeth when smiling!
What treatment is best for you depends on the factors discussed and more! Ultimately the severity of the amount of gums showing and its impact on self-esteem must be considered by both the patient and doctor. There are so many things that make you beautiful! It’s not always a worthwhile improvement to try to be like others right now! A slightly gummy smile in your teen years will mean you appear younger in your 40’s. 😉