Excess of gingival tissue display during smiling is called as gummy smile. Smile is very subjective , some patients are ok with excessive gingival display and some are not . Gingiva is a part of the oral mucosa that covers the alveolar process of the jaws and surrounds the neck of the teeth in a collar like fashion . Gummy smile has no adverse effects it only hampers aesthetics for some patients . Abnormal tooth eruption or jaw discrepancies with improper bite give rise to gummy smile. Before going further with the treatment the dentist examines the size, shape of the tooth, face and lips to get good results to restoring in the smile.
Causes of Gummy Smile:
1. Hypertonic upper lip
2. Short upper lip
3. Vertical maxillary excess( overgrowth of maxilla , short ramus )
4. Altered active and passive eruption
1. Gummy smile due to hypertonic upper lip/ short upper lip: Lip repositioning surgery – the upper lip is brought closed to the teeth by making an incision at the mucogingival junction from inside the lip . Partial thickness flap is removed and the underlying connective tissue is exposed The lip is then pulled down and sutured to the teeth . This is done so that the lip cannot retract much
2. Gummy smile due to excessive gingival display :
a) Gingivectomy : The excessive gums are cut by scalpel or laser .The gums may replase to their original position then the procedure has to be repeated a few months later .
b) Crown lengthening with osseous surgery : In this both gingiva and bone surrounding the roots of the teeth are trimmed for more stable results to attain smile correction . Tooth size should be kept in mind before performing this procedure
3. Gummy smile due to vertical maxillary excess: Orthodontic surgical correction is required in such cases. However if gummy smile is not associated with severe skeletal discrepancy intrusion of anterior teeth can be done .
Proper selection of treatment options, diagnosis and patient cooperation are key factors in achieving satisfactory results for gummy smile correction.