Excessive gingival display also known as gummy smile, is a condition in which a high lip-line exposes an abnormal amount of gingival tissue. Several potential factors could contribute to a gummy smile. For example, the muscle controlling the movement of the upper lip could be hyperactive, resulting in an upper lip that rises higher than normal. When this occurs, more of the gingival tissue is exposed when smiling. Other factors can include, but are not limited to, delayed passive eruption and factors related to the dentogingival complex.
Causes
There are several possible causes of gummy smile, including:
- An excessive display of gum tissue in your upper jaw can result from the abnormal eruption of the teeth. Teeth covered by excessive gum tissue appear short, even though they may actually be the proper length.
- The muscle that controls the movement of your upper lip could be hyperactive, causing your upper lip to rise up higher than normal. When this occurs, more of your gum tissue is exposed when you smile.
- The manner in which your upper jaw bone grew and developed could cause the appearance of a gummy smile. For instance, if there was an excessive bulging protrusion of the upper jaw within the gum tissue, you would experience an obvious gummy appearance when you smile.
Gummy Smile: An Esthetic Problem or Something More?
The smile line or esthetic zone – the teeth that are showing when you are smiling – is determined by several factors, including:
- The shape and size of your lips.
- Your facial muscles.
- The shape and size of your teeth.
- Your gum tissue.
The optimal smile line appearance should reveal the least amount of gum tissue possible. Gum tissue visible in the smile line should have balanced, even contours that are in harmony with the upper lip. It is for this reason that many people with a gummy smile or excessive gingival display feel their smile to be unattractive, oftentimes feeling reluctant to smile at all.
However, depending on the factors causing a gummy smile, more serious underlying dental conditions could be present. For example, if you have a gummy smile caused as a result of how the teeth erupted and how the jaw developed, you may also have an uncomfortable or improper bite that could ultimately affect your long-term oral health.
If you think you have a gummy smile, visit your dentist for confirmation and treatment options. Your dentist will examine your mouth, teeth and gums to determine the extent of the excessive gingival display and any possible causes. This examination may involve conventional and/or digital impressions of your teeth and gums. You may also need X-ray imaging so that the tooth roots and jaw bone can be carefully examined.
If you suffer from a severe gummy smile, your dentist may refer you to a specialist, like a periodontist, orthodontist or an oral surgeon. Depending on the nature of your specific clinical condition, treatment for your gummy smile could include one or more of the following:
- Same-day laser treatments (in minor cases).
- Surgical lip repositioning.
- Orthodontics (braces) to move the teeth into more suitable positions.
- Surgical Sculpting of the gingival tissues and bone to create healthier and more attractive looking gum contours.
- Maxillofacial surgery to reposition the bone.
For example, according to the American Academy of Periodontology, a periodontist, a dentist specializing in the gums, soft tissues and other structures supporting the teeth can perform a “crown lengthening” procedure to correct the appearance of a gummy smile. During this procedure, the periodontist will remove the excess gum tissue and possibly bone in order to expose more of the tooth’s surface. This Surgical Sculpting procedure can be performed on one or more teeth to create an even gum line or a more natural looking smile.
As a result, gummy smile sufferers see more of their teeth when they smile and less of their gums.
