What Is a Gummy Smile?
A gummy smile is a condition where the upper gums are excessively exposed when smiling, affecting the aesthetics of the smile. This condition is quite common, occurring in approximately 6% of men and 14% of women.
A smile is classified as"gummy smile" when the upper gums are exposed beyond 2mm, classified into three levels:
- Mild: 2–4mm
- Moderate: 4–8mm
- Severe: Over 8mm
An ideal smile should reveal no more than 2mm of gum tissue.
Benefits of Treating a Gummy Smile
Treating a gummy smile helps achieve a naturally beautiful smile by revealing more of the bright, white upper teeth. At the same time, procedures that reposition or remove excess gum tissue reduce the surface area where bacteria can accumulate, improving the patient's overall oral hygiene.
What Causes a Gummy Smile?
A gummy smile stems from four main causes:
- Overgrowth of the upper jaw bone, leading to a protruding jaw.
- Overactive upper lip elevator muscles, pulling the lip too high when smiling.
- An excessively short upper lip, fails to adequately cover the gums.
- Disproportionate development of teeth and gums — enlarged gums or gum tissue that continues to grow after the teeth have stopped.
Gummy Smile's Treatment Methods
Illustration of the benefits of gummy smile treatment
To improve or fully resolve a patient's gummy smile, the doctor will identify the primary cause and recommend the corresponding treatment:
For overgrown upper jaw case, causing a protruding jaw (overbite), the doctor will perform Maxillary prognathism / Overbite correction surgery.
For cases involving overactive muscles, the doctor will administer B.o.t.o.x injections to relax the muscles and reduce the lifted range when the muscle activated.
For cases where the upper lip is too short, the doctor will perform Lip Repositioning surgery, which lengthen the lip to provide enough coverage of the excess gum tissue.
In remaining cases, the doctor will perform Gingivectomy, or gingival removal.
Lip Repositioning Surgery Procedure's details?
Upper lip lengthening surgery is a technique that removes a portion of excess mucosa to narrow the distance between the upper lip and the tooth body. This method preserve the gums or gingival tissue, ensuring a naturally beautiful result.
Illustration of upper lip lengthening surgery
The steps:
Incision design:
The doctor examines the patient's condition to determine the area and location of the mucosa to be removed.
The width depends on the width of the smile, typically extending from the first or second premolar on one side to the first or second premolar on the other side.
The height of the mucosa to be removed is usually double the amount the lip needs to be lowered in order to fully correct the gummy smile.
Based on these parameters, the doctor marks the incision lines:
- Lower incision: Lie along the mucogingival junction, which may be 1–2mm higher or lower depending on the case.
- Upper incision line: Lie at the base of the vestibule, no more than 12mm from the lower incision line.
Performing the Surgery:
After designing the incision lines, the doctor administers local anesthesia to ensure the patient's comfort throughout the procedure.
The doctor makes incisions along the marked lines, then separates the mucosal layer. This is a procedure requiring high expertise, adhering to the following principles:
- Do not compromise the vermillion border of the lip.
- Maintain a minimum of 2–3mm of attached gingiva on all teeth within the surgical area.
- Ensure the post-surgical vestibular depth does not interfere with any functions of this area.
The doctor sutures the upper and lower wound edges with absorbable sutures, shortening the distance between the tooth body and the lip border, effectively treating the gummy smile condition.
Post-Operative Care and Recovery
The recovery period for this surgery is relatively short, lasting 1–2 weeks depending on the case. Patients may experience swelling, pain, or a feeling of tightness when smiling immediately after surgery, but these symptoms will gradually subside over time.
Patients should follow the doctor's instructions to ensure a smooth and comfortable recovery:
- Keep the treatment area clean: Avoid vigorous brushing; use mouthwash instead.
- Avoid touching the treatment area.
- Eat soft or liquid foods.
- Take all prescribed medications regularly and on time.
- Apply cold compresses within the first 48 hours to reduce swelling.
* The final result also depend on individual's physiology.
