Having excess gum tissues while smiling can affect your confidence and discourage you from displaying your teeth. This is a condition known as gummy smile or excessive gingival display. Luckily, it’s a treatable condition that you can correct. At the La Puente Advanced Dentistry, we are here to fix your gummy smile. We want to help you be proud of your smile. Make an appointment with us and learn more about how we can help you.
Definition of Gummy Smile Treatment
There’s no exact definition of a gummy smile. The definition rests in the eyes of the beholder. A perception for gum line can be affected by the:
- The height and shape of your teeth
- Your lips movement when you’re smiling
- The angle of your jaw compared with your face
Generally, when the gum is exposed for three to four millimeters, it’s considered disproportionate and can be referred to as a gummy smile.
Causes of Gummy Smiles
Several factors can cause gummy smiles. Genetics plays a significant role in a gummy smile, but several other factors are associated with this condition. Here are a few causes of gummy smiles that you should know about.
Genetics and Anatomy
Genetics plays a big role in their gummy smiles for most people, especially when combined with a large jaw, short upper lips, and small teeth.
In some rare cases, a gummy smile can result from a hereditary condition known as hereditary gingival fibromatosis (HGF). This is a slow but progressive enlargement of keratinized gingiva that can be enough to result in speaking problems.
Changes in your body’s anatomy, like hormonal imbalances associated with puberty and pregnancy, can also cause a gummy smile.
Poor Dental Hygiene
Keeping your teeth dirty can lead to plaque buildup. Plaque allows bacteria to find their way under your gum, making it inflamed and enlarged.
People wearing braces can also find themselves dealing with gummy smiles indirectly. Patients with braces don’t regularly floss or brush their teeth since the braces can cause obstruction. Bacteria can end up building around the gum, causing inflammation and a gummy smile.
Altered Tooth Eruption
Some people experience an uneven eruption of their teeth, a situation referred to as altered passive eruption. APE can cause a person to appear “gummy” since the gums partially cover one or several of their teeth since they don’t fully protrude into the mouth.
This does not significantly play as a health risk, but it can affect the aesthetic of a person’s smile hence the need for treatment.
Side Effects of Certain Medication
All prescription drugs have certain side effects. Certain medications can lead to the enlargement of the gums. Some of these drugs include:
- Immunosuppressants like Cyclosporin A, which is used during transplants
- Phenytoin, which people with epilepsy use
- Heart disease medications like Verapamil, Diltiazem, and Nifedipine
Types of Gummy Smile Treatment
Once you contact a dentist for your gummy smile treatment, they will diagnose the exact cause of the issue and determine the best treatment option. Here are the common treatments that you can choose from.
Crown lengthening is a procedure used to reshape your gums to achieve the desired tooth or teeth length. This procedure aims to expose other tooth surfaces, and if possible, adjust your bone level. Here is a detailed view of the crown lengthening period.
The Crown Lengthening Procedure
The crown lengthening procedure starts with an injection of a local anesthetic. You can ask your dentist to combine it with sedation if you desire it. The selected area of the tissue will be reduced and contoured by removing some tissues. The goal of the procedure is to lengthen your appropriate teeth and achieve an optimal symmetry of the gum line.
The duration that this procedure lasts depends on the number of target teeth. It also depends on whether you will have to remove both the soft tissue and the bone. Your dentist will start by examining your teeth to check whether there are signs of decay or damage before handling the procedure.
Your dentist will then make a small incision to allow the gums to be pulled away, expose the tooth’s surface, and expose the root of the bone. Removing the gum is necessary to expose enough teeth. The dentist will sterilize the area with salt after exposing the tooth and suture the gum back in place.
In severe cases, your dentist might decide to remove a bit of your bone. They will gently free your gum tissues from the tooth and bone and pull back, exposing the bone to support the tooth. Your jawbone’s width and height will then be reduced and contoured to reposition your gum.
You should return to your normal routines in a few days, and the gum will completely heal in about one or two weeks. However, you can return to the clinic for a comprehensive treatment plan if needed.
Botulinum Toxin(BT) Injection
You can also treat your gummy smile with Botox. The best thing about this procedure is that it’s not invasive and is quick. The procedure depends on a Botox with a botulinum toxin type A which relaxes your muscles in the upper lip when injected. This procedure aims to limit the rise of your upper smile while smiling and ensure that your gum remains covered.
Your dentist will inject two or more units of Botox in the area between your nose and upper lips to reduce your “gummy” smile and create a more appealing and natural smile.
This treatment aims to relax your upper lip and ensure that it no longer elevates when smiling. This treatment is extremely effective and usually lasts for three months. In most cases, you’ll be getting more time between treatments as you continue using this procedure. The results are almost immediately after treatment, but a full experience occurs within two weeks.
Botox carries several advantages over other treatments for gummy smiles. Some of the benefits include:
- You’ll experience a little bit of discomfort, especially after repetitive care
- Recovery is almost instant as soon as the procedure is completed
- The procedure is cost-effective than surgical
- The results are quick and natural
- You can adjust the injections based on the results you intend to achieve
Orthognathic surgery is a type of corrective jaw surgery that you can use to correct your gummy smile. It’s a complex procedure that involves a dental surgeon and an orthodontist. You might need to use braces on your teeth before and after your surgery until you achieve the desired results.
What to Expect in an Orthognathic Surgery
Your orthodontist and surgeon will perform the surgery under general anesthesia. It takes place in a hospital and would require a two to four days stay.
The dental surgeon will perform the surgery inside your mouth. So, you shouldn’t expect any facial scars on your chin or around your mouth. However, the dental surgeon might make small incisions outside your mouth.
The process starts by cutting the jawbones to move them to the correct position. Once the jaw movement is completed, they will place small plates, screws, and rubber bands to secure the bone into its new position. These screws, which are smaller than those used for braces, integrate into the bone structure as time goes by.
In some cases, the surgeon might add extra bone to the jaw. The bone can be transferred from your rib, leg, or hip and secure with screws and plates. In some cases, the oral surgeon might reshape the bone to allow a better fit.
The initial jaw healing process takes six weeks after the surgery, but it can take twelve weeks to heal completely. In about six weeks, your orthodontist will finish aligning your teeth with braces. This takes the entire process for several years, especially when the braces are removed and retainers are used to hold your teeth in position.
Lip Reposition Surgery
Lip reposition is a procedure used to correct a gummy smile by reducing the amount of lip that rides up your smile. Some people refer to it as reverse vestibulopathy or a “gummy tuck.”
You probably think that the procedure is scary, right? Well, you don’t have to be afraid of the procedure since it’s probably less invasive than you would think.
A lip reposition surgery lowers your lip through a straightforward procedure. An oral surgeon will only need to remove a small band of gum tissue from under your lip. The hum tissues are then saturated into a lower position. No scars will form once the place heals. You don’t also have to worry about any changes in the outer part of your face while smiling. The only difference that you’ll notice is that your lips will pull much higher when you smile.
Please note lip reposition surgery isn’t good for all people with gummy smiles. It’s only suitable for people whose upper lip rises too high when they smile.
The lip reposition surgery is a simple process that takes about forty-five minutes to complete. An oral surgeon can complete the process with local anesthesia or IV sedation. Most patients complete the procedure using local anesthesia, but those with high anxiety opt for IV sedation.
Recovering from a lip reposition surgery takes three to five days. You’ll be experiencing moderate pain and swelling during this time, but they’re manageable with antibiotics and medications. You can get back to work or school after four days but will have to avoid strenuous activities for about two weeks.
The best way to heal after a lip reposition surgery requires you to avoid laughing or smiling during the four-week healing period. Smiling too much while healing stretches the stitched area, and the lip healing might be slightly higher than you intended.
Temporary Anchorage Devices
Temporary anchorage devices or TAD attach to the upper jaw bone and allow individual teeth to reposition by gradually pulling them upwards using force. The procedure might seem painful, but you’ll experience little or no pain. Your oral surgeon will remove the TADs once the teeth shift to the desired position.
The process might seem unappealing, but you should remember that it will not last forever, but your healthy smile will!
Hyaluronic Acid Injection
Your dentist can also suggest hyaluronic acid injection as a way to correct your gummy smile temporarily. The procedure involves the injection of hyaluronic acid fillers into your upper lips. The fillers restrict the movement of muscle fibers for a maximum of eight months.
You should note that injecting fillers has some risk, though it’s rare to experience any complication. However, it’s possible to damage your blood supply, leading to stroke, blindness, or tissue loss. You can also affect your body’s immune system if your body reacts to hyaluronic acid.
Potential Risks and Complications of Gummy Smile Treatment Options
Every gummy smile treatment option comes with its potential risks and complications. These complications can either be severe or mild. Here is a breakdown of the few risks and complications associated with gummy smile treatment.
Risk of Crown Lengthening
Although crown lengthening is a safe procedure, there are several risks associated with this procedure. For instance, exposing too much of your teeth can lead to more sensitivity to hot or cold. The experience can last for a few days, while it might be permanent to other patients.
Some patients might experience excessive bleeding after a crown lengthening procedure, although it involves minor bleeding. The oral surgeon will provide a coagulant to ease this complication if it happens.
Risk of an Infection
Just like any other surgery, there’s a risk of infection associated with a crown lengthening procedure. The risk of an infection might be a result of poor dental hygiene during the recovery process. You might be having an infection if you experience redness, fever, discoloration of the gum tissues, and severe swelling.
Risks Associated with Botox Treatment
There are possibilities of experiencing several risks with Botox treatment, although it’s a relatively low-risk gummy smile treatment. The few risks associated with this treatment include:
- The requirement to maintain it for twelve to sixteen weeks depending on the Botox dosage
- May involve slight swelling and redness around the injection site
- May fail to provide drastic results to some patients
Risks Associated With Orthognathic Surgery
The complexity of Orthognathic surgery brings along several potential risks and complications. These risks are as follows:
- Blood loss
- Jaw fracture
- Relapse of the jaw to its original position
- The need for a further surgery
- Need for root canal therapy on specific teeth
- Nerve injury
Risk Associated With Lip Reposition Surgery
Lip repositioning surgery can increase the risk of pain, bleeding, or infection, although it tends to be relatively safe. Some patients might also experience discomfort, bruising, and swelling, though these side effects are usually minimal. Most scars are usually hidden inside the mouth.
The Costs of Gummy Smile Treatment
The cost of gummy smile treatment differs according to the specific treatment that your dentist recommends. Below is a breakdown of the estimated costs of different types of gummy smile treatment.
The Cost of Crown Lengthening Procedure
Crown lengthening costs an average of $1,000 to $4,000 if the procedure is purely based on cosmetic improvement. However, if it’s part of your dental treatment, your dental insurance can partially cover some of the costs to offset the costs.
The Cost of Orthognathic Surgery
Orthognathic surgery is one of the most expensive forms of gummy smile treatment. If you have to pay the full cost, you can part with $20,000 to $40,000 per tooth. Orthognathic surgery might seem expensive, but its results are long-lasting or permanent.
The Cost of Lip Repositioning
The cost of lip repositioning depends on the place you live. On average, your dentist will charge between $500 to $5,000 for the surgery.
The Cost of Temporary Anchorage Devices
TAD or temporary anchorage devices are a less expensive and invasive form of treatment than surgery. They cost around $3,000 to $6000 for each device.
The Cost of Botox Treatment
Botox is another less expensive gummy smile treatment option. On average, it would cost around $400 for an injection. However, this option has a major drawback since you’ll be requiring an injection every three to four months, which might be expensive in the long run.
The cost of Hyaluronic Acid Treatment
The use of hyaluronic acid is a less expensive option than surgery. It costs an average of $682 per vial.
Follow-Up Care after Gummy Smile Treatment
Although every gummy smile treatment is different, the alteration of the gum results in similar healing processes. Understanding your recovery requirements ensures that your healing goes as planned. Taking the right care of your gum tissues is also essential in avoiding pain. Some of the follow-up care that you can use are as follows:
- Use of over-the-counter pain treatments to ease your pain
- Limiting your physical activities for at least a week
- Restricting yourself from eating small seed fruits, crunchy foods, and anything hard
- Brush and flossing regularly to keep bacteria off the tissues and affect the healing process
- Follow up with your dentist as scheduled. If you notice swelling, bleeding, and pain for the first week after the procedure, contact your dentist
Find a La Puente Dentist Near Me
Now you have familiarized yourself with information you need to know about gummy smile treatment. The next step is consulting a gummy smile specialist. At the La Puente Advanced Dentistry, we provide a full spectrum of gum adjustments procedures that will get you the look you want. Contact us today at 626-626-7075 and schedule an appointment with us.