Hiding your smile because of your gums?
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By George Malkemus  May 23, 2014 12:00 am

Ever see a person smile and see more gums than teeth? That condition is called a gummy smile. Often times, the gum tissue partially hides the upper teeth. 

Many times, more gum tissue than teeth is seen when smiling or laughing. In the perfect smile, the upper lip sits just above the top of the teeth. But for people with a high lip line, too much of their upper gum is revealed, creating the gummy smile.

The unflattering appearance of highly visible gums causes many people with a high lip line to avoid smiling or place their hand over their mouth when they smile, laugh or train their facial muscles to limit their smile. Usually, there is no physical health effect from a gummy smile, but there can be a psychological affect. Many of my patients say that they never smile because of the look of their gummy smile. They are self-conscious about their smile and it can affect their personality and self-confidence.

The good news is a gummy smile can be easily corrected. What a wonderful change for a person after a smile makeover.


Gummy smile makeover

A few years ago I treated a successful, 32-year-old businesswomen to whom smiling did not come naturally. She had a gummy smile. In grade school, she was the victim of cruel taunting from her classmates. She tried to ignore their remarks about her “short” teeth, but their words deeply hurt her. By the time she began middle school, she was so withdrawn and shy that her teacher suggested that she talk to the school counselor. Eventually, she learned to smile without parting her lips. Whenever she laughed, she would always cover her mouth to avoid embarrassment.

Today, however, that is all behind her. She knew she needed to correct Mother Nature’s mistake. She felt an engaging smile was critical to her work success. After a smile design and gum sculpturing, she has a full radiant natural smile that she always wanted. No more excess gum tissue covering the tops of her teeth. She feels her new self-confident smile has made her a greater success in life and work. She confided in me that it was the best thing that she has ever done for her business. Establishing immediate rapport with a winning smile is so vital in building relationships.

Studies have shown that 93 percent of communication between people is non-verbal. Only 7 percent of what people react to is the content of what is being said. What is most important is the person’s body language and facial expression. A beautiful positive smile helps make people listen to you and respond in a positive way.


What can be done?

Gummy smile can be corrected in various ways, depending on the severity. If only small amounts of gum tissue need adjusting, then a soft tissue laser can be used to contour the gums to a pleasant smile line level. If greater levels of gum tissue need contouring, then surgical sculpting is needed. In many cases the gummy smile can be corrected with orthodontics. In all cases, a smile design workup is necessary to determine the best treatment.

A soft tissue laser is a new technology that is used to sculpt gums and soft tissue around the teeth. Light emitted from the laser removes the excess gum tissue, cutting at the cellular level, only the width of the wavelength of light. The cut is so fine, there is no bleeding and often no discomfort. Such fine control with the laser allows predictable shaping of the gums. Using a soft tissue laser is a quick procedure that also results in fast, excellent healing.

In more severe gummy cases, bone recontouring is necessary to allow the ideal shaping of the gums. A gum specialist, called a periodontist, usually does this procedure after a smile design by the cosmetic dentist.

Though the gums are often sculpted for cosmetic reasons, the procedure is important for health reasons as well. Perhaps the tooth has a large decayed area below the gum. The laser can be used to contour the gum to allow access for the decay removal and shaping of the gums to allow better cleaning when brushing and flossing. This procedure is called a gingivectomy, the Latin word for gum removal.

If a tooth fractures at the gum line, there is not enough remaining tooth for a crown to grip firmly. The crown needs to be extended below the gum. The gum tissue can be decreased in a procedure called crown lengthening or tooth lengthening. Once the gum tissue is removed and the gum heals, a permanent crown can be fabricated.

Dentistry has come a long way. When I started practice in Rohnert Park in 1985, silver/mercury fillings were the norm. (I have not done one in more than 20 years.) Cosmetic dentistry was for movie stars, and they had to have all their teeth ground down for crowns. Now, with modern technology, with the likes of the laser, all things are possible from smile design makeovers using braces, bonding, veneers, crowns and implants. And with sedation dentistry, it can even all be done while comfortably asleep. Gummy smile is one of many aspects of dentistry that was not even talked about 20 years ago and can now be easily corrected.

Frown and you frown alone, but smile and the whole world smiles with you.

Enjoy life and keep smiling.


George Malkemus has a family and cosmetic dental practice in Rohnert Park at 2 Padre Parkway, Suite 200. Call 585-8595, or email info@malkemusdds.com. Go to his website at www.malkemusdds.com.

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