What is a gummy smile?
A Gummy smile or excessive gingival display (EGD) is described as a lack of balance between the gingival margins’ static landmark and the upper lip’s dynamic positioning, defining the smile line.
While the patients’ subjective complaints express mostly their increasing concerns about their gummy smile affecting their social and professional roles, the clinicians may analyse the clinical features of the excessive gummy smile to make a correct clinical diagnosis on which an appropriate treatment procedure can be planned. Identifying the source of this aesthetic concern caused by a dento-alveolar, skeletal or neuro-muscular origin leads to a correct therapy plan.
What are the causes of gummy smiles?
In periodontal practice, altered passive eruption, mild vertical maxillary excess and hypermobile upper lip are interchangeably identified as gummy smiles. Causes of the gummy smile could be classified into 3 categories:
- Dento-alveolar aetiologies could be due to gingival overgrowth or dentoalveolar extrusion, also called altered passive eruption, which results in short clinical crowns.
- Non-dental-alveolar skeletal anomalies like excessive maxillary height or vertical maxillary excess are unfortunately recognisable after orthodontic treatment by dentoalveolar compensation.
- Oral facial soft tissue anomalies, including short and/or hypermobile upper lip.
What are the available treatment options for a gummy smile?
- The lip-repositioning procedure is one of the most performed procedures to rectify the gummy smile or excessive gingival display.
- The first category of gummy smiles with short clinical crowns would benefit from crown lengthening, implementing the correction of smile design or smile enhancement (please see the case studies).
- The second category of gummy smile would benefit from orthognathic or facial plastic surgical approaches.
- A Gummy smile caused by a short and/or hypermobile upper lip would benefit from myotomy (resection of the smile muscles. A periodic injection of Botulinum toxin-A (BTX-A) could effectively treat the gummy smile; however, this approach requires repeated treatments.
- To mask mild to moderate cases of excessive maxillary height combined with hypermobile upper lips, lip-repositioning or reverse vestibuloplasty procedures have recently been popularised to correct such gummy smile cases almost permanently.
Please consult with Dr Nico Kamosi for a complimentary consultation about the correction of your gummy smile by crown-lengthening or Smile enhancement treatment.
Gummy Smile Case Studies
See our gummy smile before and after photos from our happy patients.