There are several causes of a gummy smile, including excessive gum tissue, excessive bone around teeth (sometimes causing short teeth and/or jaw protuberance), disproportionate jaw formation, a short upper lip, and/or a hyperactive upper lip. Dr. Holland will provide a thorough evaluation to determine the cause(s). He will consult with your restorative dentist and potentially an oral surgeon and/or orthodontist to offer options to achieve the desired result.
Because of the different causes of a gummy smile, there are several treatment options to consider. In the case of excessive gum tissue, a gingivectomy is performed where the extra gum tissue is removed.
With excessive bone around teeth, a gingivectomy is sometimes performed in conjunction with aesthetic crown lengthening. Incisions are made to access and reshape the bone and gums to make the teeth appear longer. This procedure is sometimes performed together with veneers or crowns on the front teeth to create ideal contours for a beautiful smile. Your restorative dentist would plan the veneers or crowns and pass the information on to Dr. Holland so he can place the gums in the correct position.
When looking at disproportionate jaw formation, sometimes the upper jaw has grown longer in proportion to the bottom jaw, causing a large distance between the upper and lower lips and a retruded chin. In mild cases, Dr. Holland may be able to pull the upper lip down to reduce the gummy smile. In more advanced cases, Dr. Holland would consult and refer to his oral surgeon and orthodontist colleagues who could adjust the upper jaw to be more functional and aesthetic. Finally, in the cases with a hyperactive upper lip, a referral to a Botox specialist may be considered.
The treatments listed above have different recovery times ranging from no time to a few months. For the procedures performed with Dr. Holland (gingivectomy and crown lengthening), the tissues will normalize in 1-2 weeks but will take 8-12 weeks to mature to their final position.
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