Smiles are different. But they are always formed by teeth. With excessive visualization of gum tissue (the upper gum opens at the moment of smiling), a so-called “gum smile” (also known as a “horse smile”) or Gummy Smile. And although this feature often has absolutely no effect on the functionality of the dentofacial apparatus, the owners of such a smile cannot always be envied.
Looking ahead, it is necessary that this is not a pathology, but most likely an aesthetic (visual) defect. However, the presence of such a defect in a person can cause psychological discomfort and develop serious complexes. That is why it is recommended to eliminate a “gummy smile”. If the defect is not severe, and the owner of an unusual smile does not have any malocclusion or complexes, then it is not necessary to resort to any treatment.
Gummy smile: does it require treatment?
Symptoms of a gummy smile – is there a problem?
It is worth noting that a gummy smile in itself is not a pathology , it does not in any way affect the health of the teeth, and does not have a negative impact on the process of chewing and digestion.
But many owners of this feature, most of them women, want to get rid of it, make their face more harmonious, because with such visualization it is sometimes visible, for example, that the teeth are dentures, the color of the gums has changed to bluish, yellowish or purple, the gums are affected by periodontal disease. In this case, we are talking about smile aesthetics , which can be achieved by several types of correction.
Video: Gummy Smile. Correction methods
A person’s gummy smile is immediately noticeable - not only the upper teeth are exposed, but also most of the gums, and in some cases the demarcation line between the gum and lip is visible, as well as the place where the upper frenulum is attached to the gum.
A high smile is indicated by the degree of gum exposure. A relative norm is a smile in which the upper lip remains on the upper line of the teeth - or no more than 2 mm above it.
Postoperative care
Postoperative oral care plays an important role in the treatment and recovery of dental deficiencies. To alleviate the condition during rehabilitation and protect yourself from the development of serious complications, you must follow the following rules:
- Avoid temperature and chemical irritants (hot, sour, spicy).
- Stop drinking alcoholic beverages and tobacco products.
- Carry out antiseptic and anti-inflammatory oral baths daily with a solution of chamomile and miramistin.
- Perform hygiene procedures 2 times a day using a soft toothbrush and medicated paste.
If your health worsens or suspicious discharge from the gum tissue appears, you should immediately consult your doctor.
When purulent exudate forms, the dentist-surgeon removes discharge from the gum pockets using special instruments, after which he prescribes antibacterial therapy.
Reasons for the formation of a high gummy smile
In the vast majority of cases, high gums when smiling are the result of individual developmental characteristics of the maxillofacial region of a person, which are formed in utero.
There are a number of other reasons when a person develops a gummy, or “horse” smile:
- Abnormal growth of the maxillofacial apparatus in infancy and childhood under the influence of various negative factors.
- Formation of malocclusion in a child.
- Irregular growth of teeth, their severe curvature and protrusion.
- Very short and thin upper lip.
- Shortening of the upper frenulum that was not corrected in time.
- Disproportionately small incisors on the upper jaw.
- Greater mobility of the upper lip.
- Spastic conditions in this area.
Causes
A horsey, or gummy, smile can be present due to various factors. Firstly, this may simply be a structural feature of the upper jaw or an anomaly of the entire facial skeleton. In this case, there is a lengthening of the entire middle part of the face and a special arrangement of the teeth. Secondly, there is the concept of hyperplasia, that is, the growth of gums. Thirdly, the cause of the deficiency may simply be a shortened upper lip or its hypermobility due to increased activity of the orbicularis oris muscle. Finally, another cause may be an incorrect bite.
At the same time, a gummy smile of varying degrees of severity is observed in approximately 15% of people around the world, including very well-known ones.
Gingivectomy is a dental or surgical method for correcting high gums.
The gingivectomy method is indicated for conditions where there is too much gum above the upper teeth. As a result, it covers a very large part of the teeth, as if hanging over them, which forms a visual gummy smile.
Types of osteomucogingival surgeries in dentistry
It must be borne in mind that the results of this method are irreversible, so surgical correction is prescribed in the most extreme cases with the above-described features, and this happens infrequently.
Video: Gingivectomy - treatment of a gummy smile
The operating method is the most difficult. It is associated with the removal of gum tissue, which invariably has all the consequences of surgical intervention - bleeding of the gums, scarring, possible infection, asymmetry. The development of laser surgery helps to minimize the above-described consequences in operative dentistry, but it is still necessary to keep them in mind, paying due attention to preventive measures.
Removing gum tissue can lead to another consequence that has aesthetic and dental significance - excessive exposure of teeth. This will visually lengthen the teeth and partially expose the roots, which will negatively affect subsequent aesthetics. Therefore, further orthodontic correction with the use of dental crowns and onlays is required.
In order to get the most successful results, the dentist will make a decision not alone, but with a council of specialists, which should include a specialist in aesthetic dentistry.
A decision is made collectively about the need for surgery, and the volume of gum tissue that will be removed without negative consequences for aesthetics is determined as accurately as possible.
How to fix a gummy smile
Aesthetic dentistry uses surgical, orthodontic, orthopedic, cosmetic and even speech therapy correction methods. The degree of patient involvement depends on the method. In surgical cases, it is minimal, the effect is lasting, the patient is only required to follow the usual recommendations. Installing braces requires more discipline and involvement, and speech therapy exercises depend almost entirely on the patient’s responsibility and constant monitoring of articulation.
Surgical intervention
- Gum plastic surgery
for a gummy smile (gingivoplasty) is the most common correction method.
It is considered a simple operation and does not require going to the hospital. Takes a maximum of 2 hours, often less.
A dental surgeon performs an operation to remove excess tissue (gingivectomy) and shape the contour of the gums. The mucous membrane is lifted to make a larger area of the crown part of the tooth visible, and excess tissue is removed. Surgery to correct a gummy smile is minimally invasive and is done using a laser beam. It immediately seals the vessels, preventing bleeding. There are no stitches, so the recovery period takes little time. In addition, the laser destroys pathogenic flora; there are practically no complications after such operations.
The only thing worth remembering is that if you remove too much tissue, it will lead to the opposite aesthetic effect - long teeth. A special technology helps to avoid this result: “digital smile design.” Thanks to it, the result of the intervention can be seen even before the operation and it is possible to determine exactly how much tissue needs to be removed.
- Frenum cutting (frenuloplasty)
Another simple operation that improves not only the aesthetics of a smile, but also diction. The fact is that the lips are actively involved in articulation. A short lip cannot do this 100%, which affects the pronunciation of individual sounds and makes speech unclear and blurred. Additionally, people with a short frenulum tend to breathe through their mouths. This dries out the mucous membrane, creating conditions for colds and inflammatory processes in the nasopharynx. Frenuloplasty eliminates these problems by promoting clear articulation, correct breathing patterns, and at the same time making the smile more attractive. Typically, this procedure is performed in childhood, but some adults also experience a shortened frenulum.
- Suturing the orbicularis oris muscle
A minor surgical intervention reduces the tone of the muscle, and it stops lifting the lip too much. You can get rid of a gummy smile in less than an hour.
Orthodontic treatment
If you have problems with your bite, braces or aligners can help correct the position of your jaws. Some malocclusions cause the upper teeth to move out of the jaw, and the gums attached to them also move downward. Treatment with braces or mouthguards brings the teeth back, and with them the gums.
With severe pathology of the maxilla, orthognathic surgery is necessary. It is performed by a gnathologist or maxillofacial surgeon under general anesthesia. Some bone is removed to recreate symmetry between the upper and lower jaw. As a result, the height of the upper jaw decreases, the mucous membrane is not exposed excessively.
Orthopedic intervention
To visually lengthen teeth in case of pathological wear, for example, an orthodontist installs veneers or crowns. Veneers build up teeth by no more than 1-2 mm; if you need to build up more, artificial crowns are used.
Correction of a high smile using a cosmetic method using Botox
In case of hypermobility of the upper lip, excessive facial expressions of the patient, when they cause the visualization of the gums when smiling and talking, there is an excellent method for correcting the condition - Botox injections, which relax the active muscles of this area and help reduce their mobility.
Treatment is achieved by administering bolutoxin type A (Botox and Dysport, popular drugs in cosmetology).
Video: Correction of a gummy smile with Botox
Women who receive Botox injections in cosmetology clinics to reduce wrinkles on the face and enlarge lips also note correction of a gummy smile, if present.
This method, unlike the surgical one, is reversible - this is both a minus and a plus at the same time. Up to six months, the effect of the injections wears off, and so does all the correction he achieved. The procedure must be repeated if desired.
It is very important to entrust the injection Botox correction of a gummy smile to an aesthetic dentistry clinic, a specialist with extensive experience and relevant medical knowledge.
Attention! The consequences of incorrect administration of Botox can be asymmetry of the face and lips, with an incorrectly calculated dose - lack of results, or vice versa - a strong degree of immobilization of the perioral area.
Muscle suturing
Another method used to remove a gummy smile is to perform a small operation under local anesthesia. After the anesthesia takes effect, the doctor makes an incision under the upper lip, through which the orbicularis oris muscle is sutured, depriving it of hypermobility, as well as the mucous membrane. This procedure is more serious, but quite effective.
Speech therapy correction of a gummy smile
The method is indicated for insignificant visualization of the gums, or for excessive facial expressions of the patient, hypermobility of the lips.
The correction process is carried out with a speech therapist who teaches a person to correctly pronounce sounds and words, control his speech apparatus while talking or smiling.
Excellent results are achieved by performing certain exercises regularly. In the future, the person simply automatically controls the movement of his lips, stopping the upper lip in the correct position, which allows him to achieve an excellent aesthetic effect without any intervention in the tissue.
The method of speech therapy correction perfectly complements other methods from our list. It is suitable for most people who want to correct a high type of smile.
Keep in mind! But without constant self-control and regular exercise, you may not get results.
Surgical correction of the upper lip and upper frenulum
The surgical method consists of excision of a section of the mucous membrane on the inner surface of the upper lip and further attachment of the muscle fibers of the lip slightly lower than their original state.
If the cause of excessive visualization of the gums - and errors in eating and speaking - is a greatly shortened upper frenulum, which forms a dense cord and does not allow the upper lip to be lowered to the desired level, it is corrected.
As a rule, such an operation on the frenulum is performed in childhood.
After the surgical field has healed, the desired visual effect is achieved.
Orthodontic correction of high smile and dental problems
If a gummy type of smile is the result of improper formation of the dentition, deformation of not only the teeth, but also the bone tissue of the jaws, the help of an orthodontist is required.
This method may include several types of orthodontic correction, depending on the type and degree of pathology, the age of the patient, and the presence of other pathological conditions.
Most often, orthodontic correction consists of straightening the teeth through long-term wearing of braces.
In most cases, this correction method is used in combination with others - for example, surgical or cosmetic.
Maxillofacial Surgery
Some very serious problems cannot be solved except in the operating room. Anomalies in the development of the jaw due to improper breathing and nutrition in infancy can result in adult problems not only of an aesthetic, but also of a medical nature. Fortunately, modern surgery can do almost everything - doctors can shorten the upper jaw, raising the teeth to their correct place. True, such a procedure not only requires longer rehabilitation, but will most likely cost a pretty penny.
