Cosmetic Treatments for a Gummy Smile: From Botox to Lip Surgery

Gummy Smile

If you’re self-conscious about your gummy smile, you’ll be grinning from ear-to-ear when you discover that there are several cosmetic treatments available to address the issue.

Most people incorrectly assume that the only options to correct excess gum tissue are surgical procedures performed either by a periodontist, a cosmetic dentist or an oral surgeon. However, there are less invasive and more affordable options out there. Luckily, achieving your ideal smile doesn’t have to be a long, drawn-out process that drains your bank account or forces you to confront your fear of the dentist.

The gummy smile is technically called “gingival display” or “excessive gingival exposure” and it occurs for a wide variety of reasons. Unfortunately, genetics are mostly to blame for a thicker gum line since it’s caused by a short upper lip, small teeth or excessive gum tissue, all of which are passed down to you from your parents in your genetic makeup.

 Genetics are mostly to blame for a thicker gum line since it’s caused by a short upper lip, small teeth or excessive gum tissue

This condition can also be caused by a hyperactive upper lip, which results in a lip that rises higher than normal as well as an overbite and improper development of the teeth. Vertical maxillary excess, or excess in the vertical growth of the upper jaw, is another common contributor to a gummy smile.

Several studies have been conducted to assess how much gum exposure is “normal”, with almost all revealing that two millimeters or less of gum tissue looked best to dentists, plastic surgeons, dermatologists and laypeople alike. With that being said, there are few issues beyond cosmetic ones that deem this type of treatment necessary.

Typically, a dentist or plastic surgeon will only recommend gummy smile treatment options in situations where the patient is distressed by his or her smile and believes it will help boost self-esteem. Some of these treatment options are also recommended for those with extreme cases of gum disease and other dental issues.

Gummy Lift Surgery

Surgical procedures to address this concern are largely referred to as crown-lengthening procedures, since they generally aim to lengthen the appearance of the teeth rather than minimize the thickness of the gums. Gingivectomy (also called a “gum lift”) is widely regarded as one of the most common and quickest surgical options for fixing a gummy smile.

This procedure requires the surgical removal of gum tissue from the crown of the tooth, effectively “lengthening” the appearance of the top teeth. Periodontists essentially carve away the surplus gum tissue in order to reveal more of the tooth, creating the illusion of a slimmer gum line.

A periodontist may also recommend maxillofacial surgery, a type of jaw surgery performed in order to shorten the upper jaw bone and move it upwards. One specific procedure, called orthognathic surgery, is often recommended to patients who have excessive vertical growth in the maxilla. Your doctor will have to take X-rays in order to determine whether this condition contributes to the appearance of excess gums. Consulting with your dentist and cosmetic surgeon will help you decide if surgery is necessary for your desired result.

The majority of these traditional options require a surgical procedure, which equates to various medical risks and a lengthy recovery time. They can also ring up for significantly more money than some of the less invasive procedures outlined below. It is important to note that in severe cases, the best option for treating a gummy smile is often crown-lengthening or gingivectomy procedures.

Botox Injections

There are some instances where Botox can be used as an alternative to orthognathic and aesthetic crown-lengthening procedures in the treatment of gummy smiles. Botox injections in the upper lip may help lessen the appearance of large upper teeth and gums by relaxing the muscles in the face and upper lip.

A plastic surgeon or qualified cosmetic injectable provider may recommend Botox in instances where the patient has a strong upper lip muscle, which recedes to show more of the gum line. Some specialists combine Botox with other injectable substances, such as Restylane, for a more dramatic and longer lasting effect. Leading professionals are also touting the benefits of a similar injectable, called Dysport, for treating excessive gingival display.

In an article published in the American Journal of Orthodontics and Dentofacial Orthopedics, Dr. Joseph Niamtu II said that treating a gummy smile with Botox “produced consistent, statistically significant and aesthetically pleasing results.” However, Niamtu advises that there are some risks associated with this type of treatment. Namely, that Botox in the mid and lower face can cause issues such as the inability to pucker one’s lips and an asymmetrical smile.

Niamtu goes on to add that choosing a highly qualified Botox specialist can greatly reduce a patient’s risk. Injectables are a great option for those who want to minimize the appearance of the gums without surgery. The downside, however, is that it won’t provide the same long-term benefits as plastic surgery.

Lip Augmentation Surgery

Lip repositioning surgery, also known as lip lowering, is a popular cosmetic surgery option for successfully treating even the most severe cases of excessive gingival display. Plastic surgeons may recommend this option for patients who have exposure caused by a high upper lip position.

Doctors perform this procedure by repositioning the height of the lip through the removal of a small strip of tissue from beneath the upper lip. The exposed area is then stitched into a lower portion, effectively eliminating the exposure of excess gum tissue. This procedure, also referred to as a Gummy Tuck, takes only 30 to 45 minutes. Since it requires only local anesthesia recovery time is quicker, making the Gummy Tuck that much more popular.

Orthodontic Treatments

Those who aren’t in a hurry to correct their gummy smile but prefer the non-surgical route may want to consider orthodontic treatment options. Braces can be used to help treat a gummy smile in instances where the “gumminess” is caused by an overbite.

Those who don’t want to go the traditional route may consider using Invisalign or other discreet braces options to gradually move the teeth into the correct position and to eliminate the wide appearance of the gums. Porcelain veneers also provide a dramatically different look in those who have small teeth which contribute to the appearance of gumminess. A prosthodontic professional will correct this issue with larger veneers that compensate for large gums.

Laser Treatments

Contemporary gummy smile correction solutions, such as soft-tissue diode laser treatments, are a popular option for individuals with gummy smiles but who do not require any of the gum contouring that accompanies traditional surgical choices. This option, also referred to as gum contouring, allows professionals to sculpt smiles with minimal pain and quick recovery times.

Doctors numb the mouth with a local anesthetic to eliminate any discomfort and then administer diode lasers which slim and smooth the appearance of the gums for a more desirable smile. There is very little recovery time with laser gum contouring and the potential associated risks, such as excessive bleeding or swelling of the gums, are highly unlikely.

Combining Multiple Treatments

The best plastic surgeons and gummy smile specialists will often sit down with their patients and assess their expectations, budget and various recovery options. In some cases, a combination of procedures may be recommended. For example, crown-lengthening partnered with lip repositioning in order to create a fuller, more beautiful smile with minimal recovery time.

Additionally, your doctor may recommend pairing Botox with laser gum reshaping in order to relax the upper lip and simultaneously create the appearance of a smoother, thinner gum line. In other words, there’s no single treatment or one-size-fits all solution to correcting a gummy smile. Instead, it should be tailored to each patient’s particular needs.

The bottom line is this: surgery is not the best option for every gummy smile sufferer, but this doesn’t mean you can’t find a viable alternative that meets and exceeds your expectations.

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