There can be a wide variety of reasons that you may not be happy with your smile, often related to the appearance of your teeth. This could be that they’re too small, chipped, crooked, yellow or have gaps between them.
Another common concern occurs outside the teeth. If you feel like you show too much gum when you smile, chances are you may actually have a condition known as ‘gummy smile’. This can occur for a number of reasons, and can also be treated in several ways, both temporarily and permanently.
Find out more about this condition below, and your options for creating the smile you’ve always wanted!
- What is a gummy smile?
- Causes of gummy smile
- Gummy smile treatment options
- Muscle relaxant injections for gummy smile
What is a gummy smile?
A gummy smile (Excessive Gingival Display) occurs when a larger than proportionate amount of gum tissue shows above the upper teeth when smiling. The perception of a gummy smile can be determined visually, but has also been described as occurring when there is more than 4 millimetres of gum tissue being exposed.
If you believe you have a gummy smile, it’s best to visit your dentist who can take x-rays and do a few tests to determine the cause of your gummy smile before deciding which type of treatment will be most suitable.
Causes of gummy smile
There are several reasons a gummy smile can occur, relating to:
- Tooth issues
- Gum issues
- Lip issues
- Jaw issues
Teeth may be too small, which can be genetic or as a result of use. If teeth become worn down over time, the top teeth will attempt to maintain the correct bite by erupting down further, or for some people, the teeth may also have erupted further down naturally.
Another issue may occur where the upper teeth erupt further forward than they should in relation to the lower teeth. Instead of touching, they move past each other and erupt too far.
With each of these scenarios, as the teeth move downwards, the gums also move down as they are attached to the teeth, which makes the teeth appear shorter and the gums longer.
Gums can grow too far over the teeth as a result of mouth breathing, some medications or inadequate dental hygiene. This means there is still a significant amount of tooth concealed underneath the gum.
A hypermobile or hyperactive lip occurs when the muscles around the lips are too strong, which pull the lips up to reveal more gum tissue than usual when smiling. Normally, the lip moves 6-8mm from its resting position to a complete smile position, but hyperactive lips travel further than this.
Another lip issue involves the lip being too short, showing too much gum even when the jaw and teeth size are standard.
The most common cause of a gummy smile is that the upper jaw is longer than it should be, in relation to the size of the face and lip tissue available to cover the gums, so there is an excessive amount of gum tissue visible on both sides of the teeth.
After your dentist determines the cause of your gummy smile (which can be multiple), they can advise which type of treatment will be suitable to correct the amount of gum exposed when smiling. These options will vary in cost, complexity, longevity of results and possible risks.
Treatment for gummy smile can include:
- Orthodontic treatment
- Gingivectomy/Gum lift
- Professional teeth cleaning
- Jaw surgery
- Lip surgery
- Muscle relaxant injections
If a gummy smile has been caused by tooth issues as mentioned above where teeth have erupted too far, braces can be used to push the teeth back to their correct position into the gums. Once the teeth and gums have moved up to the optimal placement, cosmetic dental treatments such as veneers or crowns can then be added to restore the tooth structure so the bite still matches between the top and bottom teeth.
If the cause of the gummy smile is overgrown gums, a gingivectomy can be the best treatment option. This is a type of periodontal surgery also known as a ‘gum lift’. A gingivectomy can be completed in the dental chair as quickly as one appointment with your dentist or periodontist, and can involve using a laser to reshape and remove the excess gum tissue. This will effectively shorten the height of the gums and can create more symmetry to the gum line while revealing more of the tooth to improve the appearance of your smile.
Professional teeth cleaning
Gums can also swell due to gum disease or particular medications. Swelling can be treated by professionally cleaning the teeth and root surfaces. You should also consult your doctor to find out if there are alternative medication options that don’t produce this side effect.
In certain cases where the jaw is severely too large (usually more than 7mm of gum exposed), a bone shortening procedure known as Orthognathic surgery may be performed by a specialist orthodontist and oral surgeon. This involves surgically moving the entire jaw upwards.
A hyperactive or hypermobile lip can be successfully treated with permanent surgery by an oral or plastic surgeon to restrict the motion of the upper lip.
If the lip is too short, another surgical procedure can be performed to lengthen the lip. This is more complicated than restricting the lip with surgery, due to the movement of scar tissue and smiling which can counteract the lengthening.
Muscle relaxants (anti-wrinkle injections) are the simplest gummy smile treatment option when the issue is related to overactive muscles surrounding the lips. When injected into the right area, they temporarily paralyse the muscle which lifts the lip too high, with the results lasting approximately 6 months.
What are muscle relaxant injections?
Although several brands of muscle relaxant injections exist, they each contain the same active ingredient, Botulinum Toxin A. They contain sterile proteins that inhibit muscle contraction, reducing its strength. The more of the product used, the more it relaxes the muscle and reduces the contractions. Muscle relaxants are eliminated from the body over time, eventually regaining its normal function, so the treatment needs to be eventually repeated.
How are muscle relaxant injections used to treat a gummy smile?
Depending on the extent of the gums exposed, your dentist will decide on the dosage of muscle relaxant required. The injections are then placed on both sides of the nose, to affect the muscles that move the lip. These muscles will be prevented from contracting as significantly, which causes the upper lip to relax and extend over the excess gum that shows when you smile.
What should I expect when getting muscle relaxant injections?
Some patients may experience a slight sting during the injection, which is very mild and only lasts a couple of seconds. The skin may be red or bleed immediately afterwards, followed by a tingling or itching sensation for several minutes. Results will usually take several days to begin taking effect, with the full outcome taking up to 2 weeks to be completely evident. A review appointment is recommended with your dentist at this stage to determine if another dose will be necessary to increase the effects.
What are the risks of muscle relaxant injections for gummy smile treatment?
Muscle relaxant injections are a safe and effective treatment, but all medications do carry the potential to cause side effects, most in rare cases. Your dentist will discuss these with you after thoroughly assessing your health and medical history before treatment, which will minimise the risk of complications occurring by knowing it is safe for you to undergo this treatment.
The most common problems occur from the injection itself as opposed to the product, which can include redness, bruising, swelling and possible skin infection. If not placed properly, the injection can affect a muscle in a location other than those it was supposed to, or may relax the muscle too much. This means potentially your smile and the way your mouth moves can be affected, which is why it is important to choose a dentist with plenty of experience providing this treatment. Extremely rare complications can include allergic reactions, flu-like symptoms or headaches.
After the crazy Christmas period is over and done with and you’ve had a chance to get back into your routine, book a check up and clean with one of our Gold Coast dentists to make sure your teeth are in their best shape after indulging and start the new year with a healthy smile!
Book an appointment online or give our friendly team a call: