The surest way to not show gums when smiling is to pretend that you are Humphrey Bogart. Anyone familiar with the film star knew of his seemingly paralyzed upper lip. While there are several stories on how the star obtained the scar that caused his upper lip to remain semi-rigid while speaking, the star was always quiet.
One rumor says he received the scar when the Navy vessel he was serving on was shelled. That never happened. Another says he was transporting a prisoner who escaped and hit him across the face with a handcuff to cause the scar. That probably didn’t happen either and several people think the rumor was made up by the studio.
There are no records of the scar on Bogart’s official Navy discharge documentation.
The most plausible story is one from Bogart’s childhood. Apparently, the young Bogart had a wood sliver stuck in his lip. Left untreated, infection followed. The scar is supposedly the result of a doctor who, while removing the sliver, did extensive damage to the tissue, causing the scar.
Whatever the reason for Bogart’s distinctive speaking style, the one surety is that he never displayed a gummy smile.
Exploring the Gummy Smile
A smile that exposes too much gum tissue is often called a gummy smile. The technical term is a gingival smile. In many respects, whether or not this type of smile is a problem rests in the eye of the beholder. Many people don’t see it as a problem, while others don’t like the look.
According to the American Academy of Medical Orthodontics (AAMO), the definition of a gingival smile is subjective. The determination is based on a person’s perception rather than any defined medical determination. The basic definition is that too much gum is visible above the teeth.
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According to studies, a smile displaying more than 2 to 3mm of gum tissue is not “attractive.” Although quite common. there is a higher occurrence among women than men. A gummy smile often creates the disproportionate appearance of small teeth even when tooth size is normal.
When we consider the aesthetics of a smile our view includes the lips, teeth, shape of the jaw, the alignment of the bite, and the visibility of the gumline.
Gummy smiles are not considered a medical or health condition. There may be a problem with jaw alignment if top teeth create an underbite. Fortunately, gingival smiles are completely correctable, often with non-invasive measures.
Causes of a Gingival Smile
There are many suspected causes of a gingival smile:
- A short upper lip
- Small teeth due to genetics
- Teeth not fully erupted
- Hypermobility of facial muscles controlling the upper lip
- Gingival hypertrophy (enlarged gums)
- Vertical maxillary excess (VME) (overgrowth of the upper jaw)
- Gingival hyperplasia (caused by medications)
Most commonly thought to be genetic in nature, sometimes a gingival smile can be a side effect of medications.
The types of medications that may cause gingival hyperplasia treat conditions such as high blood pressure, seizures, and immune system suppressors. These medications cause an overgrowth of gingival tissue, also called clinical overgrowth. This condition can lead to a greater risk of periodontal disease if left untreated.
How to Fix a Gummy Smile
In some instances, a gummy smile will ebb on its own as a person ages. However, not everyone wants to wait that long to see if it will, indeed, just go away. For those people, there are several options they can discuss with their dentist or orthodontist.
Gingivectomy (Contouring)
This is considered minor oral surgery and it is usually performed by a periodontist. The process begins by contouring the edges of the excess gum tissue using a scalpel or laser. This exposes more of the tooth surface. When teeth do not fully erupt, crown-lengthening surgery may be necessary to expose more of the teeth.
Botulinum Toxin
Botulinum toxin, or Botox, can alter the movement of hypermobile facial muscles. When the muscles controlling the upper are hypermobile, it can cause the lip to raise higher exposing excessive gum tissue. Used in small doses, Botox can freeze, or paralyze hypermobile muscles offering the appearance of a less gummy smile.
One of the primary problems with Botox is that it is not a permanent solution. The procedure would need to be repeated every three to six months to maintain consistency in appearance.
Crowns and Veneers
One of the ways to not show gums when smiling is by having crowns or veneers installed. While crowns and veneers can be useful in improving aesthetics, this “shortcut” is usually not a recommendation. It will provide a more balanced look but could have undesired effects as the patient ages.
Orthodontic Treatments
In many instances of a gummy smile, traditional braces or Invisalign can be useful in creating a better smile. When the gingival smile is the result of an orthodontic problem, such as inward leaning front teeth, alignment will adjust the smile to decrease the visibility of the gums.
How Braces and Invisalign Work with a Gingival Smile
If a gingival smile is the result of an orthodontic issue, braces and Invisalign are both potential solutions.
Braces work by using tension to create force. The doctor affixes brackets to each tooth then threads the archwire through the brackets. When the wire is tightened it creates tension. By applying the tension, the doctor can guide tooth movement to align the smile.
Invisalign works in a similar manner but without the brackets and wires. Using custom-fit tray aligners, gentle pressure moves teeth. Patients progress through a series of sequential tray sets, with each set of trays shifting teeth closer to the goal of alignment.
Although neither braces nor Invisalign reduces the amount of gum tissue, the act of aligning the teeth broadens the smile. This wider smile and improved smile arc often reduce the amount of visible gum tissue.
Discuss Your Options with Lasley Orthodontics
If you are not satisfied with the appearance of your smile you should discuss the matter with Lasley Orthodontics. Whether you simply want to know how to not show gums when smiling or you have a different orthodontic problem, Dr. Andrew Lasley can offer solutions.
To find out how to not show gums when smiling or to discuss discovering your dream smile, request your Complimentary Examination today. You may also speak directly to our Appointment Coordinator by calling (425) 496-7030.