Cosmetic Dentistry — Treating a Gummy Smile

by

DrAmitGoswami

The Smile is the most recognizable signal in the world. Smiles are such an important part of communication that we see them far more clearly then any other expression. Just as a nice smile can act as a powerful communication tool, an unpleasant one can have an equally powerful negative impact that s why patients seek orthodontic treatment. As society raises the bar on an acceptable smile, we have more patients reporting for smile make-over job at our Dental Center. But Gummy Smile is one aspect which may still vex up.

In this article we are giving you an insight about gummy smile and its treatment modalities available at Delhi Dental Center — to get a desirable, predictable and achievable result.

As society raises the bar on an acceptable smile, we at our Delhi Dental Center are having more number of patients reporting to get smile makeovers by correcting there gummy smiles .

GUMMY SMILE :

The gummy smile is a condition known by an excessive display of maxillary gingival during smiling. 2 mm or more of maxillary gingival exposure while full smiling can be treated as gummy smile.

Gummy smiles are classified according to the amount of gum tissue that shows in relation to how much tooth structure is displayed while smiling. These classifications are determined by measuring the patients gum tissue as a percentage of total tooth length.

Gummy smiles ranges from mild, moderate, and advanced, to severe gummy smiles.

MILD GUMMY SMILE If the amount of gum tissue shown while smiling is less than 25% of the entire length of the teeth, it is considered as mild gummy smile.

MODERATE GUMMY SMILE If the amount of gum tissue shown while smiling is between 25% – 50% of the entire length of the teeth, it is considered as moderate gummy smile.

ADVANCED GUMMY SMILE If the amount of gum tissue shown while smiling is between 50% – 100% of the entire length of the teeth, it is considered as advanced gummy smile.

SEVERE GUMMY SMILE If the amount of gum tissue shown while smiling is more than 100% of the entire length of the teeth, it is considered as severe gummy smile.

ETIOLOGY :

1. Vertical maxillary excess, skeletal and dental.

2. Short anatomical upper lip.

3. Hyper functional upper lip elevator muscles.

4. Gingival hypertrophy.

5. Short or insufficient clinical crown length.

6. Combination of any of above.

TREATMENT PLAN —

Once the diagnosis is established and etiology becomes apparent there are two treatment options : –

1. Orthodontic option.

2. Surgical option. Periodontal.

3. Surgical crown lengthening.

4. Botox.

5. Le-fort 1 osteotomy.

1. ORTHODONTIC OPTION —

* Intrusion of teeth will help to reduce gummy smile and proclination of teeth, as the teeth intrude, gums also follow the intrusion but not at the same rate.

* Developing vertical maxillary excess may be corrected by Appling orthodontic forces with help of a head gear.

2. SURGICAL OPTION —

* PERIODONTAL — It includes simple gingivectomy up to about 2mm.

* Surgical crown lengthening — When there is short clinical crown in combination with increase gingival display, it can be corrected with removal of crestal alveolar bone.

* Botox — Increase gingival display due to hyper active muscle may be corrected by botox, the upper lip becomes flaccid and falls down there by decreasing gingival display.

* Orthognathic surgery– Sever cases of 8mm or more gingival display are best corrected by this method.

CONCLUSION —

Patient cases reporting to our center for gummy smile correction usually doesn t fall purely in any of above category. Overlapping etiological factors may contribute to difficulty in analyzing the case. However the above mentioned diagnostic criteria help to arrive at a proper etiology based diagnosis followed by logical treatment planning.

Authors —

Dr. Amit Goswami.

Dr. (Mrs.) Vandana Goswami.

http://www.delhidentalcenter.com/knol/CosmeticDenistry-TreatingAGummyTeeth.html

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