Gummy Smiles and Short Teeth

Porcelain Veneers for Gummy Smiles

gummy smile before porcelain veneers and gum liftgummy smile after porcelain veneers and gum lift

Gummy smiles are aesthetically unpleasing. They are caused by short upper lips or a long maxillary alveolar bone due to long roots of the upper anterior teeth. Since the alveolar bone is that part of the skull that harbors the roots of the teeth, the formation of long dental roots coincides with a long alveolar bone. If the philtrum above the upper lip is short and the roots of the upper front teeth are long, a gummy smile may be the result. Misaligned and protruded teeth may aggravate the gummy appearance of a smile.

Gummy smiles can be corrected by different treatment modalities. Depending on the cause and the cosmetic dental treatment goal, it can be corrected by orthodontic intrusion of the involved teeth, gingivectomy, or a crown-lenghtening procedure. A gingivectomy is only possible if the patient has a hyperplastic gingiva or sulcus probing depths of more than 3 mm. It is important to evaluate the distance between the crest of the alveolar bone and the gingival margin. Nature establishes a distance of about 3 mm between the osseous crest and the gingival margin. It is called "biological width."

If the cosmetic dentist violates this distance and leaves less than 3 mm from the free gingival margin to the crest of the bone, the body may respond with local inflammation and resorption of osseous tissue until the biological width has been reestablished.

Orthodontic intrusion is the treatment of choice if the teeth have short roots or if there would be a lack of attached gingiva remaining after the crown-lengthening procedure.

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See also:

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Lanning SK. Surgical crown lengthening: evaluation of the biological width. J Periodontol. 2003 Apr;74(4):468-74.