Good morning,
I get asked this question quite frequently in clinics. Did you know that up to 10% of us have gummy smiles ? Hence there are solutions for you and I am sure you will be comfortable with one of the options suggested below:
There are a few reasons as to why one can have a gummy smile. Depending on these variables, the dental surgeon will recommend options tailored to your condition and needs.
These options can be either short term or long term solutions. The benefit of short term solutions is that they are reversible, however the disadvantage is also that it's reversible and patients get unhappy feeling that they need to keep coming back for treatment. Long term solutions are more 'unreversible' if you like - and you have to really understand what you are getting to before taking the plunge.
In general Botox is short term and my patients will return every 4-6 months to get additional Botox injected. The results can be amazing however some patients do not like the thought of having reliance on this muscle relaxation technique.
Certain patients have maxillary excess - or just too much of vertical height of upper jaw bone. In such cases Jaw Surgery might be the only option. This is obviously more invasive and also irreversible.
However for a large percentage of patients who I see, Lip Repositioning Surgery might be a less invasive and aesthetically pleasing procedure. In this procedure, muscles that cause elevation of the upper lip are surgically detached and hence reduce this gummy smile. This procedure usually takes about 30-45 min and has a very short down time of 3-5 days. This can cost from $5000 - $10,000.
For a smaller group of patients, Crown Lengthening might be a viable option. I do this procedure with the aim of increasing the apparent length of the upper 6-8 teeth hence improving the ratio of teeth seen versus the excess gum. The down time for this is also about 3-5 days. In certain patients, some tooth straightening options (such as Invisalign) or even veneers might be a useful adjunct.
I tend to utilise a step wise approach:
Step1
Botox trial - since this is short term
Step 2
Crown Lengthening (this can be combined with tooth straightening or veneers)
Step 3
Lip Repositioning
Some patients will go for tooth straightening or veneers even after this
Please note that there is no one size that fits all and you will need a full detailed consultation with photos, xrays and even a CT scan if need be. Sometimes, the steps can be modified depending on the time constraints patients have and budget.
For those patients who need jaw surgery, I typically refer to an esteemed colleague for management.
Do some background reading and of course it always helps to speak to patients who have had the procedure done before.
Best
Dr Samintharaj Kumar
