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Posts for: February, 2015

By Randall Furman DDS
February 27, 2015
Category: Oral Health
Tags: gummy smile  
TreatingaGummySmileDependsonitsCause

Something about your smile isn’t quite right. It’s too “gummy” — too much of the upper gum line is visible and it looks out of proportion to your teeth and lips. Most dentists identify a smile as too gummy if four millimeters or more (approximately an eighth of an inch) of the gum tissue is visible at a full smile.

Fortunately, there are ways to minimize this effect. It’s important, though, to first determine the true cause before we embark on any treatment plan.

Your teeth may be the actual cause. As we mature, teeth “erupt” through the gums and the supporting bone and appear in the mouth. They continue to erupt until meeting their “antagonists,” the opposing teeth from the opposite jaw. In addition, the gums go to the proper position where the root meets the enamel of the teeth around late adolescence. The normal result is a length of the crown (the visible portion of the tooth) of approximately 10 mm.

If the teeth don’t erupt fully or the gums don’t go to their proper position, the teeth appear shorter and the gums more prominent. Using a surgical technique called crown lengthening, we remove excess gum tissue and, if necessary, reshape the underlying bone to reveal the proper amount of tooth length. Teeth also shorten due to excessive wear; the teeth continue to erupt to compensate for the wear that occurs over time. The attached gum tissue follows with the tooth. This can be corrected with orthodontic treatment (for bite correction) and porcelain veneers.

Two more causes of a gummy smile are when a person has a hyper-mobile upper lip — the upper lip can raise too much lift when smiling — and an upper jaw length that appears too long for the face. If lips rise higher than the normal 6-8 mm when we smile, too much of the gum line appears. This can be treated temporarily with Botox injections to reduce the mobility of the muscles, or there is a surgical procedure that reduces the mobility of the upper lip. For an elongated upper jaw, orthognathic (“to straighten the jaw”) surgery relocates the jaw to a more upward position that diminishes the amount of gum tissue that shows during smiling.

Treatments for a gummy smile range from simple techniques to more complex surgical procedures. Only a thorough dental exam will reveal the best treatment path to follow.

If you would like more information on treatments for “gummy” smiles, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Gummy Smiles.”


ChristieBrinkleySharesHerExperienceWithDentalImplants

Fracturing back molars is an experience no one ever wants to have. But when a helicopter crashed during a back country ski trip, supermodel Christie Brinkley soon discovered that she had fractured two molars. Fortunately for Christie, her oral health was restored with two dental implants. As she said during an interview with Dear Doctor magazine, “I am grateful for the dental implant technology that feels and looks so natural.”

While Christie's dental implants replaced back teeth, we routinely use them to replace both back and the more visible front teeth. But best of all, we have demonstrated expertise at making dental implant crowns look real. This is where we meld science and artistry.

What drives the most natural and beautiful result is how the crown (the visible, white portion of a tooth) actually emerges through the gum tissues. We also match the adjacent teeth identically in color, appearance, shape and profile. But we can't take all the credit, as it takes an entire “behind-the-scenes” team to produce dazzling results. Choice of materials, the laboratory technician (the person who actually handcrafts the tooth), the expertise we use in placing a dental implant crown and the total quality of care we provide are the ingredients necessary for success.

Another critical factor required is ensuring there is enough bone volume and gum tissue to support an implant. Both of these must also be in the right position to anchor an implant. However, if you do not have adequate bone volume, you may be a candidate for a minor surgical procedure to increase your bone volume through bone grafting or other regenerative surgical techniques.

To learn more about dental implants, continue reading the Dear Doctor magazine article “Matching Teeth & Implants.” Or you can contact us today to schedule an appointment so that we can conduct a thorough examination, listen to your concerns, answer your questions and discuss treatment options. And if you want to read the entire feature article on Christie Brinkley, continue reading “The Secret Behind Christie Brinkley's Supermodel Smile.”