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Prof. Irfan Qamruddin BDS FCPS PhD (Malaysia)
reasons for Excessive visibility of gums
Gummy
Smile Treatment
Many patients visit dentists with complain of excessive visibility of gums on top of their teeth and in dental terminology we call it gummy smile. Patients with gumy smile are self-conscious. We should keep in mind that there is not only one reason for excessive visibility of gums and therefor there is not only one treatment option for this problem. The cause of the gummy smile can be multifactorial and must be accurately diagnosed to render appropriate treatment.
How to diagnose the exact etiology of gummy smile?
It is very important to do a proper diagnosis before starting treatment because these cases are difficult to treat and when a dental surgeon tries to treat them without proper planning, then it is almost impossible to achieve a desirable outcome that results in unsatisfied patients.
In this video Prof. Irfan Qamruddin effortlessly explained how to diagnose gummy smile properly.
A published case of prof. Irfan Qamruddin
Gummy Smile Patient Treated Nonsurgically
A 16-year-old female patient came with the presenting complaint of protrusion along with excessive visibility of upper incisors and excessive display of gums on smiling.
There was no significant medical history while dental history revealed her visit to a local general dentist 2 years ago with the same complaint where she was treated by trimming of her incisors to reduce visibility.
Incompetent Lips
Incisor visibility of 7 mm with relaxed lips and gingival display of 6 mm on smiling.
Diagnosis and treatment objectives
The patient was diagnosed to have severe skeletal class II relationship with mandibular deficiency. The desired treatment objectives included
Intrusion of upper incisor
To achieve esthetically pleasing smile.
click here
Ideal treatment plan offered to the patient and that was
Jaw Surgery
The ideal treatment plan offered to the patient was the subapical segmental osteotomy in the upper jaw to move the whole anterior maxillary segment upward and backward with surgical mandibular advancement in the lower jaw.
The patient rejected the surgical plan; therefore alternate treatment plan was followed.
01
extraction of maxillary first premolars
02
nonextraction treatment in lower arch
03
class II molar and class I canine relationship
In between treatment
The treatment was started with banding and bonding procedure using 0.022 slot preadjusted edgewise brackets, MBT prescription. Vertical placement of brackets on central and lateral incisors was kept at the same level so that the incisal edges can be restored after the treatment.
Alignment and leveling were achieved with continuous archwire used in the following sequence: 0.012 Niti, 0.016 Niti, 0.017 × 0.025 Niti followed by 0.017 × 0.025-in SS wire.
Extractions of upper first premolars were carried out along with insertion of mini implant in the same appointment. Self-drilling type of titanium mini implants (1.4 mm diameter and 8 mm length) was inserted between the roots of upper first molar and second premolar bilaterally.
Self-drilling type of titanium mini implants (1.4 mm diameter and 8 mm length) was inserted between the roots of upper first molar and second premolar bilaterally.
Implants were loaded immediately with elastomeric chain to retract the canine first into class I relation. After achieving class I cuspid relationship bilaterally, NiTi closed coil springs were extended from implants up to the helix formed in the archwire distal to the lateral incisors on both sides. Force of 150 gm was applied (measured with Dentus gauge) with the force vector passing above the CRes of maxilla, so that the anterior teeth are retracted upward and backward.
Forces were repeated after every three weeks till the extraction spaces are completely closed.
this treatment ended after 27 months
Orthodontic treatment duration varies case to case. the average orthodontic treatment lasts around two years.
However, orthodontists can repair more moderate issues in as little as six months while more complex issues can take 3 years or more.
Frequently Asked Questions
gummy smile treatment options
What Is a Gummy Smile?
A gummy smile is characterized by an excessive display of gum tissue when you smile, often making the teeth appear shorter than they actually are. This condition can affect your self-esteem and the aesthetics of your smile.
Are gummy smile attractive or unattractive?
The attractiveness of a gummy smile is a subjective matter and can vary from person to person. What some individuals find attractive, others may not. Beauty standards and preferences are highly influenced by cultural, societal, and personal factors.
Are there any celebrities with gummy smile?
There are several celebrities who are known for having gummy smiles. It’s important to note that a gummy smile can vary in its appearance and may not be considered a flaw by everyone. Here are a few celebrities who have been noted for their distinctive gummy smiles:
Nicole Kidman: The Australian actress Nicole Kidman is known for her radiant smile, which often shows her gums when she grins. Her gummy smile is considered one of her unique and endearing features.
Katie Holmes: Actress Katie Holmes has a smile that occasionally displays her gums, giving her a youthful and charming look.
Julia Roberts: Julia Roberts, one of Hollywood’s most famous actresses, has a wide and infectious smile that often reveals her gums. Her smile is often celebrated as one of her most iconic features.
Princess Diana: The late Princess Diana had a warm and engaging smile that occasionally revealed her gums. Her genuine smile was one of her most beloved qualities.
Megan Fox: Actress Megan Fox has a smile that sometimes shows her gums, which adds to her overall appeal and beauty.
Gwen Stefani: Singer and fashion icon Gwen Stefani is known for her distinctive smile, which often reveals her gums. Her smile is considered one of her signature looks.
It’s important to remember that beauty is subjective, and what one person finds attractive, another may not. Many of these celebrities embrace their unique smiles and are celebrated for their individuality. Gummy smiles, like any other feature, can be a part of a person’s charm and personality.
Can gummy smile be fixed?
Yes, a gummy smile can often be improved or fixed through various dental treatments and procedures, depending on the cause and severity of the gummy smile. Here are some common methods to address a gummy smile:
Orthodontic Treatment: If the gummy smile is primarily due to an issue with the positioning of the teeth or the jaw, orthodontic treatment such as braces or clear aligners can be used to move the teeth into a more balanced position.
Gum Contouring: Also known as gum reshaping or gum recontouring, this procedure involves removing excess gum tissue to reveal more of the tooth surface. It is typically done with the help of lasers or traditional surgical techniques.
Lip Lowering Surgery: In some cases, the upper lip may be excessively mobile, causing it to rise too high when smiling and exposing more gum tissue. Lip lowering surgery can help restrict the upward movement of the upper lip.
Botox Injections: In less severe cases, Botox injections can be used to relax the muscles responsible for elevating the upper lip, temporarily reducing the appearance of a gummy smile.
Surgical Lip Repositioning: This surgical procedure involves repositioning the upper lip to cover more of the gums when smiling. It’s typically reserved for cases where other treatments have not been effective.
Orthognathic Surgery: In cases where the gummy smile is caused by a more complex issue with the position of the jaw, orthognathic surgery may be recommended to reposition the jaw and achieve a more balanced smile.
The appropriate treatment option will depend on the underlying cause of the gummy smile and the individual’s unique dental and facial anatomy. It’s essential to consult with a qualified dentist or oral surgeon who can assess your specific situation and recommend the most suitable treatment plan for you. Treatment success rates are generally high, and many people can achieve a more balanced and aesthetically pleasing smile with the right approach.
when does gummy smile botox work?
Botox can be an effective treatment for a gummy smile in cases where the excessive gum exposure is primarily due to the overactivity of the muscles that elevate the upper lip. Here’s when Botox may work for a gummy smile:
Muscular Hyperactivity: Botox is most effective when the gummy smile is caused by the overactivity of the muscles responsible for lifting the upper lip when smiling. These muscles, known as the levator labii superioris and the zygomaticus minor, can cause the upper lip to rise too high, exposing more of the gums.
Temporary Solution: Botox provides a temporary solution for reducing gum exposure when smiling. The effects typically last for several months, after which the Botox gradually wears off, and the muscles regain their full function. This temporary nature can be an advantage for those who want to try a less invasive approach before considering more permanent options.
Quick Procedure: Botox injections are a relatively quick and minimally invasive procedure. It typically takes just a few minutes to administer the injections, and there is minimal downtime. Most people can resume their normal activities immediately after the treatment.
Non-Surgical Approach: Botox is a non-surgical option, making it suitable for individuals who prefer to avoid more invasive procedures or surgery.
YOU DESERVE BEST TREATMENT
Prof. Irfan Qamruddin is specialist orthodontist and has treated more then 2000 patients .
First Floor, 8th Commercial Street, hall no.1, Zamzama Commercial Area Defence V Karachi, Karachi City, Sindh 75600
For appointment & details
0314-4544626 (ILIIOCO)