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I am Teppei Tsukuyama, a part-time cosmetic dentist at Bianca Clinic.
A gummy smile is generally defined as a smile that reveals more than 3mm of the upper gums when smiling. The name comes from the English word “gum,” meaning "gums. Gummy smile is not a disease and does not necessarily require treatment. However, a gummy smile can easily lead to the impression that the teeth look small and the mouth is prominent, and some people wish to have a gummy smile for aesthetic reasons. Some of them may wonder, "Why do my gums stand out so much?" Some people may wonder why their gums are so prominent.

In this article, we will explain the causes of gummy smiles in an easy-to-understand manner, and also introduce the treatment we provide at Bianca Clinic.

References: Tatakis DN. (2022), "Lip Repositioning Techniques and Modifications"/Dent Clin North Am
https://pubmed.ncbi.nlm.nih.gov/35738733/

Why do I get a gummy smile? What are the causes?

The answer to why gummy smiles occur may be due to the following reasons.

Source: Tsukiyama Dental Clinic, Specialty Medical Clinic Tenjin

Cause 1] Cases related to the jaw structure and teeth alignment.

The first type is affected by skeletal structure and tooth alignment. This is a cause with a strong innate element that is difficult to change through your own efforts.

• Long vertical upper jawbone

Technically, it is called "vertical maxillary overgrowth". When the upper jaw is vertically long from a skeletal point of view, the area of the gums is also larger. As a result, the gums are easily visible even when the lips are slightly raised.

• Bucktooth or deep bite

Those with so-called "bucktooth (protruding maxilla)" and those with "overbite," in which the bite is so deep that the upper teeth are largely overhanging the lower teeth, also tend to have their upper front teeth fall back, and as a result, their gums are more prominent.

Cause 2] Strong "habits" of the muscles that move the lips.

The next type is related to the function of the muscles around the lips.

• Strong force to raise upper lip

When we smile, we unconsciously use the muscles that pull the upper lip upward (upper lip elevators). If these muscles are naturally strong, or if we have a habit of moving them frequently, our lips are pulled up more than necessary, making our gums appear larger. This is technically called "upper lip hyperactivity.

• Thin or short upper lip

Those who have thin lips themselves or a short distance from the bottom of the nose to the upper lip (the middle of the person) also tend to have relatively more visible gums.

Cause 3] Cases caused by the balance between teeth and gums

The last type is related to the size and growth of the teeth and the condition of the gums.

• Teeth are buried in the gums.

Even after the teeth have fully erupted, the gums may not come down to their normal position and remain over the teeth (passive eruption abnormality). This causes the teeth to appear shorter than they should be and the gum area to appear larger.

• The teeth themselves are small

Dwarf teeth," in which the teeth are naturally small in size, also tend to stand out due to the balance between the teeth and gums.

• Swollen gums.

Swelling or proliferation of the gums themselves (gingival proliferation) due to periodontal disease or medication side effects can also cause the gums to physically stand out. In this case, treatment of the disease that is causing the problem or a change in medication should be considered first.

Congenital? Acquired? The Inheritance of Gummy Smiles

There are both congenital and acquired factors that contribute to the gummy smile.

<Congenital Factors

If you have parents or relatives with a gummy smile, there is a tendency for your children to have a gummy smile as well, due to the similarity of their skeletal structure. In particular, the following characteristics are said to be susceptible to genetic influence.

• Upper jaw skeleton (e.g., vertical maxillary overgrowth)
• Tooth size and shape (e.g., dwarf teeth)
• Strength of the muscles that raise the lips (upper lip elevator muscle hyperactivity)
• Length from the bottom of the nose to the lips (in person)

However, this does not mean that it is always inherited. Having a similar skeletal structure does not necessarily mean you will have a gummy smile.

<Acquired Factors

It can be acquired through childhood habits and other factors. For example, mouth breathing, finger sucking, cheek swallowing, nail biting, lip biting, etc. Many children start to have a protruding smile around the age of 3 or 4, but treatment can begin at 6 to 8 years of age. If you are concerned about your child's teeth when they begin to change, it is best to consult with a clinic that offers orthodontic services.

Treatment approaches for those who want to cure a gummy smile

This section describes the treatment used to cure a gummy smile.

Self-care is also an option for mild gummy smiles.

If the gummy smile is mild, improvement can be attempted through facial muscle training and by reviewing posture and habits. Specifically, movements to strengthen the muscles around the mouth and improvement of mouth breathing. However, a moderate or larger gummy smile cannot be completely corrected by self-care. When self-care reaches its limits, it may be time to consider professional treatment such as cosmetic dentistry or orthodontics.

Bianca Clinic's Gummy Smile Treatment

Bianca employs the following treatment methods for gummy smiles

Esthetic crown lengthening (crown lengthening)

This is a treatment in which the gums and underlying bone are slightly shaved away to give the visible portion of the tooth (the crown) a longer appearance in order to improve the shape and position of the gums.

Upper lip mucosectomy (lip repositioning)

This is a procedure in which a small piece of excess mucosa on the underside of the upper lip is cut away and stitched together in a position where the upper lip is not lifted too much. The goal is to reduce the amount of visible gums by adjusting the upper lip so that it does not lift too much when smiling.

Gammy Botox

This treatment uses a botulinum toxin preparation to relax the muscles of the upper lip and temporarily weaken them. The upper lip is no longer raised as much as necessary, thus making the gums less visible. In some cases, when a severe gummy smile is caused by the skeletal structure, surgical procedures such as osteotomies may be necessary. In such cases, we will collaborate with Bianca's cosmetic surgeons to propose a treatment that takes into account both functional and aesthetic aspects as much as possible.

If you want to cure your gummy smile, please visit Bianca Clinic! Please come to Bianca Clinic if you want to get rid of your gummy smile!

The bright and friendly atmosphere of a gummy smile can be a charm point that leads to “your personality. However, if you feel that you lack confidence in your smile or don't like your mouth, we want you to know that there are a variety of treatment options available to you. At Bianca, we are ready to help you achieve your ideal smile. If you are interested in advanced gummy smile treatment, Bianca Clinic is ready to help you.

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