The “Gummy” Smile

As we age, some of us begin to get the “long in the tooth” look.  The reason for that is that the gum tissue and the underlying bone are thin and weak. Over a period of time, the gums recede, exposing the root surface.  I have written about several options available to shore up the gums and bone, and in many cases, cover over the exposed root surfaces.

But there is also the opposite problem. Instead of the surrounding gum and bone being thin and receding, the gums and particularly the underlying bone are too thick.  That produces what might be called the “short in the tooth” look, or the “gummy smile.”

What is the gummy smile? You’ve seen it. The teeth look short. They’ve always looked short. When the person smiles, you see more gum than tooth. People are under the misimpression that they are born with short teeth.  That is almost never the case. The teeth are actually the correct length. The problem is much of that length is hidden under an overabundance of bone around the tooth. So because the bone is so thick, the gums appear thick and cover much more of the tooth than usual. The remainder of the tooth is hidden beneath that gum and bone tissue. It’s like a turtleneck sweater that goes over your chin. Your chin is hidden. Same way with the tooth.  The neck of the tooth is hidden.

Gummy smiles are not only a cosmetic problem, they can cause other problems as well. If for example you get a cavity between the teeth,  the cavity is much more difficult to treat because the decay is buried beneath the excess bone and gum tissue.  You may get bleeding and a periodontal pocket as a result because the filling is intruding into the space occupied by the gum and bone.

The good news is that the gummy smile and overabundant gum and bone tissue can be treated.  And while the treatment for this problem is surgical in nature, the healing after the surgery is comfortable and the results are permanent.

Here’s what is done: The periodontist will lift the gum tissue away from the teeth and bone and then sculpt the bone around those teeth into the proper shape.  The gum tissue is then returned to place. Because the underlying bone is no longer propping up the gum tissue, the gum can now rest in the proper relationship with the tooth.  The result is front teeth that are the correct length, taller than they are wide. The result is back teeth are the correct length, allowing for crowns to be placed in their proper position, making them less likely to fall off or cause tissue irritation.

So if when you smile, you see short teeth, rest assured that those teeth are not really short. The rest of those teeth are hidden, and with just the right surgical procedure, your teeth can look totally normal.

Lee N. Sheldon, DMD