In my last blog post, I wrote about how well planned orthodontic treatment can positively affect facial appearance by improving the profile. Consideration of the profile is critical in orthodontic treatment planning. A well balanced profile is our goal on each and every patient we treat. Another aspect of orthodontic planning that few people know much about is how orthodontic treatment can affect a “gummy smile”.
A gummy smile is one in which there is an excessive amount of gum tissue that shows over the front teeth when a person smiles. It is normal for a teenager to show a small amount of the gums, but when there is too much gum tissue that shows, it is not attractive by most people’s standards. As a result, a person with a gummy smile will “hide” their gummy smile by not smiling as big. Imagine not being able to fully smile when you are happy! People with gummy smiles get so good at hiding their gummy smile that they actually forget how to smile naturally!
Here is a smiling picture of a patient who shows about 4-5mm of gum tissue above his front teeth when he smiles. This is not a big, natural smile either. When he actually smiled fully, he showed even more of his gums. Orthodontic treatment can be designed to move the upper front teeth in an upward direction. This is not intuitive to most people, as it seems like the teeth would get shorter as they are moved upwards “into” the gums. Actually what happens is that the gum tissue will move upwards with the teeth, and the gummy smile will be eliminated or reduced.
Here is a picture of him while he was still wearing braces, after his upper front teeth had been moved upward to reduce the gummy smile. You can see that his gums are now hidden behind his upper lip when he smiles.
After orthodontic treatment, you can see that even with a big, happy smile, he doesn’t show too much gum tissue when he smiles. This is a more attractive smile, and he is no longer self-conscious about his smile so he fully smiles when he is happy. The change in his smile did not happen by chance, but by a well thought out orthodontic treatment plan that included moving the upper front teeth in an upward direction as part of his overall bite correction. This process (orthodontists call it intrusion) can be added to most orthodontic treatment plans in order to help correct a gummy smile. The key is that the problem must be identified, and the orthodontic plan designed to correct this problem. Straight teeth are not all that is necessary to have an attractive smile!