Today’s post is a little different, because the patient it features has given us permission to show her whole face. So this is a post in which I will mix the patient’s own words with the clinical reasoning behind how I solved this gummy smile case using the gingivoplasty technique.
This is Bárbara. As you can see, the patient had a gummy smile when she came to see us. She had had orthodontic treatment at another practice, but she still looked in the mirror without seeing the version of herself she would truly feel comfortable and attractive with.
“My teeth are still small; I would love to have a bigger tooth and not show so much gum”
After listening to Bárbara and analyzing her case, I noted the following:
- The patient did indeed have a gummy smile: when she smiled and raised her upper lip, she showed her teeth and an excessive amount of gum. As a result, the teeth looked very small.
- The patient also had very dark teeth, something we had to correct with teeth whitening in order to improve the look of her smile.
It is worth noting that teeth are naturally longer than they are wide. When someone sees their teeth as short, square or small, it is usually down to one of three factors:
- The gum has grown too much and covers part of the teeth: this is called altered passive eruption. What happens is that, as the teeth erupt, instead of the gum receding to the neck of the tooth it stays halfway down the crown, so that much of the tooth remains hidden beneath the gum.
- This also sometimes happens because, during treatment with braces, the gum tends to grow towards the bracket, and that gum overgrowth also hides the teeth. In this second case, all that is needed is to trim the gums without going down to the bone. With altered passive eruption, however, both the gum and the bone supporting the tooth usually have to be recontoured, so they are two different treatments.
- Another reason for teeth looking short is that the patient clenches so much that, over the years, the teeth have worn down considerably; if that is not stopped, they can end up losing the teeth altogether.
In our patient’s case it was altered passive eruption, so we carried out gum surgery that included recontouring both bone and gum. It is a procedure done under local anesthetic that takes around 30 minutes. It is an area with no real recovery period, so the patient’s daily life is not disrupted.
“I did not feel any discomfort after the surgery and I carried on with my life as normal. I was a bit frightened at first, but then it was nothing!”
Once we remove the stitches, we wait at least 2 or 3 months (depending on the case and how it heals) before carrying out the whitening treatment.
In this case the whitening technique we are using is the at-home one with trays, in which the patient applies the product for 90 minutes a day.
After correcting this gummy smile with the gingivoplasty technique, the patient has the smile she had always wanted. We will show you the results of the whitening treatment in another post: it is working wonders on Bárbara’s teeth. 🙂
