Gum Shaping
 Sometimes overlooked in appearance related dentistry is the influence of the gums. In the same way that a picture is affected by the matting and frame, so it is that the gums impact tooth appearance. Too much gum display, uneven gums and receded gums can all detract from otherwise nice teeth and compromise the total smile effect.
A little consideration to this smile component can reap significant benefits. Too much gum tissue can result in teeth that look short and stubby. Too much lip mobility can create a "horse smile". Uneven gum levels disrupt the symmetry and harmony that we associate with beauty. Loss of gum tissue can lead to being "long in the tooth". We have treatments for each of these conditions. Some are quite dramatic and profound. Others are subtler and less predictable.
Gummy Smile
 A gummy smile can overwhelm the teeth, becoming the first smile component that people notice. Studies have shown that this is broadly considered unaesthetic. When you smile, your upper lip should ideally fall where your gum touches your two front teeth. The average person allows a deviation from this ideal position of 1 to 3 millimeters before it becomes noticeable and disrupts a potentially attractive smile.
Altered eruption - Many gummy smiles are due to an alteration in the eruption pattern of the teeth and are characterized by teeth that appear shorter and wider than average. This is generally easy to remedy by a treatment called crown lengthening. It involves trimming some the gum away so that less shows in the smile and reveals a tooth of normal proportions that was hiding under the high gum. As a routine procedure, the postoperative experience is generally easy and uneventful. It does require stitches. The results are nearly always quite pleasing and stable.
High lip line - If you have a gummy smile, but the size of the front teeth are normal, the facial proportions are normal, and the length of the lip is normal, then you may be dealing with a hypermobile lip. The remedy is to lower the upper lip so that it reveals less of your gum line when you smile. This can be accomplished with a surgical procedure in which the lip is reattached from the inside at a level that is closer to the teeth. Although this surgery doesn't produce perfection every time, it often reduces the excessive upward movement of the lip satisfactorily. Relapse (going back to how it was before) is occasionally reported.
Wear - Sometimes the front teeth wear and then erupt to compensate, dragging the gum down with them and causing the gums to show in a smile. This can be treated with orthodontics and/or gum surgery and/or crowns.
Bite - In certain bite situations the front teeth over-erupt and the gums come along with them. This results in excessive gum display while smiling. Orthodontic treatment is the preferred approach.
Longer than usual upper jaw bone - If there is considerable gum shown when not smiling and the lip is not short and the above categories have been ruled out, then the diagnosis of vertical maxillary excess (long midface) is likely. This may treatable by an oral surgeon.
Short upper lip - This is found when there is excess tooth display at rest and the person has normal facial proportions. An upper lip that measures shorter than 22 millimeters usually characterizes it. Consultation with a plastic surgeon is advised, but generally this situation is not amenable to treatment.
Loss of Gum Tissue
 Loss of gum tissue can occur on a single tooth, multiple teeth, or in an area where a tooth is missing and the tissue has collapsed. When the condition happens in isolated areas it creates an asymmetry, which results in a lack of harmony, creating an unaesthetic situation. When the tissue loss is generalized, the teeth begin to look too long. This relationship of unnatural length to width ratio is intuitively recognized as unattractive. Deficiencies of tissue in the site of missing teeth create shadows and abnormal appearance of replacement teeth (bridges or implants). They don't seem to be naturally growing out of the gum.
Remedies are on hand for most of these circumstances. Often we can replace lost tissue to it's original condition by grafting donor tissue obtained either from another site in the patient's mouth or from a variety of other sources. These are relatively successful processes, but not exceedingly precise.
As you may gather, I enjoy addressing the smaller details that almost unconsciously affect our sense of balance and harmony.
Other Cosmetic Dental Services
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