Gummy smile: why the frame matters more than the teeth
Three extra millimetres of gum on display change a smile more than any crown shade, but the same picture has four causes and four different treatments.
Measure before you treat
At a full smile most people show the gum line and no more than two millimetres above it. Beyond three or four millimetres the eye reads the smile as gummy. Four different things produce that same picture: gum that never finished migrating during eruption, an over-active upper lip, a naturally short lip, or a jaw that is simply too long vertically. Only a photograph at full smile plus measurements can separate them.
Crown lengthening and the rule people ignore
Gum cannot simply be trimmed away. About three millimetres of attachment re-forms above the bone crest no matter what, so if the bone is not recontoured at the same time the gum grows straight back within a few months. That is why a laser gingivectomy alone suits only the cases with enough distance to the bone, and why definitive crowns wait six to eight weeks for the tissue to settle.
When the answer is not gum surgery at all
An over-active lip is treated in the lip elevator muscles, lasts three to four months and has to be repeated. A short lip may need a lip repositioning procedure. Vertical excess of the upper jaw is skeletal, and no veneer, laser or injection changes it. That is maxillofacial surgery, and if that is what your face shows, we will tell you and refer rather than sell you ten crowns.
Sequencing with crowns and veneers
Pink work comes first, white work second. Digital planning sets the gum zenith heights and checks them against the lip line before a single tooth is prepared. Patients notice a one millimetre asymmetry in the gum line far more readily than a shade difference between neighbouring teeth, so zirconium is wasted money if the frame around it is crooked.
The Ones People Actually Ask.
Does gum contouring hurt?
The procedure itself is done under local anaesthetic and most patients describe the following days as tenderness rather than pain. Laser contouring bleeds very little; when bone has to be recontoured, expect three or four days of soreness.
Will the gum grow back afterwards?
If the attachment distance to the bone was respected, no. Relapse happens almost exclusively when gum was cut without addressing the bone underneath, which is the single most common reason people come to us for a second attempt.
More On Dental.
Peri-implantitis is the leading cause of implants lost after year three, and it starts in gums that were never…
The crown margin: why a good crown shows a line years laterThe line at the neck of a crown usually appears because the gum moved, not because the crown failed, and where the…
Gum pocket depth: what 3mm, 5mm and 7mm really meanOne to three millimetres is healthy, six or more means bone loss, but a shallow pocket that bleeds every time tells…
Braces or veneers? Moving teeth versus covering themAligners take a year and remove nothing; veneers take a week and remove enamel for good, the crowding measured in…
What Stands Behind The Plan.
