GUMMY SMILE PART 2 BY DR. MAHMOUD ABU ZAINAH

Temporary anchorage devices

If you don’t want to have surgery, talk to your dentist about whether a temporary anchorage device (TAD) is right for you. This device can help pull your teeth into a position that may reduce a gummy smile.

What to know about TADs

TADs are tiny screws implanted into the bone in your mouth.

They’re usually put into place in the office of an oral or maxillofacial surgeon.

Local anesthetic is used to numb the area where the screws are implanted.

TADs are less invasive and less expensive than surgery. They typically cost around $300 to $600 each.

Whether they’re the right solution for you will depend on what’s causing your gummy smile.

Botox

If moving your lips too far up over your gumline when you smile causes your gummy smile, you may have success with injections of botulinum toxin, also known as Botox.

In a 2016 study, 23 women with gummy smiles received a Botox injection to paralyze the elevator muscles in their lips. After 2 weeks, 99.6 percent of the women saw a difference in their smiles.

Botox is less expensive and less intrusive than surgery. On average, it costs around $397 per injection.

The drawbacks? You’ll have to repeat the injections every 3 to 4 months. There’s also the risk that your doctor will inject too much Botox, which will cause your smile to look distorted.

Hyaluronic acid

Another way to temporarily correct a gummy smile caused by hypermobile lips involves injections of hyaluronic acid fillers. The fillers restrict the movement of muscle fibers in your lip for up to 8 months.

It’s important to note that injecting fillers comes with risks. Though complications are rare, it’s possible that:

Your blood supply could be damaged, leading to tissue loss, blindness, or stroke.

Your body’s immune system could react to the hyaluronic acid and form a nodule or granuloma.

Compared with surgical options, hyaluronic acid fillers are inexpensive, costing around $682 per vial on average.

The bottom line

A gummy smile is one that shows more of your gumline than you’d prefer. It’s also known as excessive gingival display.

A gummy smile can be caused by:

the way your teeth grow in

the length of your upper lip

the way your lips move when you smile

If a gummy smile is affecting your self-esteem or you’re concerned about the health of your gums, you have several options for correcting it.

Some treatment options are more invasive and expensive than others. Talk to your doctor or dentist about which treatments are best for you.

Whether you decide to alter your gums or not, know this: The world is a brighter place when your smile lights it up, no matter what it looks like.

What Is Gum Contouring and Why Is It Done?

Everyone’s gumlines are different. Some are high, some are low, and some are in between. Some may even be uneven.

If you feel self-conscious about your gumline, there are ways to change it. Gum contouring, also known as gingival sculpting or gingivoplasty, is one of the options that can help reshape your gumline.

In some cases, your dentist may even suggest it, especially if you have issues with your gums that affect your oral health. But, what exactly does it involve?

This article will shed light on what gum contouring is, how and when it’s done, and what the recovery is like.

What is gum contouring?

Gum contouring is a procedure, done by a dental specialist, that reshapes or resculpts your gumline.

The process of gum contouring involves cutting away or removing excess gum tissue around your teeth. If you have gum recession, the procedure involves restoring gum tissue.

In many cases, gum contouring is an elective procedure. This means that it isn’t medically necessary. Instead, it’s done to improve the look of the gums, teeth, or smile.

But there may be times when your dentist recommends gum contouring for oral health reasons.

When is it medically necessary?

Many times, gum contouring is done for cosmetic purposes. But there are times when it may be a medical necessity.

If you have periodontal disease, gum contouring may be a treatment option. But your dentist will first try to treat the gum disease with nonsurgical options. This may include antibiotics to kill the bacteria and infection, or dental cleanings to restore gum health.

If these efforts don’t work, your dentist may recommend a treatment such as pocket reduction surgery on the gums and surrounding bone to save a tooth. Or you may need a regeneration procedure to regrow damaged bone and gum tissue.

Gum contouring might be part of these procedures. And if so, dental insurance may cover the cost, or part of it, if it’s deemed a medical necessity. You’ll need to speak with your dental insurance provider to find out what’s covered and if there are out-of-pocket expenses.

What does gum contouring involve?

Gum contouring is usually done by a periodontist or a cosmetic dentist. It’s an in-office procedure that’s typically done in one visit.

In most cases, you’ll remain awake during the procedure. Before the doctor starts, you’ll receive local anesthesia to numb the gum area.

During the procedure, the doctor will use a soft tissue laser or scalpel to remove excess gum tissue and resculpt the gumline to expose more of the tooth. Sutures may be used to hold the gum tissue in place.

If your gums recede and the procedure involves adding gum tissue, your doctor will remove tissue from another part of your mouth, maybe your palate. Surgery secures this tissue around your teeth to lengthen and restructure your gumline.

The length of the procedure will vary depending on the extent of the contouring and the amount of resculpting that’s needed. Generally, gum contouring takes about 1 to 2 hours.

Does gum contouring hurt?

You’ll be given local anesthesia before the procedure starts. This will numb your gums so you won’t feel pain while the doctor is working on your mouth. But you can expect some tenderness and numbness afterward.

The amount of discomfort depends on how much of your gums had to be reshaped or removed.

After the surgery, your doctor may prescribe a pain reliever, or you can take over-the-counter pain medication like acetaminophen (Tylenol) or ibuprofen (Advil). Since aspirin can cause bleeding, your doctor might discourage this medication.

You can also reduce pain and swelling by applying an ice pack or cold compress to your mouth for a couple of days after the procedure. It’s best to apply the compress for 15 to 20 minutes at a time.

How long is recovery?

Gum contouring involves little downtime, but complete healing might take days or weeks, depending on the extent of the surgery. You may have to limit some activities for a day or two based on how you feel and any tenderness you may have.

Since your gums and mouth will likely feel sensitive or tender at first, you’ll want to eat soft foods for about 2 to 3 days after the procedure. This might include foods such as:

soup

yogurt

applesauce

Jell-O

Your doctor will provide post-surgery dietary instructions and will also let you know if there are any foods to avoid while you’re recovering.

You’ll typically have a follow-up appointment a few days or a week after the procedure. Your doctor will check your gums to monitor how you’re healing and look for signs of an infection.

They may prescribe an antibiotic mouth rinse to reduce the risk of infection. Signs of infection include increased pain and swelling and discharge from the gums.

How much does it cost?

Gum contouring is often done for cosmetic reasons, which makes it an elective procedure — meaning it isn’t medically necessary. For this reason, dental insurance typically doesn’t cover the cost.

If not medically necessary, you’ll pay for the procedure out of pocket. The cost will vary depending on the amount of gum tissue removed or restored, and whether a specialist performs the procedure.

Costs range from $50 to $350 for one tooth or up to $3,000 for all of your front top teeth.

If your dentist recommends gum contouring for oral health reasons, dental insurance may cover part of the cost. You’ll want to talk to your dental insurance provider for details about how much is covered.

The bottom line

Gum contouring, also known as gingival sculpting, is a process that involves reshaping the gumline. It’s often used to improve the look of the gums, teeth, or smile. It’s considered a cosmetic procedure when it’s done for this reason.

There are instances, though, when gum contouring or reshaping is necessary for oral health reasons, especially if you have periodontal disease.

The procedure is typically an in-office procedure and takes about 1 to 2 hours. The cost can vary depending on how much gum reshaping is needed and whether it’s covered by dental insurance.

Can receding gums grow back?

Receding gums are gums that have pulled away from a tooth, leaving its delicate root exposed. This also creates small spaces where plaque, a sticky film of bacteria, can collect. This can lead to more recession. Left untreated, it can eventually cause bone and tooth loss.

Many things can cause receding gums, including poor dental hygiene, brushing too hard, and aging.

Your gum tissue doesn’t regenerate the way other types of tissue does (like the epithelial tissue of your skin, for example). As a result, receding gums don’t grow back.

Keep reading to learn what you can do to treat receding gums, even if they won’t grow back.

What about natural remedies?

Many people claim that several natural remedies can treat receding gums. Some of the most popular ones include:

oil pulling

drinking green tea

using aloe vera

Each of these remedies can help to improve your oral health. A 2009 study found that swishing sesame oil around in the mouth seemed to help reduce plaque and gum inflammation.

However, the study only involved 20 participants, and they were all between the ages of 16 and 18, long before age-related gum recession starts to set in.

A 2009 article also highlighted the potential benefits of green tea for fighting common bacterial causes of gum inflammation. A 2011 study concluded that applying aloe vera gel just under the gums also reduced bacteria and inflammation. However, the study only involved 15 participants.

While all this research suggests that these natural remedies may be beneficial to your oral health, none of them demonstrated any ability to make gum tissue grow back. There’s no treatment — natural or medical — that can make receding gums grow back.

What can you do about receding gums?

Even though receding gums won’t grow back, there are still several things you can do to prevent them from receding more. There are also some procedures that can reduce the appearance of receding gums.

Slow down the process

Start by making an appointment with your dentist. They’ll measure how far your gums have receded to determine the most effective next steps. If you have bacteria in the small spaces created by receding gums, they’ll likely start with a deep cleaning procedure called scaling and root planing.

Scaling and root planing involves scraping away tartar from your teeth and under your gum line. It’s done with either a hand-held scraper or an ultrasonic device that uses vibrations to loosen and remove plaque.

In some cases, your dentist might apply a slow-release antibacterial gel under your gum line or prescribe an antibiotic mouthwash.

This is often the first step in treating receding gums, since removing bacteria can slow down and sometimes even halt the process. To maintain the results, you’ll need to follow up with good oral hygiene to avoid future buildups of plaque.

This involves:

gently brushing your teeth twice a day with a soft-bristled brush

flossing in between your teeth daily before brushing

going in for regular dental cleanings every six months

Consider surgery

For more severe cases, your dentist might suggest surgery to remove bacteria that’s deep under your gums or to replace missing gum tissue.

Common surgical treatments include:

Flap surgery. Your dentist will make a small incision in your gum tissue to lift it up and remove any plaque they couldn’t get to during the scaling and root planing procedure. After they’ve removed the bacteria, they’ll secure your gum tissue in place. This can prevent eventual bone loss.

Gum graft. An oral surgeon will take gum tissue from another part of your mouth and surgically place it around the receding area. This can both reduce the appearance of receding gums and protect your tooth and bone from future damage.

Bonding. Gum-colored resin can be placed over the roots of your affected teeth. This both reduces the appearance of receding gums and protects the sensitive roots of your teeth.

The bottom line

Receding gums are a common condition. Even with good oral hygiene habits, aging and genetics can still cause gum loss.

While your gum tissue can’t grow back, there are many treatment options that can help stop or slow down the process.

Work with your dentist to figure out the most effective treatment option based on your general oral health and the amount of recession you have.