I Hate my Gummy Smile, Should I Have Gum Reduction Surgery Before Getting Crowns/Veneers? (photo)

Would you suggest gum reducing surgery, and then crowns/veeners? I have some bonding now, that is chipped and dis-coloring. Is a gum lift/grafting a smart choice before veeners/crowns?

Doctor Answers 7

Gummy Smile Correction, Then Veeners

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Thank you for your question and including photos. It's always recommended that a patient correct his or her gummy smile before moving forward with getting veneers or crowns. As for your specific case, there are a number of options available to reduce the amount of gums that show when you smile. I've developed a lip-lowering technique as an alternative to more invasive jaw surgery that is sometimes used for gummy smile patients. Gum contouring is another choice. Schedule a consultation with an experienced periodontist, who can recommend an appropriate treatment plan after a thorough evaluation of your specific condition.

Gummy smile

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The cosmetic dentist or an orthognathic surgeon should evaluate the area.  If you can afford to remove some gum without sacrificing the biological health and over lengthening the teeth (in proportion to your face), then the gum surgery can be done. After measuring, they would tell you how much gum would be left to reveal itself post surgery. If still not satisfied, then jaw surgery is the solution. Another simple way is to see how much tooth you show, is when your lips are apart and at rest. females should show 2-3mm of front teeth.

Good luck!

Majid Jamali, DMD
New York Oral & Maxillofacial Surgeon
4.8 out of 5 stars 19 reviews

A "gum lift" would improve your smile

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Great question!  You must have already done some research to realize that a "gum tissue lift" would greatly improve the esthetics of your smile since there is currently an excessive gum tissue display.  There are a few different options available, but you need to find a dentist with advanced training in cosmetics to best determine the type of gum tissue surgery that is needed.  A detailed exam including x-rays and photos will be needed.  Many times gum tissue procedures can be done with lasers.  Other times, people are referred to a periodontist for the gum tissue procedure.  

To answer your second question, yes you should definitely have the gum tissue lift done before the crowns and veneers.  That is the best way to ensure a beautiful result because then the crowns and veneers can be the ideal shape and size for you.

Kristen Berning, DDS
Dubuque Dentist

Laser gum re shaping, use a safe laser!

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Usually, the best way to do a case like you are describing is to have a well qualified cosmetic dentist or prosthodontist work in conjunction with an experienced laser periodontist that uses multiple laser wavelength machines to ensure that the safest laser is used that will not damage any of the supporting structures in your mouth.
In fact, ask to see pictures of cases that the cosmetic dentist and periodontist have completed.
Then you can you see what you might expect to look like after your treatment.

Eric Linden, DMD, MSD
New York Periodontist

Gummy Smile

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I would be cautious in your case.  It looks like you have a lot of gum in your smile.  Typically, gum can only safely be raised by 2-3 mm.  THe gums should then be allowed to heal for many weeks before the veneers.  THere may be a refinement surgery necessary.  The gum lift surgery may get you close enough to where you want to be.  The other more dramatic solution is upper Jaw surgery where the upper jaw is impacted up - this is more indicated when there is 6 or more mm of excess gumminess.  We call the condition vertical maxillary excess - VME.  Make sure you get a few consultations an clearly communicate your expectations.  Make sure you see before and after photos of the doctor's own work that is specifically applicable to you.  THese types of cases are often botched.  Do not do the laser crown lengthening.  I do it myself and it is for mild cases only.  You need full surgical crown lengthening

Lawrence Singer, DMD
Washington Dentist
5.0 out of 5 stars 4 reviews

Gum Surgery is done Before Crowns/Veneers

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Ideally you always want to do gum surgery (elective or not) before you do your crowns and veneers.  In the front of your mouth this may mean waiting 4-8 weeks for final healing prior to starting the dental work.  I find a laser to be much gentler to the gums and results in speedier healing.  Sometimes this is not possible.  It is very important that you are using an experienced Dentist & possibly Periodontist team.  You will need x-rays and a thorough checking of your bone height and gum health prior to starting.  The Cosmetics with a "gum lift' in the right hands can be quite stunning.  Good Luck.

Madeleinne Zapantis, DMD
Long Island Dentist

Gummy Smile...Gum Reduction before veneers or crowns?

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You would first start with the appearance of a gummy smile that you dislike.  I would use waterlase laser on a tooth by tooth basis and remove portions of the bone material and gum tissue, thereby exposing more of the tooth structure.Then the crown lengthening and gingival trimming would be monitored  very closely to assure a perfect match for each new veneer that was to be placed on the  tooth.The final cosmetic result should show a harnony and symmetrical balance between the amount of gum showing and the the length of the tooth to create a natural beautiful smile.  Make sure you find a dentist who uses laser technology to do the gum reduction!  Good luck and enjoy a beautiful new smile!

George Koutsoukos, DDS
Valencia Dentist

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.