What is the Best Way to Treat my Gummy Smile? (photo)

Question

I went to a consult for botox for my gummy smile.The surgeon said he wouldn't do botox because of the unknown effect but would do lip repositioning.He said he would put me to sleep and it would take 40 minutes.This is the first I am hearing of this and can not find anyone else in Long Island who does this to get a second opinion. I also can not find much about it online like what can go wrong.Is this a easy procedure?Is this a permanent solution?Do you do crown lengthening with this? Thank you!

Nick M. Mobilia, DDS · Answer

A gummy smile can be corrected with Botox injections as a temporary solution.  As a matter of fact, in certain cases, a properly trained practitioner can not only correct a gummy smile but can also reduce your naso-labial folds or smile lines by strategic placement of Botox alone but these treatments would have to be repeated.  From the profile photo submitted, a better and long term solution might include a surgical and orthodontic consultation.  A photo of your normal smile with teeth apart would also be helpful.  Reshaping of your gums should also be a consideration, either by a laser if reshaping involves soft tissue alone or by surgical intervention if the bone supporting your teeth needs to be recontoured.  After your occlusion or bite is evaluated with an emphasis on the health of your TMJ, there still might be a need for conservative restorative treatment such as porcelain veneers or possibly crowns.  The question to you would be do you want to go through all of this permanent treatment or would a temporary solution suffice?

Alex Farnoosh, DMD · Answer

Thanks for your question. The surgeon
you spoke with was likely referring to a technique that's sometimes called
"lip lowering" and is often the preferred option for treating gummy
smile. During the procedure, the surgeon makes a small incision along the
tissue where the upper lip meets the gum. He or she then uses a special
technique that limits the retraction of the upper lip so that it exposes less
gum when you smile. Unlike BOTOX injections, it is a permanent solution, and
although it usually alleviates a gummy smile on its own, crown lengthening can
be incorporated into the procedure depending on the nature of your condition.
This option is safer, less invasive, and often less costly than jaw surgery.

Majid Jamali, DMD · Answer

I see a moderate maxillary (upper jaw) excess. This is a skeletal issue and it should be corrected surgically.

Alina Krivitsky, DDS · Answer

Gummy smile treatment options can cary depending on the origin.  Gummy smile can be of skeletal origin, dental origin or a combination of both. For skeletal cases, usually orthognathic surgery is the treatment of choice.  However, since orthognathic surgery is a difficult surgery which can be very costly and with many permanent side effects, many patients choose other options. In such instances, as well as  dental or combination cases, treatment of choice is crown lengthening, lip repositioning (also called reverse frenectomy), and restorative treatment if necessary.  From the pictures you posted, I believe that lip repositioning is the best treatment.  It's a very simple procedure which we routinely do on our patients and teach to our residents.  I hope this helps with your concern.

	Best,

	Dr. Krivitsky

What is the Best Way to Treat my Gummy Smile? (photo)

Answers (4)

Answer: Lip Repositioning

Answer: Lip Repositioning

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What is the Best Way to Treat my Gummy Smile? (photo)

Answers (4)

Answer: Lip Repositioning

Answer: Lip Repositioning

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