The gingival smile, also called a high smile, is one in which, when smiling, four or more millimeters of gingiva are taught. However, it is a concept that depends heavily on the perception of the set of lips, teeth and gum at the time of the smile.
Gingival smile: definition and causes
A definition of gingival smile could be considered as: that situation in which there is a disproportion between teeth, gingiva and upper jaw.
The origin of the gingival smile depends on different elements:
1) The amount of gingiva that is conceived
2) The size and shape of the teeth
3) The length and degree of mobility of the upper lip
4) The position relative to the general vertical composition of teeth and jaw with respect to face and skull
Treatment based on cause
To address the treatment of gingival smile it is necessary to make a previous study and establish its diagnosis by the specialist in Dentistry with the objective of determining what the cause in each case.
- Tooth-gingiva set
Sometimes there is an alteration in the process of growth of the teeth in which the gum continues to over-cover the tooth, thus covering part of its crown. In this way the tooth appears shorter and shows more gingiva, which is a factor that contributes to the appearance of the gingival smile.
The gingival smile caused by excess gingival tissue covering a part of the dental crown is treated with periodontal surgery by a procedure consisting of: a gingivectomy and a "crown elongation". During gingivectomy exclusively gingiva is removed, while in crown elongation, excess gingival tissue and sometimes minimal bone are removed to provide the correct shape and thus expose the appropriate length of the crown of the tooth.
- The influence of the upper lip
The act of smiling actively activates many of the muscles that are used for facial expressions, especially those that facilitate the rise of the lip and indirectly expose the teeth and gums.
The average movement of a normal lip is between 6 and 8 mm from the normal resting position to a complete smile. If the lip has excessive mobility, which means that it rises more than normal, the smile may expose more gum than normal and result in a gingival smile. There are different ways to modify the action of these muscles; from a treatment of infiltrations with Botox, to temporarily paralyze these muscles, or decrease their action until the replacement of muscle insertions, to prevent excessive movement.
- A long upper jaw
When the proportion of the tooth - gum complex is normal, but there is still a lot of gingiva in the smile, the cause may be that the maxilla is too long for the face. This is called a vertical maxillary excess because the maxilla has an excessive size relative to the base of the skull. The treatment of this problem is the orthognathic surgery by which the maxilla is repositioned upwards to decrease the height of the same and to reduce the amount of gingiva that is exposed during the smile.