Gum aesthetics involves assessing the appearance of the gums in relation to the teeth and lips. Differences in gum level, excessive coverage of tooth surfaces or exposed roots caused by recession may have different causes. Gum health and tooth-supporting tissues need examination before planning an appearance-related procedure.
If bleeding, swelling or inflammation is present, the cause is addressed first. Changing the shape of unhealthy tissues alone is insufficient. Oral care, scaling and necessary periodontal treatment may be part of planning. Preserving healthy gums is as important as appearance.
In suitable cases, excess gum tissue adjustment, clinical crown lengthening or soft tissue grafts for recession may be considered. These procedures have different purposes. Tissue thickness, bone level and restoration margins influence the approach. Treating the gums alone may not be sufficient in every case.
Healing varies with the procedure. Tissue stabilisation is assessed together with cleaning habits and reviews. Gum levels cannot be guaranteed never to change, and complete coverage of every exposed root cannot be promised. Expected changes, limitations and alternatives are explained during planning.
Gingivectomy
Gingivectomy is the surgical removal of excess or enlarged gum tissue in suitable cases. Its purpose is not limited to appearance; in some cases, it also reduces enlargement that makes cleaning difficult. The cause and relationship with underlying bone are assessed first.
Gum enlargement may be related to plaque accumulation, certain medicines or health conditions. Surgery is not decided upon before necessary oral care and initial treatment. If a medicine is suspected to contribute, it must not be stopped independently; this is assessed with the relevant physician. Not all enlargement is treated in the same way.
Planning examines the gum tissue that must be preserved, tissue structure and tooth-supporting tissues. Excess tissue is adjusted using an appropriate technique. If bone also needs reshaping, this is not considered equivalent to gingivectomy alone; a different surgical plan may be required.
Temporary sensitivity or bleeding may occur afterwards. Care and review arrangements are explained according to the procedure. Enlargement may recur if contributing factors persist. Oral care and control of the cause are therefore considered a continuation of surgical treatment.
Gum aesthetics
01Gummy Smile
A gummy smile means prominent gum display when smiling. This appearance alone does not indicate disease, and natural differences exist between individuals. Visible tooth length, gum level, upper lip movement and jaw structure may all contribute. Assessment therefore considers more than the amount of visible gum.
Excess gum coverage of the tooth surface, gum enlargement and pronounced lip movement may require different approaches. Alongside photographs and intraoral examination, the relationship between the gums and underlying bone is assessed. Orthodontic or jaw-related assessment may sometimes be necessary. Correct planning requires identifying the tissues responsible for the appearance.
Adjusting gum levels or lengthening the clinical crown may be considered in suitable cases. Simply removing gum tissue is not sufficient or appropriate for every gummy smile. Bone position and tooth-supporting tissues determine the limits of treatment. Several contributing factors may require assessment across different disciplines.
Healing and monitoring of gum levels are important after treatment. Changes in appearance vary with the individual and selected method. Treatment need, possible risks and alternatives are discussed together; before-and-after photographs do not mean another person will achieve the same result.
Before and after
01 / 01Gummy smile: patient example. Treatment and outcomes vary between individuals. Outcomes of surgical or interventional procedures vary between individuals. Ask your clinician for detailed advice before a procedure.