A gummy smile or excessive gingival display is a condition where an excessive amount of gingival tissue shows on the upper teeth when smiling. While it’s not a major medical concern in most cases, many people seek cosmetic correction due to aesthetic dissatisfaction. In modern times, dentistry offers effective and minimally invasive solutions for this issue through gummy smile treatment, which can be performed as a routine care procedure. The most common approaches include gingivectomy and gingivoplasty.

Understanding the gummy Smile treatment.

If there is more than 2 to 3mm of gingival tissue visible while smiling, it is considered a gummy smile. The causes of a gummy smile include:

• Excessive gingival tissue,

• Short upper lip or hyperactive lip muscles,

• Vertical maxillary excess, and

• Adapted teeth with excess gum coverage.

Depending on the underlying cause, smile treatment is planned to restore balance between the teeth, gums, and lips for a more aesthetic smile.

Non-surgical versus surgical approaches.

The gummy smile treatment varies depending on the underlying cause. In cases where the excessive gingival show is a concern, surgical contouring of the gums is effective. These procedures are typically performed under local anaesthesia and on an outpatient basis, which requires minimal recovery time.

In cases where the cause of excessive gingival show is because of the excess underlying bone that is leading to protrusion of the Maxilla or mandible, Orthognathic surgery has to be performed. 

GINGIVECTOMY

Gingivectomy is a surgical procedure involving the removal of excessive gum tissue. This procedure enhances the smile by exposing more of the tooth surface. It is indicated in cases of generalised gingival overgrowth, short clinical crowns, or when improvised aesthetic contouring is desired. As part of gummy smile treatment, gingivectomy is one of the most effective options for achieving a balanced and attractive smile.

It is a minor surgical procedure performed under local anaesthesia. Using a scalpel or laser, excess gum tissue is removed following the perfect margins of the gingiva. The gingival margins are then shaped to create a harmonious scalloped line.

As part of gummy smile treatment, this procedure offers immediate aesthetic improvement with a minimally invasive recovery time. It can also be combined with crown lengthening if required, ensuring a more balanced and confident smile.

GINGIVOPLASTY

This procedure is often performed in conjunction with a gingivectomy as part of gummy smile treatment. It involves the reshaping of the gingiva to correct asymmetry or any irregularities present.

The procedure involves sculpting of gentle margins using a laser, scalpel, or rotary instrument, following tissue removal if required.

This procedure provides a more natural appearance to the gingiva and refines the gum line. It is indicated when the gum contours are uneven or if there is any presence of bulgeous tissue. The advantage of this gummy smile treatment is that it provides aesthetic enhancement without removing a significant amount of tissue.

Case report :

A 25-year-old female presented with excessive gingival display measuring 5 mm on smiling. Following gingivectomy and gingivoplasty, the gingival display was reduced to <2 mm, significantly improving smile aesthetics.

Advantages of daycare surgical management

• The procedure is done on the same day of discharge.
• Very minimal and quick recovery time, which is in 2 to 7 days for most patients.
• Very minimal discomfort due to advanced and modern anaesthesia.
• High patient satisfaction as immediate visual improvement can be noticed.
  
  

Postoperative care

• Mild discomfort and swelling will be present, which is managed by analgesics. 
• Patients are advised to switch to a soft diet for a few days and practice gentle oral hygiene.
• Follow-up visits to ensure proper healing and tissue adaptation during the recovery time.
  
  

Conclusion

Gingivectomy and gingivoplasty to correct a gummy smile is a safe, effective, and efficient day care procedure that transforms a patient’s smile and boosts confidence. With advanced technologies present, the procedure is even less invasive, providing improved aesthetic results. The recovery time is very minimal, which will help patients to switch to their daily routine very quickly.