Having a gummy smile can make one feel just as insecure as a smile with missing teeth. But by coming to see Dr. Petricca at Periodontal & Implant Clinic, he can provide crown lengthening services in Nanaimo for patients throughout Vancouver Island. To see if this procedure might be right for you, please feel free to read the supplementary information we’ve provided or contact our office to book a consultation.
Determinants of Esthetics
What one considers to be esthetically pleasing is generally a personal opinion. What a dentist may consider to be esthetic may have the following basis:
1. When a person smiles a certain number and proportion of our teeth and gums is on display within the "window" created by our lips (the buccal corridor). Genetics (jaw structure, soft tissue contours of our face, lip form, facial harmony, etc.), and sex (female vs. male) are major determinants. Females generally show more tooth and gum on smiling than men do.
2. The amount of tooth and gum that is on display when a person smiles.
Amount of Gum Seen on Smiling
Some individuals show too much teeth and gums ("the gummy smile") – others, not enough. This can be influenced by the length/height of our upper jaw and the length of our natural teeth.
Length of Natural Teeth
Some individuals have too much gum such that some of their gums covers a portion of their teeth that normally are not covered. This makes one's teeth look disproportionately square and short. Research has found that the ideal ratio of the length to the width of a tooth is 0.75 to 0.8 such that a tooth should be longer than it is wide.
Number of Teeth Seen on Smiling
This is influenced by a number of factors including our facial profile (the jawbone and facial structures and their proportions surrounding our mouth), our lip form, lip tone (how much our lips move or don't on smiling), and age. As we get older we lose elastin, a highly elastic protein that allows many tissues to resume their shape after stretching or contracting.
In recent years the dental profession has allowed dentists to perform procedures to compensate for loss of elastin, one of which is injection of botulinum toxin (Botox®). Our office does not provide this service and is primarily focused on working within the oral cavity rather that outside of it or around it.
Options to Create Ideal Tooth Proportions
Some of the gum around a tooth is cut away.
The "natural relationship" distances (also known as biologic width) between gum and bone around a tooth is constant. We generally have a 1 to 3mm pocket measured from the gumline to where the gum attaches to the root below the gumline, the attachment itself is 2mm, and then we reach the crest of bone. This translates into a total of 4 to 5mm from the gumline to the crest of bone. If the above measurements already exist, then simply cutting away gum without trimming away bone does not respect this "natural relationship." In this case, crown lengthening is indicated. In some cases however, the distance from the gumline to bone is in excess of 4 to 5mm. In such cases, a gingivectomy may suffice.
(Crown Lengthening) - Before
(Crown Lengthening) - After
Esthetic Crown Lengthening
Determining what a person likes or does not like about their smile.
An assessment of a person's smile using known research based-criteria for what is esthetically desirable.
Measurements of existing tooth dimensions.
An assessment of the health of the bone and gums in question.
A minor surgical procedure whereby some bone (millimeters) and soft tissue (gums) are trimmed around our tooth.