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04-01-14 | Posted by

Do you show a lot of gum when you smile? Dentists have a name for that—it’s called a “gummy smile.” Think Miley, Gwen Stefani, and Beyonce in the early days without Photoshop®.

According to New York City Cosmetic Dentist Brian Kantor, “Gummy smile refers to an excessive display of gum tissue when smiling. The causes can range from overgrowth of the upper jaw, a short upper lip, hyperactive upper lip, as well as an overgrowth of gum tissue.” If you put your hand over your mouth when you laugh or are self conscious about smiling too broadly to avoid showing too much of your gums, BOTOX® can be an easy temporary fix for the problem of a gummy smile. A small injection of BOTOX® in the upper lip can reduce the lifting action of lip muscles, which reduces the amount of gum tissue that shows. The treatment lasts about 3-4 months.

In an off-label study published in the Aesthetic Surgery Journal March 2014 issue on the application of onabotulinumtoxinA (BOTOX® Cosmetic, Allergan) for treatment of excessive gingival display, also known as “gummy smile,” researchers found that this injectable treatment offers an effective, minimally invasive, and safe alternative to surgery, yielding a significant improvement in smile aesthetics with high patient satisfaction. The findings are presented in the article, OnabotulinumtoxinA for the Treatment of a ‘Gummy Smile’.

According to lead author Tampa Plastic Surgeon Jessica Suber, MD, “Approximately 14% of women and 7% of men have excessive gingival exposure upon smiling.” The study showed that participants had significant improvements in their smile aesthetics, and the vast majority indicated high satisfaction levels and interest in repeat treatments.

Participants in the study had a minimum of 2mm of gingival or gum tissue exposure above the central incisors upon smiling naturally, a trait often considered aesthetically unappealing. All patients were initially classified as having a “cuspid smile,” where elevator muscles raise the upper lip—like a window shade—to expose the upper teeth and gingival scaffold, contributing to a “gummy smile.” OnabotulinumtoxinA was bilaterally injected into participants’ lip elevator muscles at three sites. Two weeks after treatment, all patients showed a significant decrease in gingival show, with an average reduction of 85% over the central incisors and 83% over the canines. In addition, all but one patient was highly satisfied with their post-treatment smile.

“The smile is such a meaningful facial expression, and it is very important for the overall aesthetics of patients,” said Foad Nahai, MD, Editor-in-Chief of Aesthetic Surgery Journal.

If BOTOX® is too temporary for your tastes, Kantor says, “An alternative to correcting a gummy smile is to have a gum lift followed by porcelain veneers to get the total smile transformation.”

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