How is a gingival smile diagnosed?

In the previous article, we considered the signs, main causes and mechanism of development of a gingival (gingival) smile.

In this article on estet-portal.com read about modern methods of gingival smile correction, who needs it and when.

The presence of a gingival smile can sometimes be manifested by some symptoms and sensations, both physical and psychological.

If the gingival smile is the result of excessive vertical growth of the upper jaw, then patients may be disturbed lack of lips and at rest.

• Main complaints and symptoms in the presence of a gingival smile
• What methods are used to diagnose a gingival smile
• Basic methods of gum smile correctionki

Main complaints and symptoms in the presence of a gingival smile

Complaints may include enlargement of the lower third of the face.

Approximately 75% of cases of a gingival smile may complain of  retrusion of the upper incisors, i.e. tilting of the crowns into the oral cavity. 

If the cause of the gingival smile is gingival hyperplasia, it is possible to develop gingival bleeding when brushing your teeth and the presence of a feeling of swelling gingival tissue.

Gummy smile is a cosmetic defect that can cause psychological problems.

In addition, a gingival smile can be a symptom of hyperfunction of mimic muscles, as well as a cause disturbance of the structure of the facial skeleton.

Sometimes, a gingival smile can lead to a decrease in masticatory function, which provokes diseases of the temporomandibular joint and the gastrointestinal tract. If the cause is gum hyperplasia, then if the diagnosis is not timely, periodontitis may develop, which can lead to tooth loss.

As a rule, a gingival smile is not a pathology that can lead to complications.

Correction of such a condition is carried out if it causes  severe psychological discomfort to the patient, and he wants to lose itgo.

What does aesthetic dentistry do

What methods are used to diagnose a gingival smile

Diagnosis of the gingival smile is carried out by the dentist at the usual appointment, as well as before the correction in order to choose the method of correction.

This patient is asked to smile broadly while looking for additional problems or abnormalities, such as  malocclusion.

The methods for diagnosing a gingival smile include:

• Photography.

They take pictures in different projections, in some cases they use an intraoral mirror.

This photo protocol is made to evaluate the results of treatment or for the purpose of presentation to patients.

• External examination and interrogation.

The patient is asked to smile broadly, assessing how uncomfortable the state of his oral cavity and smile is for the patient, whether he has complexes because of his problem, whether he wants to fix it.

• Impression taking.

The impression is a negative and accurate impression of the dentition and mucosa.

It is obtained from silicone or alginate masses.

Used for casting plaster models and planning orthodontic treatment.

• X-ray examination.

Before surgical treatment, teleroentgenography, CT scan, orthopantomography are performed, according to which the state of bone tissue and teeth, joints of the upper jaw and sinus are assessed, angularc and linear dimensions are calculated.

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Basic methods for correcting a gingival smile

Gummy smile correction can be carried out by dentists, lores and plastic surgeons.

In clinical dentistry, there are 3 directions in the correction of a gingival smile.

It is surgical, cosmetic and orthodontic.

• Orthodontic treatment.

It is not uncommon for a gingival smile to be accompanied by a malocclusion.

To correct such a violation, with still incomplete bone growth, use orthodontic apparatus "facial arch", or bracket system.

Then the upper anterior incisors move backward and the gum tissue becomes less visible.

Bracket systems are also used in case of excessive teething for their insertion together with the surrounding gum into the bone tissue.

• Surgical treatment.

If the patient has a tall upper jaw and is at an age when facial skeleton growth is complete, then the best solution would be le Fort maxillary osteotomy I.

In this method, the upper jaw is shortened.

An incision is made in the oral cavity at the level of the pear-shaped notch, if necessary, excess gingival tissues are excised (in case of a hyperplastic process or slow migration of gingival tissue). 

In some cases, the frenulum of the upper lip is corrected (frenuloplasty) for further growth of the filtrum.

It is also possible to operate on the circular muscle with massages to reduce hyperfunction and move the vestibule.

• Cosmetological methods.

 botulinum toxin is injected into the muscle that lifts the nasal wing to eliminate the increased function of the striated muscles.

Botulinum toxin is a muscle relaxant. After that the normal contractile function of facial muscles returns, and the exposure of the gum tissue when the lips move upward becomes normal.

It is also possible injectable lip augmentation by injection of a special gel.

The increase in lip volume results in a longer upper lip and less gingival exposure.

To prevent a gum smile, it is necessary from childhood to regularly visit dentist and orthodontist for the purpose of early detection of defects, problems and anomalies.

Pregnant women should avoid factors that may affect the development of the skeletal system in the child.

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