Page 22 - Amazing Smiles

CHAPTER TWO figure 11
figure 12
A very common lip variation is called a “high
lip line,” giving a patient a “gummy” smile look
(figure11). This occurs when the muscles of the
mouth pull the upper lip up too high, when smil-
ing or speaking or when the bone supporting the
upper teeth (maxillary bone) is too prominent. On
most people’s smiles, the lips cover the part of
the teeth that enters the gum line (called the
gingival margins). The actual gum line appear-
ance in these patients is not cosmetically impor-
tant because it can’t be seen during a smile.

When the lip line is high, the gums and
shape of the gingival contours play a more critical
role in how the teeth and smile looks.

Ideally, all the gingival margins should be
even, as if they were lined up against an imaginary
line at the top of all the teeth. Unfortunately,
gingival margins are often at different levels giving
teeth an unbalanced look or a sense of uneven-
ness. Whether it is a single tooth or a group of
teeth that have uneven gingival margins, it should
be corrected if the gums show when the person
smiles. Otherwise, eyes will always focus on the
uneven gum line when the person smiles (figure
12). If the gums are covering too much tooth
structure, correction is accomplished by a simple
surgical procedure called a gingivectomy.
Sometimes a much greater amount of gums must
be removed. This involves a more advanced crown
lengthening procedure with bone reduction to
remove underlying bone support of the tooth.

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