Gummy Smile Correction – San Antonio, TX

Treatment of the “gummy smile” is one of the most overwhelmingly satisfying procedures we do in our practice. Patients are able to show off their newly sculpted smile within minutes of the procedure. In a short outpatient procedure, excess gum and bone (if necessary) is sculpted away to expose the natural tooth structure hidden below.

Ana presented to us in 1998 just prior to some big changes in her life: completion of her post-graduate residency, a trans-Atlantic move back to Greece, and her upcoming wedding. She sought us out to finally get the smile she always envisioned before the Big Day. As you can see below, the results were dramatic and beautiful - and due to her move, the “Final” photos are from just 3 weeks post-surgery. No additional dental work was needed nor performed in Ana’s case.

Thanks to Dr. Lorenzana’s involvement in several international groups and congresses, he was able to recently reunite with Ana in Barcelona, Spain, at the ITI Annual General Meeting (AGM). It’s like not a day has passed!

Orthodontists do amazing work moving teeth and closing gaps to create beautiful smiles. Sometimes, however, the gums do not cooperate and additional gingival sculpting is necessary to provide the finishing touch.

Mary was referred by her orthodontist just prior to completion of her orthodontic treatment in order to correct her gummy smile before the removal of her braces. This is the best time to perform any necessary gingival sculpting and/or crown lengthening because towards the end of orthodontic treatment, the teeth need to be held stationary for a certain amount of time before the braces can be removed. Surgical treatment and healing can be completed during this “holding phase,” followed by removal of the braces and fabrication of the retainers without any additional delays.

Notice below what a difference the Esthetic Crown Lengthening procedure made for Mary. She was so inspired by the results, that she entered an essay contest sponsored by the San Antonio District Dental Society on how dentistry has affected her life. Mary’s essay won First Place, winning her scholarship money for college and the title Miss Smile.

Orthodontic work by: Dr. Brad Bruchmiller (San Antonio, TX)

Orthodontists do amazing work moving teeth and closing gaps to create beautiful smiles. Sometimes, however, the gums do not cooperate and finishing touches are necessary to get the result you’ve always wanted. Notice what a difference an Esthetic Crown Lengthening procedure made for the patient below - and it is so satisfying to see the results maintained long-term!

Orthodontic work by: Dr. Brad Bruchmiller (San Antonio, TX)

More and more adults are seeking out orthodontists in order to straighten their teeth and beautify their smiles. There are many positive reasons for considering adult orthodontics: healthier teeth and gums, a prettier smile, a more professional appearance, maybe even because the kids are all taken care of and now it is YOUR turn (we hear that one a lot!).

Just as with teenage patients, adults can also sometimes require Esthetic Crown Lengthening to complete their makeover. This was why Tunisha was referred to our office. As evident in the pictures below, Tunisha’s teeth were hardly visible under all her gum tissue. This was even after braces and maxillofacial surgery to reposition her upper and lower jaws.

Tunisha’s Esthetic Crown Lengthening procedure was completed in just one visit and while her recovery was uneventful, the effect on her smile was much more dramatic. Again, no additional dental work was required once the lengthening was complete - no veneers, no crowns. What is seen in the photos are her own natural teeth!

Orthodontic work by: Dr. Christopher Megna, Stone Creek Orthodontics (San Antonio, TX)

There are many reasons why a patient may exhibit a “gummy” smile:

• Excessive gum tissue
• A long upper jaw
• Worn teeth
• Over-erupted teeth
• A short or uneven upper lip
• Excessive lip mobility

Along with excessive gum tissue, Jessica exhibited the last two traits. Her smile tended to be uneven due to hypermobility of her upper lip on the left side. This left her with what she described as her “crooked” smile. We did not seek to change Jessica’s smile; it was one of her most defining characteristics. However, she was referred to our practice because she and her dentist felt that her smile could be enhanced by removing the excess gum and bone tissue and exposing more of her natural tooth structure.

As Jessica said when we finished, “it’s still my smile, just better.”

The patient below was referred to us by the Graduate Program Director (at the time) of the Orthodontic Department at Baylor College of Dentistry by pure luck. “Pure luck” because as she was leaving his office after having her braces removed, she casually mentioned the next thing she wanted to do was “to have her front teeth cut down so that they would not be so big.” Her orthodontist explained to her that her front teeth were not “too big” - it was that the teeth around them were too small and referred her our way for gingival sculpting of the lateral incisors and canines.

As you can see, by creating the correct proportions of the surrounding teeth, her front teeth no longer appeared “big” - now they were “just right” and she avoided what could have been a catastrophic decision, cutting down perfectly good teeth for crowns that she did not need, and would not have even addressed her main concern.

Orthodontic work by: Dr. Jeryl English (Currently Chair, Orthodontic Dept., UT Dental Branch, Houston, TX)

Committing to having veneers done is a difficult enough decision. When a dentist suggests to a patient that an additional procedure may be required and that the additional procedure is a surgical one, that decision to follow through with treatment becomes even more difficult. This was the situation our next patient found herself in. Her dentist had suggested prior to starting treatment that she could benefit from Esthetic Crown Lengthening. She declined, but once the temporary restorations were in place, she realized that the likely result was not going to be what she wanted.

She was still hesitant when she visited with us so we offered to do a quick photoshop rendering of what her smile could look like after Esthetic Crown Lengthening and new veneers (Figure 1 and 2). Having seen her “new” smile, she agreed to proceed and the results were beyond her expectations.

Oftentimes, the perfect smile requires a Team effort.

Restorative work by: Dr. Randall Klint (San Antonio, TX)

Sherri came to see her restorative dentist because one of her porcelain veneers had recently chipped and because she was still unhappy with the length of her teeth. She had the veneers put on years before because she wanted longer teeth. In the end, she didn’t feel that they were that much longer and now they were also chipping and breaking.

Her dentist informed her that the problem was not the length of the teeth, but the amount of gum covering her teeth. He referred Sherri to our practice where we performed the Esthetic Crown Lengthening procedure prior to her new veneers being made. The final result is the smile Sherri had always pictured for herself.

The moral of the story is that when it comes to the ideal length of the teeth, sometimes it can be all about the gums.

Restorative work by: Dr. Kurt Riewe (San Antonio, TX)

“Is the investment really worth it?” It is a question we hear from time to time when it comes to the reconstruction of teeth and smiles that have seen better days. It is also a question that we are often unable to answer because every patient is different and every situation is unique. With this patient’s treatment, maybe we can put a few things into perspective.

Maurice presented to his prosthodontist with severely worn, decayed, and stained teeth that made his smile look slanted thanks to a pipe smoking habit. When teeth wear down, many different symptoms can occur: pain in the jaw joints, sensitive teeth, decayed teeth, irritated gums, an unattractive smile, among others. Thankfully, Maurice did not have any pain/sensitivity symptoms, but he did have decayed, fractured, and worn-down teeth and he was a semi-retired physician. He was very conscious of his appearance (not once was he without coat and tie during his visits), especially when making the rounds seeing patients, colleagues, and students, He knew his smile could use improvement.

Thanks to the pre-operative work by his prosthodontist mapping out the new length and shape of the teeth (including taking models, bite registrations, creating models of the proposed end result), the crown lengthening procedure accomplished the dual goals of evening out his gumline and creating longer teeth for his final crowns. Maurice was in his mid-70s and going strong when his treatment was complete. So as you take a look at Maurice’s final result, the question becomes, what is your smile worth to you?

Restorative work by: Dr. William C. Martin (Gainesville, FL)