When it comes to cosmetic dentistry, there are a tonne of toothy 'tweakments' on offer for those who aren't happy with their smiles - which could be for a variety of reasons. Some feel their teeth aren't 'white enough', others worry they're uneven, and some fixate on having a 'gummy smile'. The latter, in layman's terms, being when a person feels their tooth-to-gum ratio is off.
Now, of course, it goes without saying that no cosmetic dentistry decision should be taken lightly and it won't be the right choice for everyone - nor are cosmetic procedures necessary. There's so much power to be gained by embracing what makes us unique. But, while I've been able to do that in many other ways (see: no longer hiding my eczema-covered legs away), when it came to my jagged-looking teeth and that aforementioned tooth-to-gum ratio issue... I have to confess, I just couldn't shake it. They (amongst other things) fed into me hating my smile for a long time.
After trying two rounds of Invisalign braces and plenty of whitening strips, I still wasn't happy. In particular, I found myself obsessing over one tooth that was comparatively smaller than the others, next to a particularly pointy fang. I know, I know (my mum also rolled her eyes). We all have our hang-ups, and this was truly my biggest.
So, fed up of smiling with my lips firmly shut all the time, and keen to find out if anything could be done to remedy the situation, I was kindly introduced to the team at Chelsea Dental Clinic, including Dr Rhona Eskander (London's cosmetic dentistry queen) and Dr Mitul Shah, a brilliant GDC registered Specialist in Periodontics (essentially, the man knows all there is to know about gums, tooth structure and everything in between).
After an initial consultation, they confirmed I'd be a good candidate for a gum lift, which would help with my journey towards getting a more symmetric smile and ultimately, composite veneers.
This is my personal experience of having a gum lift and Dr Shah's comprehensive answers to any and all other gummy smile-related questions you might have...
What is gum contouring?
In a nutshell, gum contouring - also referred to as a 'gum lift' or 'crown lengthening surgery' - is a technique used to improve the proportion of your teeth (read: make them look taller), as well as the shape and symmetry of the gums. "It's most commonly used to reduce the amount of gum that's shown when smiling, eating and talking," explains Dr Shah. "It can also improve the overall symmetry and harmony of your smile."
Who is gum contouring most suitable for?
Dr Shah confirms it can be suitable for all adult patients of any age. "Patients who present with a 'gummy smile', where they show undesirable amounts of gum will especially benefit from the procedure," he adds. "Equally, patients may require the procedure if they've worn down their teeth, as a result of erosion or grinding their teeth." The procedure can be performed on a single tooth or multiple teeth.
As an example, see the above before and after picture, showing a patient who has shorter teeth (a common condition known as altered passive eruption), who underwent a gum lift (carried out by Dr Shah) and followed it up by having the appearance of their teeth changed to look more even through composite bonding (by Dr Rhona Eskander).
In my specific case, Dr Shah explains, "The problem wasn't predominantly the 'gummy smile', but rather the entire left lateral incisor tooth was lower than the right lateral incisor tooth. As such, the tooth needed to be reduced slightly as part of the bonding procedure, alongside a slight alteration to the gum shape and position, to ensure a natural-looking symmetry with the other front teeth."
Are there any risks to having a gum lift?
Before going ahead with the procedure, your clinician should carry out x-rays to assess any individual risks that may be present. They will also send off for a personalised stencil to be made, so that when the time for your actual gum lift appointment rolls around, they have a sturdy base to work from.
"Generally, there are very few risks," confirms Dr Shah. "You may experience mild pain that can easily be managed with painkillers such as Ibuprofen. Small amounts of bleeding from the gums may be noted for a day or so following the procedure and you may experience some short-term sensitivity to hot and cold food and drink."
Is gum contouring painful and what is the aftercare like?
Having been through the procedure myself, I can attest that it's totally fine on the pain front! Dr Shah administered a local anaesthetic into my gum - which felt like the tiniest sharp scratch - before he set to work with removing the excess gum with a laser. I know that sentence probably sounds jarring, but I really didn't feel a thing (heads up if you're squeamish though, the burning gum smell isn't great... think: getting your hair caught in a hairdryer).
After the lasering, Dr Shah then popped a couple of stitches in (although not everybody will need those) and advised me not to brush the area directly during the subsequent healing time. Instead, I used an antibacterial mouthwash to keep the gums healthy and avoided any sharp foods that could interfere with the stitches.
When, after a week, a stitch ripped - again, didn't feel it! - Dr Shah quickly and kindly responded to my panicked WhatsApp saying it wasn't a problem as I had my follow-up appointment in a few days (where the remaining thread was speedily removed). Phew!
Can the gum grow back afterwards?
"If the correct technique is selected, there's little risk of this happening," says Dr Shah. "While some cases of contouring are very minimal and can be treated simply with a laser, more complicated cases may require more extensive surgery." He adds that the treating dentist should be trained to understand and select the correct approach to ensure the risk of relapse is minimal.
"Specialist Periodontists are recognised as being the most appropriate clinicians to carry out this procedure," Dr Shah confirms.
How long does it take to see the results of a gum lift?
You can see the difference straight away. Below is a before and after comparison of my mouth the morning of my procedure and shortly afterwards (it's not glam, but it only looked like that for a few days... and hey, we're living in the time of face masks).
"If the procedure is to be used in conjunction with other cosmetic treatments (such as composite bonding or porcelain veneers) then a minimum of 6 weeks of healing is required until the restorative work can be completed," Dr Shah adds. I also opted for composite veneers to complete my smile makeover*.
Here are my final results, which I couldn't be happier with - my teeth look so much brighter and far more symmetrical, while still looking natural (which was one of my key requirements). It's given me a huge, huge confidence boost and I'm now a little weirdo who constantly smiles, full teeth out, at randoms in the street:
How much does gum contouring cost?
The costs will vary depending on the number of teeth treated and the overall complexity of the procedure, says Dr Shah. "The full cost of the proposed treatment will be provided following a comprehensive consultation, [but as a ballpark figure] simple cases involving one to three teeth and contouring with a laser will begin from £600."
He notes that more complicated cases, involving up to 12 teeth, typically start from £2500. "It's possible to spread the cost of treatment over a number of months with a finance agreement."
*The smile makeover was gifted by Chelsea Dental Clinic exchange for an honest review.
Dr Mitul Shah is a GDC registered Specialist in Periodontics with a particular interest is in cosmetic periodontal surgeries, including the management of gummy smiles and complex gum recession. Contact Chelsea Dental Clinic for more information, or to book a consultation with Dr Shah. You can also reach out to him via Instagram.
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