Need advice...gummy smile developed after 1 yr of treatment

If your child is in any stage of orthodontic treatment, this is a place to connect with other parents in your situation. Please note: this is a forum for adults only -- kids may not post here!

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Need advice...gummy smile developed after 1 yr of treatment

#1 Post by Desertshell » Sat Mar 26, 2011 5:49 pm

This is long, but please read all of it. My 14 yr old daughter had braces put on a year ago for a slight overbite and cross bite and has been wearing rubber bands for about 4 months. She had a very pretty smile before the braces went on so the braces were put on to correct her bite. However, the orthodontist did talk to me about possibly widening her smile a bit, which I thought would be OK. Well that has happened, but now her smile does not look pretty like it used to. The upper arch has become much more rounded and wider than before and tends to fill up her mouth more giving the look of a more protruding smile and her cheeks tend to puff out where they didn't used to. She has a narrow face which makes me wonder if it is too wide. And to add to it, her smile has become very gummy...gummy to the point of other kids commenting on it. I wasn't aware of the comments until she saw a recent picture of herself and said she now understands their comments. She thinks her smile looks like a monkey's. Prior to her realization of the situation, I spoke to the Dr. about it. He hemmed and hawed and couldn't give me any satisfactory response as to whether this was a normal progression in the treatment or even whether it could be corrected. He acted like this was a situation he had never encountered which left me very unsettled since he has been in practice for 20+ years. I have seen numerous posts about surgery for this same type of problem, but for patients who started with this problem not as a result of braces. Has this happened to anyone else and does anyone know if it can be simply corrected? I plan on taking her to another ortho for a 2nd opinion, but any help and/or advise from parents or any one in the orthodontic field would be greatly appreciated.

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Re: Need advice...gummy smile developed after 1 yr of treatm

#2 Post by RMF7825 » Mon Jul 11, 2011 10:31 am

If you are comfortable posting before/after pics, it would be helpful.

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Re: Need advice...gummy smile developed after 1 yr of treatm

#3 Post by sweetcynic » Sun Sep 23, 2012 5:37 am

This actually sounds a lot like a couple of complaints I have about my current "before" smile, though mine is more extensive. In my case, I had an appliance when I was 6 that was supposed to widen my arch due to crowding. It did widen my arch, but I still had(and have) an overjet, overbite, lip incompetence(if I relax my lips with my jaws closed my lips still hang open about 1 cm), gummy smile, and crowding(albeit to a slightly lesser degree). Also I notice in pictures it was around then that my face became much rounder and as a result I looked overweight even when I wasn't. Orthodontic treatment(in this case braces)was being recommended again by the time I was 11, though due to a combination of my parents' finances and my resistance they didn't happen.

Now, at 27, the above things are going to be addressed as follows: Overjet - 2 extractions, pull the front teeth back. overbite - intrude the anterior teeth, extrude the second molars. Lip incompetence - extractions should help, as they facilitate pulling the overjet back. Gummy smile - to whatever extent the previous treatment doesn't get rid if it, I can, if I desire, get a gingivectomy(where they remove a mm or 2 of gum over the tooth crown) after treatment. Crowding - the upper extractions and lower alignment should address this. As for the wide face, I don't know if they can really do anything about that, except to the extent that the extractions will narrow my arch a bit.

I wonder, does she have enough gum room for a gingivectomy afterward? Is her treatment pushing her lower front teeth forward or pulling the upper front teeth back? If she already had an overbite, anything that pushes the front teeth further forward will make the gummy smile worse. My ortho mentioned that treating my overbite by flaring(where they change the tooth angle) rather than pulling things back would worsen my lip incompetence and gummy smile. Good luck!

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