When you think of cosmetic dentistry, you probably think of the many ways that dentists can alter the appearance of your teeth. From bleaching and straightening to bonding and veneers, there are lots of ways that the color, texture, and shape of teeth can be altered.
But if your teeth are the focal point when people see you smile, your gums are the backdrop. Healthy, attractive gums may not get a lot of remarks from people, but they improve the overall look of your mouth. And problem gums can certainly distract from even the straightest and most attractive teeth.
Not Enough Gum Tissue: Gum Grafts
Many people experience receding gums; it may even happen so gradually that it's difficult to notice. Receding gums can be an aesthetic issue – they can make your teeth look too large or long for your mouth, and if they recede unevenly, you can end up with a lopsided smile regardless of how straight your teeth are.
Receding gums can also be a serious matter for your dental health. As the gum pulls back from your teeth, parts of the tooth that are normally protected become exposed to bacteria and plaque. One of the earliest signs of this is sensitivity to hot or cold foods; if left untreated, eventually the roots of the teeth may be exposed, and root canals or tooth extractions become necessary.
Whether the problem is medical or cosmetic, a common solution is to graft additional gum tissue onto your existing gums. This graft comes from your own tissue, either from the roof of your mouth or from elsewhere in your gums, or from a tissue bank. This additional tissue can be placed to keep your gum line symmetrical while ensuring that enough of your teeth are covered to keep them healthy.
Too Much Gum Tissue: Tissue Reduction
On the opposite end of the spectrum are people with "gummy" smiles, where the teeth look disproportionately small compared with the large amount of gum tissue. Unlike receding gums, this is always a cosmetic issue (although it occasionally accompanies other dental issues like misaligned bite).
Some amount of reshaping can be done through tissue reduction, where a cosmetic dentist removes tissue from the gum line, usually by laser. This can also be used to even up your gums if they are uneven. And if your smile is slightly gummy, tissue reduction on its own may be enough to bring your teeth and gums into proportion.
However, there is a limit to how much gum tissue can be removed – if too much is removed, then the teeth become exposed just as with receding gums. If tissue reduction on its own isn't enough to get your smile how you want it, your dentist may opt to also add material to your teeth with bonding or veneers.