Metal Mouth Message Board

There’s a chance I’ll get braces in the semi-near future to fix some minor issues with my teeth, and I'd want to utilize the opportunity by thinking about aesthetics as well. There are two changes that I'm interested in; possibly widening/broadening my smile a little bit, and reducing the gumminess. Of the two, the gumminess bothers me more. I’ve read that both of these things can be achieved without surgery, but the changes will be subtle. I’m not looking for huge changes though so subtle is fine. Below is one picture of my smile and one picture of my mouth at rest.

[url=http://imgur.com/NkWdMNt]smile[/url]

[url=http://imgur.com/VswuK7N]at rest[/url]

My only concern is that I have pretty visible/prominent front teeth and I actually want their position to stay (mostly) the same. This has become a characteristic feature of my face and I'd be sad to see it go. I wouldn’t mind having the amount that my front teeth show reduced a little bit if doing so would be necessary to help with the gummy smile, but I really wouldn’t be comfortable with more than a tiny change. I'm a twenty year old female by the way.

I know some of you will probably say that my smile is fine the way it is, but I'd still like to hear whether or not the changes I have in mind sound realistic or even possible based on other people's personal experiences. Stability is a big concern of mine; if there’s a huge chance of relapse with either of these two things or there’s a significant chance that my roots could be damaged, that's something I'd need to consider. This has caused me a lot of insecurity over the past few years, but I don't want to do anything rash. I also don't know how to go about addressing these aesthetic concerns with my orthodontist without feeling kind of ridiculous. I’m worried that because they aren’t medically necessary, he’ll just brush me off or flat out say no. I don’t want to sound annoying, but I do want to feel like I’m getting a good return on my investment.

Thanks!

Looks like the hyperlink formatting got botched... Not sure how to fix it though, so hopefully it won't be an issue.

Pic links aren't working so I can't comment on that. But as for your ortho thinking you're ridiculous to discuss aesthetic changes? Most of his practice is based on giving people pretty smiles. Guaranteed he won't think you're silly for wanting things to look pretty. That's his job.

Thanks for the advice. I know the ortho won't think I'm ridiculous for caring about looks. I'm just worried that we won't agree on the subject of looks; that he'll tell me my smile looks fine and the issues are all in my head, since my teeth aren't seriously messed up or anything (I realize that whether or not my smile looks good is subjective, and I've had people tell me before that they like it - it's just that I don't like it). I'm also afraid to trust the ortho without hammering out all the little details first, because I've seen other people do that before and I almost feel like their teeth look worse after braces. I think I'm too nervous about the whole thing to just hand him the reigns and see what happens, without having a detailed plan for what the aesthetic end result is supposed to be. I feel like some orthos only focus on functionality - like fixing crookedness, giving you the perfect bite, etc. - and any aesthetic changes (for better or for worse) are just a side effect of that, instead of a primary focus of equal importance.

Also, do you have any idea how I can get the links to work?

I hope you get the comments you're looking for, but I'm going to be the guy who says that your smile is fine. I wouldn't consider that excessive gumminess at all. Just my two cents...

I can't get the links to work but agree that you need to have an open and honest conversation with your ortho about what you want the end result to be. Frame your concerns in exactly the way you have to us. It's their job (and in their interest) to achieve the best result in terms of both functionality and aesthetics.

verso wrote:I hope you get the comments you're looking for, but I'm going to be the guy who says that your smile is fine. I wouldn't consider that excessive gumminess at all. Just my two cents...

i agree

Your perception is important, so I think it is reasonable to discuss it with the orthodontist to get their opinion of what is possible. Of course you realize that they cannot predict with 100% certainty, but you should get a sense of the odds. You may want to start the discussion laying out your concerns, and your ideal end-state to give the orthodontist room to maneuver, and perhaps to suggest other options that might augment your orthodontic treatment. For example, I had a friend who had been a model at a famous New York Agency (Ford) but who didn't have "big teeth," as she described it and it bugged the heck out of her since she did have somewhat of a gummy smile. Her dentist excised gum tissue to increase the exposure of her teeth, and she was happy with the result. I don't know if that is a common or even acceptable dental practice, but there you have it. Best of luck to you!

Repost the links. I think you pasted the URL in the wrong place between the brackets.

The links work fine if you cut and paste just the URL itself and not the whole code.

That said, I don't really think your front teeth look all that prominent. Maybe it's different in person but they look pretty typical to me. I also don't think braces will do any major changes. Your teeth are already pretty much perfectly straight. It may broaden your smile a bit but it's hard to tell from the photos.

I also agree that your smile isn't excessively gummy. Overall, you have a pretty nice smile.

djspeece wrote:it bugged the heck out of her since she did have somewhat of a gummy smile. Her dentist excised gum tissue to increase the exposure of her teeth, and she was happy with the result. I don't know if that is a common or even acceptable dental practice

That's for where the issue is stubby teeth + gummy smile. In this case teeth height looks ok (I think) so the normal treatment is a maxillary impaction, assuming there is vertical maxillary excess. But that's kind of a big deal and probably not justifiable. Intrusion using anchorage devices may also be possible.

On the upside OP, your lip will sag over time and you'll still have youthful incisor display at rest. At least that's what I tell myself

OP here - thanks for all the helpful replies so far you guys! I recognize that my smile isn't excessively gummy (for some reason I feel like my smile looks more narrow/gummy in person as opposed to the picture), but I feel like reducing it even a little bit would give me a big boost to my self esteem. And I figured if I end up getting braces anyways, might as well ask just to see if it sounds feasible. I'm fine with a little gum display; I think it'd be necessary if I want to mostly preserve the position of my front teeth. I just don't like how much I have now.

I've heard about intrusion using anchorage devices, but I'd be wary because of the issue of long term stability (if there's a high chance of relapse what's the point?), the possibility of damaging my teeth, and the potential for facial changes. I've heard people on this forum who describe some pretty drastic changes to their faces/bone structures after undergoing orthodontic treatment that goes beyond simply straightening the teeth (e.g. widening the palate, reshaping the arch, fixing asymmetries, impaction, etc.), and I'm wondering if an orthodontist would be able to give me an idea of what the end result would look like beforehand. I'm not saying those sorts of changes are good or bad, I'm just wondering if they would be totally unpredictable. I've also heard of the whole "don't fix the gumminess now because you'll be thanking yourself when you're older and your lips sag" thing, but a) I don't know how much the average persons lip actually sags with age, and b) I'd be pretty annoyed if I didn't do anything on the assumption that it would look good later on and I ended up being wrong.

komontell wrote:I've heard about intrusion using anchorage devices, but I'd be wary because of the issue of long term stability (if there's a high chance of relapse what's the point?)

My opinion is that you'll hear that from orthodontists and/or surgeons who can't be bothered keeping up to date with current technology. The Japanese have been doing some pretty hard core intrusion work since the late 1990s, which is a decent time period to assess stability on an anecdotal basis at least.

[quote="mmkay"]My opinion is that you'll hear that from orthodontists and/or surgeons who can't be bothered keeping up to date with current technology. The Japanese have been doing some pretty hard core intrusion work since the late 1990s, which is a decent time period to assess stability on an anecdotal basis at least.[/quote]

That sounds really fascinating. Do you have any suggested readings so I can learn more about this? Do the Japanese also work with non-surgical expansion? (Again, to a small degree). Also, do you have any advice on finding an orthodontist that isn't outdated?

The prospect of safe, effective, long-lasting intrusion being possible is exciting, especially since the changes I want would be minor. Would you say intrusion is the best option for me, considering how I like the position of my two front teeth and want them to mostly stay put?

If you google "open bite skeletal anchorage" you'll see some results. It's the same technology that can be used for intrusion of front teeth. I do recall seeing a case study somewhere of this being done, but THIS IS SPAM PLEASE REPORT IT TO THE ADMINISTRATOR. THIS IS SPAM PLEASE REPORT IT TO THE ADMINISTRATOR. THIS IS SPAM PLEASE REPORT IT TO THE ADMINISTRATOR. THIS IS SPAM PLEASE REPORT IT TO THE ADMINISTRATOR. it's not all that common. My main point was that you need to be wary of orthodontists dismissing intrusion, of open bites anyway.

Non-surgical palate expansion is a different issue, that's more controversial as the claim is to adjust bone rather than teeth.

In terms of finding an orthodontist, younger can be better - although mine isn't. Being associated with teaching at a good dental school is something to look for IMO.

For a minor gummy smile it's unlikely that an impaction is a serious option so that doesn't leave you with much else other than braces/intrusion. If intrusion isn't an option, fine, but you want to hear that from an orthodontist that does it in cases where it is know to work (such as open bite).