In addition to a well aligned set of teeth, the shape, size and proportion of teeth as well as gum contours and symmetry also contribute to a pleasing smile. The size of our natural teeth may sometimes be either too large or too small, and the shape may appear too bulky, or conversely too sharp. In addition, excessive gums may also show when we smile and if the gums which show are at a similar level
Resizing and reshaping teeth
While the use of clear aligners, veneers and crowns can give us the proverbial "Hollywood smile", sometimes all that is needed to improve our appearance is a simple reshaping or recontouring of our front teeth. This quick and painless procedure involves smoothening jagged edges, adjusting the length of teeth or rounding off uneven surfaces. We can also add or bond tooth-coloured materials to change tooth shape and size. Bonding involves roughening of the surfaces of teeth followed by etching and adding of a tooth coloured resin filling material to achieve the desired tooth contour.
Is the procedure painful
No, it is not painful as only very minimal trimming is done and there is no need even for local anaesthesia as the refinement is restricted to the outer enamel layer of the tooth which does not have any nerve supply. Rounding off edges or selectively reshaping the surface of the tooth to give it a more chiselled look will create a more slender and refined appearance. After recontouring, the surface is polished and some topical fluoride is added in order to re-establish the protective outer layer of enamel.
Do Gums Affect our Appearance?
A pleasing appearance is more than just having well aligned or whiter teeth. It also includes having healthy gums with an aesthetic amount of gums seen when we smile, or when we are speaking. Receding of gums due to disease, or excessive gums visible due to the structure of our jaws or lips also affect the symmetry and harmony of our smile. Gum health can be improved through thorough cleaning while receding, asymmetric or excessive gums can be modified through minor surgical procedures such as gum recontouring or repositioning or through gum grafting and regeneration.
What are Cosmetic Gum Procedures?
The main objective of cosmetic gum procedures is to achieve a symmetrical, balanced and harmonious gum line. The following are the common procedures used:
01. Gum Recontouring - This involves the removal of excessive gums in order to achieve a healthy, symmetrical, balanced and harmonious gum line. Ideally around 2-3 mm of gums should be visible when you smile. At the same time the underlying bony support of healthy gums should always lie around 3 mm below the gum level. If this is more than 3 mm, it forms an unhealthy pocket which traps bacteria. If less than 3 mm, the gums remain inflammed. A special instrument or bur may be required to remove a little of the bone to maintain this dimension known as the “biological width”.
02. Gum Repositioning - This procedure involves a minor surgical procedure to move the gums forwards to cover exposed root surfaces. It can also be done in the opposite direction to balance any asymmetry between gum levels or to lengthen the teeth in order to better retain a crown, if required.
03. Gum Grafting - When teeth appear long due to gum recession, we can use gum from a different part of the mouth to cover the exposed root surface. This involves a minor surgery to lift the gum around the affected tooth and slip the transferred gum to cover the root surface before stitching over it. The gums will fuse together after 6 weeks and cover the tooth thereby improving the appearance and reducing the sensitivity. The procedure which takes an hour can be done under local anaesthesia or with the comfort of intravenous sedation. You may feel some discomfort from the “donor gum” site for a week.
04. Gum Regeneration - Gums can regenerate if we create favourable conditions for the gums and the underlying bone to regrow. This involves a minor surgical procedure to lift up the gum and prop up the space with either artificial bone or a firm membrane. The teeth in the particular segment will also need to be thoroughly cleaned. In the presence of an adequate blood supply, the body is able to regenerate the gum tissues, or at the very least to heal. The use of some components of our own blood, termed medically as “PRP” or platelet rich plasma, can help improve the success of tissue regeneration.
What is a cosmetic dentistry makeover?
A cosmetic dentistry makeover is a combination of various procedures to ensure a radiant smile with well aligned teeth, appropriate amount of gum showing, well supported lips, and a pleasing facial proportion and profile. As an example, aligners alone straighten teeth but do not change tooth shape, size or colour. If done in combination with veneers, we can improve the overall smile and at the same time shorten the period of aligner wear. Likewise, veneers or crowns alone alone may improve tooth colour but adding a gum recontouring procedure will enhance the overall smile.