At Great Length

Corrective gum procedure brings smile to teen’s face.

Photo by Nerissa Johnson.

Emma is happy to show off her new smile.

Who says playing video games is a waste of time? Emma Subin certainly doesn’t. In fact, this 17-year-old high school senior, currently prepping for her first year of college, is on a path to turn her passion for video games into a paycheck.

“When I was really young, I played a lot of video games, like Mario Kart, Super Mario Bros.® and Pokémon, and when I got a little older, my dad and I would play Guitar Hero® together, and it was always something that made me happy,” Emma explains.

“I decided I’d like to make video games in a way that will make other people happy, too, so I’m going to study video-game design in college. Video-game design is a profession that can be very profitable, so I’m really excited about it.”

Emma’s excitement is evident in her smile. It’s bright and wide, and she’s so proud of it that she shows it off quite often these days. It wasn’t that long ago, though, that Emma was very hesitant to smile, even when she had good reason to.

“For so long, I was very insecure about my smile, and that was because of my teeth,” Emma says. “I had small, short, kind of square teeth that looked almost like what a little child’s teeth look like when they’re first getting their teeth in.

“I was very self-conscious of it, so I didn’t smile very much. You can see why in my senior pictures. When I look at them, all I can see are my gums, and that was very upsetting for me. I couldn’t even stand to look at them sometimes.

“For so long, I thought there was nothing I could do about it, that it was something I was going to have to learn to live with. Then about two years ago, I stumbled across an Instagram post someone put up about their gummy smile transformation.

“At first, I thought, Wow, I didn’t even know this was a thing. Then, I asked my dentist about it and told her that I was really unhappy with my teeth and gums, and she was the one who recommended Dr. DeTure to me.”

Dr. DeTure is C. Nicholas DeTure, DMD, of Stuart Periodontics. He specializes in repairing damaged gums and repairing smiles through a procedure known clinically as anatomical crown exposure, or anatomical crown lengthening.

Overlap Reduction

When Emma first visited him this past December, Dr. DeTure explained that her smile had been negatively affected by altered passive eruption, a condition where the gums greatly overlap the teeth and make them look short, like a child’s teeth.

Some medical professionals believe the condition is hereditary, but Dr. DeTure explains that in many cases, including Emma’s, it also develops as a result of wearing braces that keep the teeth in place for an extended period during their development.

The condition is considered to be a common one, and Dr. DeTure recommended anatomical crown lengthening to correct it. Emma and her parents agreed to the procedure after learning it can be completed during a single, 90-minute visit.

“We call it a gummy smile reduction,” Dr. DeTure says of the treatment. “That’s far less clinical and easier to understand, and the idea behind it is to further expose the natural crowns of the teeth so that the right amount of tooth shows when someone smiles.

“It’s something that instantly makes people more confident because they like their smile better. And a lot of times, if friends don’t know about it, they’ll ask you, Did you get your hair cut or something? because the patient looks better, but they don’t know why.”

The treatment can be performed on any tooth in either arch, upper or lower, and while some periodontists limit it to the teeth in a patient’s smile zone, Dr. DeTure prefers to go back to the patient’s first molars on either side to create a wide beautiful smile.

“We have found that if we only correct the teeth in what some people lovingly call the social six, meaning your six front teeth, then there’s a step down of the gum of the teeth behind those front six teeth, which looks awkward.

“The results of the treatment totally exceeded my expectations. Even now, I sometimes look at my teeth and think, Wow, I had no idea that much tooth was under those gums.” – Emma

“You have all those gummy teeth behind the front six, and that can be unappealing. So we tend to always blend it back to the first molar so that there is a nice, harmonious appearance that looks natural, the way it’s supposed to.”

Patients receiving the treatment, which requires cutting away a few millimeters of gum tissue, reshaping the bone supporting the teeth and suturing the gums, are usually given a local anesthetic. But Dr. DeTure says it is a relatively painless treatment.

“What typically hurts in dentistry is when something is exposed that’s not supposed to be exposed,” Dr. DeTure educates. “In this treatment, we’re not exposing anything that’s not supposed to be exposed.

“We’re exposing the enamel, or the clinical crown, of the tooth. When we remove the gum, all that’s exposed is enamel, and enamel is supposed to be exposed. If we exposed root surface, that would be sensitive afterward, but we don’t do that.

“We typically use a scalpel for the gum removal, but most of the time is spent reshaping the bone supporting the teeth and taking the precise measurements to make sure the teeth are ideally sized.

“Some patients will feel a little bit of discomfort the day we perform the procedure after the anesthetic wears off, but most heal very quickly, and the stitches we use dissolve over a short period of time.”

Merry Christmas

Emma had her surgery on December 23. She considered it an early Christmas present, and that present brought tears of joy to her eyes when her new smile was revealed to her a few minutes after the procedure was completed.

“I took a video of myself when I first saw my teeth, and I just cried happy tears because I was so thrilled,” Emma says. “I cried the whole way home, and I just couldn’t stop looking at my teeth, even though my gums were still a bit battered up.”

Emma says she needed a little more than a week to heal completely from the procedure, in part because it took a little longer than usual for her stitches to dissolve. By the time she returned to school, though, she was healed and smiling more widely than ever.

“My teeth look amazing now,” Emma exudes. “For so long, I smiled with my mouth closed, and I didn’t even want to smile in pictures. Now, I smile all the time, and I’m smiling big and showing my teeth in all my pictures.

“I am ecstatic that I had the procedure done, so if anyone is upset with their teeth or how they look or if they’re uncomfortable smiling, I definitely recommend they get this done. It has really changed the view of how I see myself.

“And I want to say that Dr. DeTure did a great job. I was a little nervous about the surgery at first, but he made me feel very comfortable beforehand because he answered all my questions and took care of all my worries. That was super helpful.

“The results of the treatment totally exceeded my expectations. Even now, I sometimes look at my teeth and think, Wow, I had no idea that much tooth was under those gums. I couldn’t be happier.”

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    • Stuart Periodontics, PA

      For a healthier mouth and a more beautiful smile, visit a respected periodontist in Stuart, FL. Dr. DeTure and his caring staff of professionals are dedicated to keeping you feeling and looking your best. Their team offers first rate dental c... Read More

    • C. Nicholas DeTure, DMD

      C. Nicholas DeTure, DMD, is a graduate of the University of Florida College of Dentistry and completed three years of graduate training in periodontology and implantology at the University of Tennessee in Memphis. He is a Diplomate of the Amer... Read More