Policy on browser cookies
This website uses cookies. To find out more about cookies, read this page. If you continue browsing this site, you are deemed to have automatically authorised Facial Sculpture Clinic to use these cookies. Please note: blocking certain types of cookies will impede the proper functioning of the website.

Orthognathic classification - Too much teeth showing - Gummy smile

Too much teeth showing, gummy smile
Synonym: ‘long face’ or ‘vertical maxillary hyperplasia’ (V.M.H.).
The primary cause of a long face syndrome is an unfavourable growth pattern (i.e. a developmental growth deformity). Very often, those people have large adenoids. Nasal polyps were present and obstructed the airway. Since their early youth, they had had a clear tendency to sleep with their mouths open and faces in hyper-extension. This caused a stretching vertical outgrow of the face during growth and sleep. Remember that slow, but continuous forces are the most influential and most determinant for developmental deformities around mouth and face.
Facial features
Facial characteristics of a long face are the gummy smile, difficulty in closing the lips, and lip strain during mouth closure. The upper jaw has grown vertically too far downwards. When relaxed, the mouth is ‘hanging open’, showing too many teeth. When the patient laughs, there is a disturbing degree of gingival show, resulting in a ‘gummy smile’.

In those patients the chin area is often too long and/or the cheek areas are deflated.
Dental features
Bite can be a dental class I, II, or III. An open bite (aperthognathia) is, in fact, the same disorder. Here the upper jaw has overgrown vertically in the back area, resulting in an anterior open bite.
The treatment
Facial Sculpture Clinic - Dr Joël Defrancq - Jaw surgery and implant reconstructive surgery The treatment is orthognathic surgery. Surgery involves a repositioning of the upper jaw into a higher position in relation to the rest of the face (Le Fort I intrusion osteotomy). Surgical results are often most rewarding. The shape of the face becomes shorter. The restlessness disappears. The smile becomes harmonious. The nose suits the face better. There is a natural closure of upper and lower lips. 

In a Class II a lower jaw advancement is performed as well, and in a Class III a lower jaw set back. Chin surgery is never far away in the harmonisation of the long face.

It is possible that Dr Defrancq might recommend chin surgery and/or a cheek augmentation as well.
Note: It must be said that some people cope very well in life with a long face to a certain degree. Often, it gives them a very characteristic face. Certainly, not all people need treatment. Undeniably, the Belgian chansonier Jacques Brel and the French film actor Fernandel both had long faces. On the other hand, Julia Roberts merely has a hyperactive upper lip partly due to her wide lips. The lip to incisor distance stays perfect.

Facial Sculpture Clinic - Dr Joël Defrancq - Jaw surgery and implant reconstructive surgery