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Braces and Invisalign move teeth. They do not fix a gummy smile, they do not rebuild teeth worn down by grinding, and they cannot replace a missing one. If your teeth are straight and the smile still is not right, send us a photo.
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What this case cost
$598/month
144 payments at 9.99% APR, on approved credit.
Total: $50,000 for the aesthetic crown lengthening, a single dental implant and twenty porcelain veneers, ten upper and ten lower.
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Treatment Plan by Dr. Mehdizadeh
- Facially-driven digital smile design
- Aesthetic crown lengthening with osseous recontouring
- Single dental implant (upper right)
- Porcelain veneers
The Patient's Journey
This patient came to our Beverly Hills practice with a gummy smile that made her self-conscious, and with teeth worn down by years of grinding. She had already completed Invisalign treatment, which straightened her teeth but couldn't address the excess gingival display or the damage from bruxism. To complicate matters, she was also missing a tooth in the upper right quadrant.
Her goal was a natural result: not the overly white, uniform look that screams "dental work," but something age-appropriate that would look like her, only better.
"The challenge isn't making teeth look good — it's making dental work invisible."
Understanding the Challenges
A gummy smile can have several causes, but hers came from altered passive eruption—a condition where the gum tissue covers more of the tooth crown than it should. The teeth themselves were of normal length; excess tissue simply hid them. Combined with the wear from bruxism, which had shortened her teeth further, the result was a smile that showed more gum than tooth.
Many patients assume a "gum lift" is a simple laser procedure. Laser-only gingivectomy treats the soft tissue but leaves the underlying bone architecture unchanged, and without addressing the bone, the gum tissue grows back. For a predictable, lasting result she needed aesthetic crown lengthening, a surgical procedure that recontours both the soft tissue and the bone beneath it.
Initial Findings
Comprehensive examination revealed: altered passive eruption causing excessive gingival display, significant tooth wear from chronic bruxism, missing tooth in the upper right quadrant, and adequate bone for implant placement.
How We Approached Treatment
Treatment began with a facially-driven digital smile design: a detailed plan of where the gum line should sit, what shape each tooth should take and how all the elements would work together. Every later procedure followed that design.
With the design established, Dr. Mehdizadeh performed the crown lengthening procedure. This involved carefully excising the excess gum tissue according to the planned gum line, then recontouring the underlying bone to support this new tissue position. The higher the gum line goes, the thicker the remaining tissue tends to become, and a thick, bulky gum line does not look natural. He therefore also reduced the gingival thickness from the facial aspect, which gives a more delicate, natural-looking gum line and healthier, pinker tissue.
After six weeks for the gum tissue to heal and mature, he placed the implant in the upper right, in the position the facially-driven digital smile design called for, so that it would support a restoration matching the adjacent veneers. Once the implant integrated with the bone, we moved forward with temporization and finally the definitive porcelain restorations.
- Facially-driven digital smile design to establish ideal tooth and gingival proportions
- Aesthetic crown lengthening with osseous recontouring
- Buccal gingival reduction for natural tissue thickness
- Six-week healing period before implant placement
- Implant placement guided by final facially-driven digital smile design
- Provisional restorations to verify aesthetics and function
- Final porcelain veneers with natural characterization
The Artistry of Natural Results
A natural result depends on details that most people never consciously notice but would immediately sense if they were wrong: subtle color gradations from the gum line to the incisal edge, surface texture that catches light the way natural enamel does, proportions that relate harmoniously to the patient's facial features.
The final result achieves exactly what she asked for. Her teeth appear longer and more prominent because the gum tissue now sits where it should. Porcelain has corrected the wear from bruxism and restored proper tooth proportions. An implant-supported crown replaces the missing tooth and blends with her natural teeth and veneers. The smile looks healthy and balanced, with nothing that looks like dental work.
"The goal isn't perfection. The goal is harmony."
Why Crown Lengthening Matters for Smile Makeovers
Crown lengthening is, in Dr. Mehdizadeh's view, one of the most underutilized procedures in general practice—let alone in aesthetic dentistry. When performed correctly, it transforms the entire framework of a smile. Combined with well-executed veneers and implant work, it enables results that simply aren't achievable through any single procedure alone.
Frequently Asked Questions About Gum Lifts and Veneers
Can you get veneers after Invisalign?
Yes. Invisalign straightens teeth and corrects alignment, creating an ideal foundation for veneers. Once the teeth are in position, veneers can address remaining cosmetic concerns like color, shape, wear damage, and minor size discrepancies. This sequenced approach produces more predictable, natural-looking results than veneers alone.
What is a gum lift?
A gum lift, or aesthetic crown lengthening, is a surgical procedure that removes excess gum tissue and recontours the underlying bone to reveal more tooth structure. Unlike laser-only treatments, true crown lengthening addresses the bone architecture to ensure lasting results. The procedure corrects "gummy smiles" caused by altered passive eruption.
How long does a smile makeover take?
A comprehensive smile makeover involving crown lengthening, implants, and veneers typically takes 4-6 months. The gum tissue requires approximately six weeks to heal after crown lengthening before proceeding with implant placement or final restorations. This staged approach ensures optimal healing and predictable outcomes.
Will my veneers look natural?
When properly designed and crafted, porcelain veneers should be indistinguishable from natural teeth. This requires attention to subtle color gradations, surface texture, and proportions that relate to your facial features. The goal is dental work that doesn't announce itself—teeth that look like they were always meant to be there.
Can a gum lift correct a gummy smile for the long term?
Yes, when performed correctly. The key is addressing both the soft tissue and underlying bone through osseous recontouring. Laser-only gingivectomy often results in gum tissue growing back because the bone level remains unchanged. Proper aesthetic crown lengthening with bone recontouring produces stable, long-lasting results.
Is a gum lift painful?
Dr. Mehdizadeh performs the gum lift under local anesthesia or IV sedation, which he administers, so you should feel no pain during treatment. Discomfort afterwards is typically mild, and over-the-counter pain medication controls it. Most patients return to normal activities within a few days.
How much does a gum lift with veneers cost in Beverly Hills?
This case was $50,000, covering the aesthetic crown lengthening, a single dental implant and twenty porcelain veneers, ten upper and ten lower. $598/month: 144 payments at 9.99% APR, on approved credit.
What is the difference between a gum lift and a gingivectomy?
A gingivectomy removes only soft tissue, often with a laser. A gum lift or aesthetic crown lengthening also recontours the underlying bone, which prevents gum tissue from growing back and supports stable, long-lasting correction of a gummy smile.
How long do porcelain veneers last?
With proper care, porcelain veneers typically last 15-20 years. Longevity depends on oral hygiene habits, avoiding habits like nail biting or ice chewing, and wearing a night guard if you grind your teeth.
Do I need Invisalign before veneers?
Not always. If teeth are relatively straight, veneers alone may suffice. However, if you have significant crowding, spacing, or bite issues, straightening teeth first creates a better foundation and often means less tooth reduction for veneers.
Can veneers fix a gummy smile?
Veneers alone cannot fix a gummy smile—they only cover the tooth surface. Correcting a gummy smile requires crown lengthening to reposition the gum line. We can then add veneers to enhance tooth shape, color, and proportions.
What causes a gummy smile?
Common causes include altered passive eruption (excess gum covering teeth), short upper lip, hyperactive lip muscles, or overgrowth of the upper jaw. A clinical examination determines the specific cause and appropriate treatment approach.
Can you eat normally after a gum lift?
Patients should eat soft foods for the first week after crown lengthening. Most return to a normal diet within 10-14 days. Avoid crunchy, spicy, or acidic foods during initial healing.
