It is a common desire to improve the appearance of a smile by making teeth look longer and more proportional. While the natural length of a tooth’s enamel cannot be increased, modern cosmetic and restorative dentistry offers several effective ways to achieve the desired aesthetic length. The solution chosen depends on the underlying reason for the short appearance, whether it is unexposed tooth structure or actual material loss. Addressing tooth length can dramatically enhance the smile’s harmony and restore lost function.
Reasons Why Teeth Appear Short
One of the most frequent causes of teeth appearing shorter is the slow, continuous process of wear, known as attrition. This wear often results from chronic teeth grinding or clenching (bruxism), which gradually removes the hard enamel and underlying dentin from the biting edges. Over decades, this habit can significantly flatten the tooth surface, leading to an aged or diminished smile appearance.
A distinct cause is a condition called altered passive eruption, a genetic variation where the gum tissue fails to recede completely to the ideal position during the natural development process. In these cases, the full anatomical crown of the tooth is present but remains partially covered by excessive gum tissue. This results in a clinical crown that looks squat and a smile that shows an unusually large amount of gum, often referred to as a “gummy smile.”
Teeth may also erupt with naturally shorter clinical crowns due to genetic factors unrelated to gum position or wear. General wear and tear that accumulates with age, combined with the normal settling of the bite, contributes to a gradual reduction in the visible length of the teeth.
Revealing Existing Tooth Length Through Gum Contouring
For individuals whose teeth are physically short only because they are partially buried under gum tissue, the solution involves a surgical procedure to uncover the hidden enamel. This technique is often referred to as crown lengthening, or sometimes gingivectomy when only soft tissue is removed. The procedure works by adjusting the gum line to expose the full, naturally existing length of the tooth that was previously concealed.
The procedure involves repositioning the gum tissue and sometimes recontouring a small amount of the underlying bone. This establishes a healthy biological distance between the tooth and surrounding structures, ensuring the gum tissue remains stable and does not grow back. It is typically performed under local anesthesia, using a specialized instrument or laser to make precise adjustments.
This approach is highly effective for correcting a gummy smile, creating a more balanced and proportional appearance between the teeth and gums. Initial healing of the soft tissue usually occurs within the first week, but stabilization of the gums and bone may take four to six weeks. Following the procedure, the teeth immediately appear their full, natural length, resulting in cosmetic improvement.
Adding Material to Increase Tooth Length
When tooth structure has been lost due to wear or fracture, the lengthening process requires adding material to the tooth surface. This is accomplished using restorative and cosmetic techniques, with the choice depending on the extent of the loss, durability needs, and aesthetic goals. Dental bonding is the least invasive method, using a tooth-colored composite resin material applied and sculpted directly onto the tooth.
Bonding is a cost-effective option and requires minimal alteration of the natural tooth structure, often being completed in a single dental visit. However, the composite resin material is not as durable as other options and is more susceptible to staining and chipping over time, typically lasting between three and ten years. For a more robust and aesthetically superior result, porcelain veneers are often recommended.
Veneers are thin, custom-made shells, usually porcelain, that are bonded to the front surface of the tooth. They are highly durable, stain-resistant, and provide an excellent, lifelike appearance, generally lasting 10 to 15 years or longer. Placing veneers usually requires removing a small amount of enamel to allow the restoration to fit properly. For cases involving severe wear, extensive damage, or a need for full structural support, a dental crown may be necessary. Crowns are full-coverage restorations that encase the entire visible portion of the tooth, providing maximum strength and the longest lifespan, often exceeding 15 years.
Long-Term Maintenance and Protecting Your Investment
Proper long-term care is essential to maintaining the results of any tooth lengthening procedure, particularly protecting new restorations from the forces that caused the original wear. If the short appearance was due to bruxism, a custom-fitted night guard is often prescribed to act as a protective barrier during sleep. This appliance prevents grinding from damaging the newly lengthened tooth edges or restorations.
Patients must maintain excellent oral hygiene, as restorations require specific care to ensure longevity and prevent surrounding gum disease. Abrasive toothpastes should be avoided, as they can scratch the surface of composite bonding and certain types of porcelain. Restorations must be cleaned gently, and night guards should only be cleaned with mild soap and cool water to prevent material warping or scratching.
Dietary habits also play a role in long-term protection; patients should avoid biting directly into overly hard foods, such as ice, hard candies, or bone, which could chip or dislodge the added material. Regular dental check-ups allow the dentist to professionally monitor the restorations and the health of the gum tissue, ensuring the aesthetic and functional investment remains intact for as long as possible.