What to do about an awkward smile?

Hardly any teeth show when I smile. I have a very small mouth. Are there any procedures that can help me?

user1559802

F, 1812, Australia

From your description it sounds like you may have a vertical deficiency in your upper jaw, a condition which leaves your upper row of teeth concealed behind your lips when you smile. It's possible to have corrective surgery to extend the upper jaw downwards, the result being a dramatically improved appearance and a longer, more slender-shaped face.

It's also possible the reason your teeth aren't visible when you smile is because your upper lip is excessively long. We can reduce the size of an upper lip with a simple plastic surgery that leaves a barely visible scar at the base of the nose.

If you are opposed to invasive surgical treatments to improve the aesthetics of your smile, there may be some cosmetic dentistry solutions available. These solutions include cosmetic crowns or veneers -- providing you are a good candidate.

It's not possible for me to offer any medical recommendations without a direct consultation but from your brief description, corrective treatments could include an orthognathic surgery solution, an orthodontic solution, a plastic surgery solution to reduce the size of the upper lip, or some combination of all the above.

Having a nice, genuine smile can improve self-esteem and a person’s social self-confidence. I encourage you to explore these solutions with an experienced maxillofacial surgeon who has a proven track record of successful surgeries -- and most importantly, a good aesthetic eye.

For most people a big smile is a beautiful smile. While not everyone can have that perfect smile like, say, Meghan Markle, having an awkward smile (for example, one with no teeth showing) can lead to social awkwardness, an awkward laugh and compromised self-confidence.

With no photograph or X-ray I obviously can’t offer you a specific answer, but my suggestion regardless is that you consult with a plastic or maxillofacial surgeon in your area to discuss which procedures are most advisable in your situation.

In many instances when the upper teeth aren’t visible, an upper surgical correction will lower the level of the upper jaw into under the lip. Alternatively, an upper lip lift reduces it’s distance from the nose, bringing the upper row of teeth into view when you smile.



It might also be possible to increase the length of the upper row of teeth with veneers or crowns that extend beneath the level of the upper lip.

The good news is that there’s a long list of available treatments, from orthodontics to surgery to veneers that correct the issue of not having any teeth showing when you smile. Of course, without a personal consultation there's no way to know which solution will be right for you.

Always remember to only consult with board-certified surgeons out of safety concerns and also, so you ultimately walk away with the best results possible.

SInce there’s no photograph accompanying your question, it's not entirely clear what you mean when you say "hardly any teeth show when you smile". There are many possible reasons teeth can be hidden while smiling.

One possibility is your upper jaw lacks sufficient vertical height. If your upper jaw is too short, a LeFort I osteotomy is a common orthognathic surgery procedure used to elongate the upper jaw, balance the aesthetics of the smile, and improve the lip contour. The LeFort I procedure also tends to make the entire face a little narrower.

This surgery is commonly performed for patients suffering from vertical maxillary deficiency. When used in combination with bone grafts it can be very effective for aesthetically improving the smile and the visibility of the upper row of teeth.

It's also possible that your upper teeth are simply too short. If this is the case, veneers or cosmetic crowns can be applied to extend the length of the upper row of teeth so they’re visible when you smile. Alternatively, there are plastic surgery procedures that raise the upper lip to make teeth more visible when smiling.

I can't make any recommendations without a personal examination, but I do encourage you to meet with a plastic surgeon, a cosmetic dentist or a maxillofacial surgeon to discuss your presentation and the treatment options that can turn your awkward smile into a beautiful one.

Generally speaking, most people define "nice smiles" as those that provide a clear view of the upper row of teeth, which are ideally straight and white. It's not clear from your question exactly what you mean by an "awkward smile" and without a photograph it's difficult for me to give you any specific answers.  

While many people use descriptive terms like  "awkward smiles", "fake smiles", and "creepy smiles", these terms can mean very different things to different people, making it difficult to impossible to offer general recommendations without visual references.

From your description as having a smile with "no teeth showing", I'm assuming you mean your upper teeth are concealed by your upper lip when you smile.

There are any number of reasons why your upper teeth may be hidden behind your upper lip; your upper teeth may be shorter than usual, or your upper lip may be longer than usual. There could be issues with your jaw, teeth, or the skin around your mouth, or the problem could be a combination of any of these things.

If the issue stems from your upper row of teeth being too short (or have shortened due to excessive wear and tear), the issue may be addressable with upper veneers that extend the length of the upper teeth. From your description, however, it's not clear whether the issue stems from a dental problem or is something that could be resolved with plastic surgery around the mouth.

I suggest you arrange consultations with a plastic surgeon, a maxillofacial surgeon, and/or an orthodontist to better understand exactly what the issue is and see which procedures make the most sense for you.

It is tough to see what can be done without photos but I suggest consulting a board certified plastic surgeon. Sometimes non surgical options could work for you.