Altered Passive Eruption: Why Your Teeth are Short and How a Dentist Can Lengthen Them

When you smile, are you showing more gum than tooth? Do your teeth look tiny in comparison to other people's? Just like a wave or a handshake, your smile is an important way of greeting people. It's one of the first and last things people notice about you during social gatherings, and it helps to break the ice with strangers. Therefore, if you aren't comfortable smiling at people for fear of how your teeth might look, you need to do something about it as quickly as possible. 

First, you need to determine the cause of the problem, and then you can decide on the most appropriate course of action with the help of your dentist. 

Altered Passive Eruption (APE)

When your permanent teeth come through, a process called "passive eruption" occurs in which the bone retreats roughly 2mm below the area where the root meets the crown, and the gum moves with the bone to cover the tooth. 

However, sometimes the bone doesn't migrate to where it should, and dentists refer to this as "altered passive eruption". When this happens, your gum stays up high on the tooth, giving you a gummy smile and causing your teeth to appear short. 

Your Options

​Laser Gum Contouring

If your case is minor, laser gum contouring (gingivectomy) could adequately give your teeth more length. A cosmetic dentist can lift your gums by up to 2mm using a soft tissue laser. This treatment is fast, and within a week, any soreness should have faded. 

Crown Lengthening

​Crown lengthening is similar to laser gum contouring, but involves the removal of bone as well as gum tissue and is for more serious cases. For this procedure, you will need to consult a periodontist to determine whether this is a viable solution for you. With the help of periodontal probing and radiographs (images produced by an x-ray), a periodontist can decide if this is the right route to take. 

During surgery, the periodontist will remove gum and bone tissue to expose more of each tooth. However, it may take up to three months for your gums and teeth to completely heal after this procedure. 

Crown Lengthening with Veneers 

​This is a good option for you if your teeth are also fairly small as well as short. Once your gums are completely healed, your dentist will remove up to a millimeter of enamel from the surface of the newly lengthened teeth in preparation for your veneers. This is so that your teeth don't feel or look bulky once the veneers have been placed. It will then take between 1-2 weeks for your porcelain veneers to be ready.

Once done, the veneers can be fitted over your teeth to complete the look. The end result should be that you can now smile with confidence.

Braces

​Braces can also be used to lengthen teeth. However, this treatment may take up to a year to complete. Over the 12 month period, the braces will gradually lengthen your teeth by gently applying continuous pulling pressure on them. 

As you can see, there are many ways to lengthen teeth. Consult with your dentist to determine the most suitable treatment for you. It may be that your teeth are short due to bruxism (teeth grinding) or previous dental work. In this case, you may have to explore different treatments to those mentioned in this article.