This advice-column-style blog for SLPs was authored by Pam Marshalla from 2006 to 2015, the archives of which can be explored here. Use the extensive keywords list found in the right-hand column (on mobile: at the bottom of the page) to browse specific topics, or use the search feature to locate specific words or phrases throughout the entire blog.
“Gummy Smile”
By Pam Marshalla
Q: I have a new referral from a dentist for a client with a “gummy smile.” Haven’t seen him yet. What do you think this means?
I would assume that the term “gummy smile” means that the upper lip is retracted and the upper gums are exposed. Assuming that this is the case, the client needs to learn normal oral rest posture. Normal oral rest consists of the lips resting gently together, the teeth resting a few millimeters apart, and the tongue-tip resting on or below the alveolar ridge.
Teaching normal oral rest is an aspect of classic orofacial myofunctional therapy. One of my deepest concerns is that SLP students still are not taught basic concepts like this while still in school. In my never-to-be-humble opinion, all SLPs should have to study the basics of the swallow and oral rest as a part of their articulation training.
Hi Pam, I think this SLP would find it helpful to google facial growth and orthotropics. This field talks about the face growing down and forward. If this type of growth is not happening, the face grows downward with a resulting long face and sometimes gummy smile. (I realize there are other causes of a gummy smile.) If she also googles ‘face focused.com’ she will find a tool called a Finder that she can copy onto card stock paper. It measures the cosmetic line from the tip of the nose to the biting edge of the upper front teeth. A measurement table is provided and is based on age. An increase of 5 or more mm from the standards set out in the chart would indicate undesirable facial growth. If the child appears to be exhibiting undesirable facial growth, I would refer them to a dentist or orthodontist who specializes in orthotropics for a consult. I agree with you about the importance of the resting posture. If the child does have an open mouth posture, I would also refer to an ENT to determine if they are able to breathe through their nose. I also agree that all SLPs should know about the basics of the swallow and oral rest posture and its significance to articulation disorders! In Brazil, myofunctional therapy is part of the curriculum. Many SLPs over there are involved in a great deal of research in this area.