What a gummy smile is
A gummy smile means that an unusual amount of gum shows when you smile. A narrow band of gum above the teeth is entirely normal and part of a natural smile. It is only considered noticeable when a broad smile reveals several millimetres of gum and the teeth give the impression of looking short. Where exactly the line lies is also a matter of personal perception. Many people do not find a gummy smile bothersome at all.
It is important to be clear: a gummy smile is not a disease. It is an aesthetic feature that some people find uncomfortable and others do not mind in the slightest. Whether a correction makes sense is for you alone to decide. Our job is to clarify the cause and to tell you honestly what can be achieved.
The common causes
A gummy smile rarely arises from a single reason. Often several factors act together. The most important are:
- Altered passive eruption. As the teeth come through, the gum normally recedes to its final height. If it stays too low, it covers part of the crown. The teeth are then actually a normal length but look short.
- A short or very mobile upper lip. If the upper lip pulls up unusually far when you smile (a hyperactive lip), it reveals more gum than the tooth and bone situation alone would suggest.
- Vertical overgrowth of the upper jaw. If the upper jaw has developed slightly too long in height, the whole tooth and gum structure sits lower. This is a bony, or skeletal, cause.
- Tooth proportions. If the teeth are naturally short or have been shortened by wear, the gum carries more visual weight.
- Certain medications. Some substances can trigger an overgrowth of the gum, which becomes thicker and covers more of the teeth.
Why an accurate diagnosis matters
These causes call for completely different treatments. Gum contouring helps with altered passive eruption but changes nothing about an overactive lip or a gummy smile caused by the bone. Treating the wrong point will not achieve the goal and stresses the tissue for no benefit.
That is why a careful assessment always comes first, not the procedure. Only once it is clear where the visible gum comes from, and which factors combine, can the right route be chosen. Often it is a combination of several measures. For more on how aesthetic treatments work together, see our comparison of composite and porcelain veneers.
The correction options matched to the cause
Which route is suitable depends on the cause:
- Gum contouring (gingivectomy) or crown lengthening. With altered passive eruption, excess gum is removed so that more of the crown shows. In crown lengthening, the underlying bone margin is also adjusted.
- Laser gum contouring. A gentle option to reshape the gum line precisely in suitable cases.
- Lip repositioning surgery. A minor procedure that limits the pull of the upper lip so that less gum is revealed when you smile. Suitable for a hyperactive lip.
- Orthodontics. Realigning the teeth can shift the teeth and gum line and so influence how much shows, sometimes in combination with other measures.
- Orthognathic surgery. With a purely skeletal cause, that is an upper jaw grown too long vertically, surgical repositioning is the only route that truly addresses the cause.
- Botulinum toxin. With an overactive upper lip it relaxes the muscles involved, so the lip pulls up less far. The effect is limited in time.
If the teeth themselves are not enough visually, gum contouring can be combined with veneers to adjust the shape and length of the teeth.
What is realistic and what is reversible
Not every measure is equally far-reaching, and not every one is reversible. Gum contouring and crown lengthening change the tissue permanently. That is intended, but it should be planned carefully, because gum that has been removed cannot simply be brought back. Orthognathic surgery is the largest step and is only an option with a clear skeletal cause.
Botulinum toxin, by contrast, is reversible. It lasts only a few months and has to be repeated to be maintained. That can be an advantage if you want to try it first, or a drawback if you are looking for a lasting solution. We do not promise a particular result. Instead, we explain what is achievable in your situation and what is not.
How the assessment works
It starts with a careful evaluation. We look at how much gum shows in a relaxed smile and in a broad one, assess tooth length and the gum line, check the mobility of the upper lip and clarify whether there is a bony component. We also discuss your medications, since some can play a part.
This picture shows which cause predominates and which route makes sense. Correcting a gummy smile is usually an aesthetic procedure and therefore, as a rule, a private treatment. You receive a written cost estimate before any treatment, so that you can decide at your own pace. If you are unsure whether and how your gummy smile can be corrected, book an appointment. If you are also considering brighter teeth, our article on teeth whitening has more information.