Not feeling confident in your smile can affect your quality of life. If you were born with—or developed—a gummy smile and have considered solutions, the good news is that there are plenty. Charlotte, NC cosmetic dentist Patrick J. Broome, DDS says deciding to address a gummy smile with a professional is like any elective cosmetic procedure: it’s worth pursuing when the concern impacts your confidence.
“Ultimately, the goal is never to erase individuality—it’s to help patients feel confident and comfortable when they smile,” adds Los Altos, CA cosmetic dentist Joseph Field, DDS.
We asked the experts to share everything you need to know before considering if—and how—to change your gummy smile.
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What Causes a Gummy Smile?
“A gummy smile can stem from several factors,” says Dr. Field. “It’s typically related to the way the upper lip moves when you smile and/or the position of the teeth and gums.” New York cosmetic dentist Lana Rozenberg, DDS explains that a hyperactive upper lip muscle that lifts too high when smiling can expose more gum tissue, resulting in a gummy smile. Additionally, “naturally short upper lip may not cover the gums sufficiently,” says Dr. Rozenberg. Deficient lip volume and asymmetry can also play a role, notes Dr. Broome.
Gum tissue issues can also be a contributing factor. These include “excessive gum tissue covering the teeth (gingival hypertrophy) or gums failing to recede after tooth eruption (altered passive eruption),” says Dr. Rozenberg. She adds that excessive gum growth is another common cause. “Certain drugs or underlying conditions (like leukemia, HIV) can cause gum overgrowth,” she notes. Teeth that haven’t fully emerged—making them appear shorter and more covered by gum tissue—are another possible factor, according to Dr. Rozenberg. Family anatomy can also play a role: undersized teeth, whether due to genetics or wear, can make gums appear more prominent in comparison.
“In more rare situations, it’s due to the underlying jaw structure,” says Dr. Field. This can include gum and jaw asymmetry, notes Dr. Broome. An overgrowth of the upper jawbone can also push the gum line downward, adds Dr. Rozenberg.
Solutions for a Gummy Smile
Dr. Field says the right treatment depends entirely on the cause. A consultation with a qualified provider is essential to determine the best approach. “Patients should seek a provider who routinely treats gummy smile cases and review the numerous before-and-after cases they have provided to understand realistic expectations and build confidence,” says Dr. Broome, noting that treatment often involves one—or a combination—of approaches.
“The key is choosing the least invasive solution that achieves a natural, harmonious result,” adds Dr. Field. These are some of the treatment options dentists may recommend.
Neurotoxins or Lip Filler
Injecting small amounts of neurotoxins into the muscles above the upper lip can help limit how high it lifts, says Dr. Rozenberg. However, she notes that it’s a temporary solution that typically needs to be repeated every three to six months. Enhancing lip volume with filler may also be a helpful temporary option, says Dr. Broome.
Gum Contouring
“For mild cases, reshaping the gum line—often referred to as gum contouring—can create a more balanced appearance,” says Dr. Field. Dr. Rozenberg notes that this can also be achieved through crown lengthening, during which excess gum tissue—and sometimes bone—is removed to reveal more tooth structure. Gum contouring can be performed manually or with a laser gum lift, adds Dr. Broome.
Lip Repositioning
“In more advanced cases, surgical options may be considered,” says Dr. Field. “We work with a very talented plastic surgeon, Dr. Jill Hessler, for situations where we need to do what is called a ‘lip repositioning’ procedure to idealize the aesthetics.”
Lip repositioning is a “procedure to reduce the amount of gum shown by altering the lip’s attachment to the jaw,” explains Dr. Rozenberg.
Orthodontics
When tooth position or jaw structure is involved, orthodontic treatment may be recommended, says Dr. Field. “Braces or clear aligners can correct bite issues and tooth alignment that contribute to a gummy smile,” adds Dr. Rozenberg.
Jaw Surgery
For severe cases in which the upper jawbone is overgrown and orthodontics alone aren’t enough, jaw surgery may be the best option, says Dr. Rozenberg. This permanent solution can also significantly change overall facial proportions.
When to Address a Gummy Smile
“I typically recommend addressing a gummy smile when it bothers the patient—not when it bothers anyone else. If someone feels self-conscious, avoids smiling or feels their smile doesn’t reflect who they are, that’s the right time to have a conversation,” says Dr. Field.
“From a clinical standpoint, treatment is elective in most cases, so the decision should always be driven by confidence, comfort and long-term oral health rather than pressure to meet an aesthetic ideal.”
Dr. Rozenberg adds that if early signs of gum or jaw issues appear in childhood, an orthodontist may be able to address mouth breathing or jaw growth patterns early.