Gummy Smile: Causes, Treatment, and More

They say your smile is as unique as your fingerprints, and there’s a lot of beauty in this variation, from adorably crooked grins to image-defining tooth gaps. But not everyone loves the smile they have, and many people with a gummy smile want to change it.

What causes a gummy smile? And can you correct it? We have all the details you need here in our guide to gummy smiles.

What Is a Gummy Smile?

Do you have a gummy smile? Ask two dentists and you might get two different answers. That’s because — for the moment, at least — a gummy smile is not considered an actual medical condition. There are no clear definitions from medical organizations just yet, so each dentist or plastic surgeon can define it as they wish.

So what is a gummy smile? That’s more or less between you and your dentist or surgeon. It’s a matter of perception, though most professionals consider anything less than two millimeters of visible gingival tissue to be aesthetic. Between 2 and 4 millimeters, opinions vary. But nearly all dentists agree that anything above four millimeters constitutes a gummy smile.

Like most aesthetic concerns, everything is relative. Two millimeters of visible gingival tissue might look perfect on someone with average-length teeth, but might appear too much on someone with shorter teeth. But in the end, what matters most is how you feel about your smile and whether you’d like to seek treatment.

Is a Gummy Smile a Medical Concern?

There are two people who can answer this question definitively: you and your dentist. In most cases, excessive display of gingival tissue isn’t a sign of any deeper problems. Depending on the length of your teeth and the fullness of your lips, showing more gum tissue than the average person might be right in balance with your features.

But if you find yourself favoring closed-lip grins or avoiding smiling altogether, your gummy smile is causing a problem: it’s dinging your self-confidence. In this case, consider treatments to correct it.

However, anyone with a gummy smile should consult a dentist to rule out underlying health conditions. Sometimes, excessive gingival display is a side effect of other dental issues, like an overbite or irregular jaw development. In these cases, treatment is essential to protecting your oral and overall health over the long term.

What Causes a Gummy Smile?

In most cases, your genetics just lean towards factors that expose more gum tissue than the average person. That’s why it’s overwhelmingly an aesthetic issue. Still, it’s not the only reason for excessive gingival display. Some other factors that contribute to the development of a gummy smile include:

• Altered Passive Eruption: With this condition, the gums cover too much of the tooth’s surface, starting when they emerged.
• Dentoalveolar Extrusion: This is when the front teeth overerrupt, growing in too far. When this happens, the gums often grow excessively with them.
• Maxillary Excess: This describes an oral health issue where the bones of the upper jaw grow beyond a healthy length, making the gums appear too large as well.
• Gingival Hypertrophy: This condition results in longer and/or thicker gum tissue.
• Lip Size: No matter the length of your gingival tissue, smaller lips can make it appear larger, especially when you’re smiling.
• Hypermobile Lips: In this situation, the lips move more than average when smiling, exposing more gum tissue.
• Medications: Certain medications can stimulate gum tissue growth. These include seizure medications, immunosuppressants, and blood pressure medicines.
• Short Teeth: Whether because of genetics or gradual dental erosion, when the teeth are short, the gums appear large in comparison.

Between all these varied factors, gummy smiles may not be the norm, but they are quite common. Researchers estimate that around 10% of people between ages 20 and 30 have gummy smiles.

How To Treat a Gummy Smile

If your gummy smile bothers you or stems from a problematic underlying condition, you can choose to correct it with either a surgical or non-surgical treatment. In general, going for less-invasive methods is best, since they’re often cheaper and have a shorter recovery time. Below are some options for fixing a gummy smile.

Orthodontic Treatment

If your gummy smile comes from an improper bite or poor jaw position, orthodontic treatment can alter the appearance of your gum line. Straightening your teeth is always a good decision, since it can prevent certain oral health issues from developing or worsening, including uneven wear on the teeth and jaw pain. This means your investment is about more than just your appearance — though that’s important, too!

Temporary Anchorage Devices

Also called TADs, these are small screws that a dentist will place in your jawbone. They work well on their own or with other small appliances to alter the position of your teeth. Depending on how the teeth move, this can reduce the appearance of a gummy smile.

Veneers

If you don’t have an underlying issue causing a gummy smile, veneers offer a solid aesthetic solution, hiding a small amount of gum tissue and possibly helping the teeth appear longer. However, most veneers require enamel removal as part of their prep, so they’re better when you’d like to hide some dental issues as well.

Root Planing and Scaling

This treatment is typically used to fight gum disease. However, a nice benefit that comes with this procedure is that your dentist can make small changes to the gum line. It won’t significantly shorten your teeth, but it might change them just enough to get the look you want.

Gum Contouring Surgery (Gingivectomy)

This procedure changes the gum line the same way as root planing and scaling. However, it comes without the deep cleaning, making it an option even if your gums are otherwise perfectly healthy. During this surgery, the dentist removes gum tissue, exposing more of the natural teeth, altering the proportions of both the teeth and gingiva. Depending on how much tooth is exposed, you might also need veneers or other protective layers.

A subset of the gingivectomy is laser gum contouring. The difference is that the dentist uses a laser instead of a small scalpel. This gives the dentist a finer level of control over the amount of tissue they remove, as well as the exact contour. Plus, laser contouring rarely requires sutures, while more traditional approaches do.

Lip Repositioning Surgery

If your lips are hypermobile and that’s the reason too much gum shows when you smile, lip repositioning surgery can alter how they pull back from the teeth. The dentist will eliminate a section of connective tissue from the underside of your upper lip, reducing the range of motion in the elevator muscles (those in the area around the upper lip and nose). This helps keep the lip lower on the gum line when you smile, without compromising your natural appearance.

Botox

This is a less invasive and temporary alternative to lip repositioning surgery. Rather than inhibiting the elevator muscles’ range of motion for life, it only inhibits them for as long as the effects of a Botox injection last for you. For most people, this is about 3–6 months, though it varies based on your metabolism. You can use this before surgery to be sure you like the results before making a permanent change or rely on it long-term. Many people prefer the temporary option since the lip tends to lower with age.

Orthognathic (Jaw) Surgery

If your jaw is contributing to excessive gingival display, you might need jaw surgery. Orthodontic treatment can make certain jaw alterations, but it has limits, and more significant alterations require surgery. Your dentist will probably only consider this if the issues with your jaw are causing other problems, since jaw surgery is invasive and has a long recovery time.

Cost of Treatment for Gummy Smile

How much you pay to fix a gummy smile will depend on numerous factors, including the severity of your condition and the fees your doctor builds into the cost of treatment.

The biggest variable, though, is the type of treatment you choose. On the low end, you might pay just a couple hundred dollars to eliminate some tissue around your upper front teeth. On the high end, you could spend $40,000 for jaw surgery. Below are typical price ranges for various forms of gummy smile treatment.

• Orthodontic Treatment: $2,000–$10,000+ for in-office treatment, $895–$3,500+ for at-home or hybrid clear aligners
• Temporary Anchorage Devices: $300–$600 per TAD
• Veneers: $250–$2,500 per tooth
• Root Planing and Scaling: $300–$700 per dental arch
• Gum Contouring Surgery: $50–$350 per tooth
• Lip Repositioning Surgery: $1,000–$6,000
• Botox: $80–$300 per treatment
• Orthognathic Surgery: $20,000–$40,000

Don’t set your mind on a specific treatment until you consult a dentist. The most affordable option might not be the best one for you. You also shouldn’t get Botox from a cosmetic surgeon or med spa until your dentist rules out underlying conditions contributing to your gummy smile.

Final Thoughts

A gummy smile isn’t something you need to change — in most cases, at least. But if yours has you concerned, there are multiple treatment options available.

The right one for you will depend on your gummy smile’s cause, the permanence of your solution, and your budget. Speak to your dentist about which treatments might be right for you.