A smile is an integral part of human connection and is important for emotional and personal expression. However, when you don’t like your smile, you’re less likely to display it. Cosmetic concerns with your smile may cause you to feel self-conscious.
Dentists refer to a gummy smile as “excessive gingival display”. This is a condition in which much of the gum tissue is visible above the top teeth when smiling. Generally, 3 to 4 millimeters of gums must be visible to be considered a gummy smile.
Some patients choose to live with their gummy smile, while others seek cosmetic dental treatment. In some cases, a gummy smile must be resolved to improve functionality.
There are four types of gummy smiles:
- Anterior: too much gum tissue is visible above the front teeth in the upper jaw
- Posterior: too much gum tissue is visible above the back teeth in the upper jaw
- Mixed: too much gum tissue is visible above the front and back teeth in the upper jaw
- Asymmetric: too much gum tissue is visible on one side of the mouth in the upper jaw
If you have a gummy smile, your dentist can help.
What Causes a Gummy Smile?
There are several factors that could cause a gummy smile. Sometimes patients are born with irregularities that can cause too much of the gum to be visible while others develop it due to improper tooth eruption or wear and tear over time.
The most common causes include:
Tooth Eruption
The size/shape of teeth and how they erupt can create a gummy smile. For example, if your teeth are smaller than average, you may think you have a gummy smile. Some common tooth eruption issues include:
- Altered passive eruption: gums cover more of the teeth as they erupt
- Dentoalveolar extrusion: front teeth grow in too far, causing gums to do the same
- Vertical maxillary excess: when bones in the upper jaw grow longer than normal
Irregularities in Gums and Upper Lip
In some cases, a gummy smile is caused by genetic irregularities in the gums and upper lip, such as:
Gingival hypertrophy: gums are enlarged/too long
Hyperactive upper lip: when the upper lip appears normal when resting, but lifts higher when smiling, exposing more gum tissue
Medications
Certain medications cause a condition known as drug-induced gingival overgrowth, or DIGO. This condition is characterized by an overgrowth of gum tissue. The most common medications that cause DIGO include:
- Anticonvulsants, which are used to treat seizure disorders
- Immunosuppressants, which are usually prescribed following organ transplants
- Calcium channel blockers, which are used to treat hypertension
If left untreated, DIGO can lead to periodontal disease. Therefore, it’s critical to discuss treatment options with your dentist.
How to Correct a Gummy Smile Without Surgery
There are several options for treating a gummy smile without surgery, including:
Orthodontic Treatment
Traditional braces or clear aligners are ideal for a mild gummy smile due to tooth misalignment. Orthodontic treatment shifts teeth into their appropriate position in the jaw, which reduces the visibility of the gums above the upper teeth. In more severe cases, the orthodontist may use temporary anchorage devices, which are titanium implants anchored into the bone, along with traditional braces or clear aligners.
Veneers or Crowns
Dental veneers are thin, tooth-colored shells that fit over the teeth to improve cosmetic concerns of size, shape, and overall appearance. Typically, veneers will be applied following crown lengthening surgery or gum recontouring. However, this is the most expensive option at $925 to $2,500 per tooth for porcelain.
Root Planing and Scaling
Scaling and root planing is used to treat infection or inflammation in the gums. During this procedure, the dentist will remove plaque from the teeth down to the root. Once the plaque is removed, the roots will be smoothed so that the gums can reattach to the teeth.
Botox
Botox injections are most commonly used to reduce the appearance of fine lines and wrinkles. These injections can be used to paralyze the hyperactive lip muscle to keep it from lifting too high when smiling, as well as reduce the visibility of gum tissue when at rest.
The number and location of the injection depend on the type of gummy smile the patient has. This option is only available for patients with a high upper lip and willing to commit to ongoing treatment, as they need to be repeated every 3 to 6 months.
Surgically Repairing a Gummy Smile
If conservative treatments are not effective, there are a few surgical options that may be used to fix a gummy smile, including:
Crown-Lengthening Procedures (Gingivectomy)
A gingivectomy is the best option for gummy smiles caused by the overgrowth of gum tissue. During this procedure, the dentist will use a laser or scalpel to remove the excess tissue, revealing more of the tooth. Typically, several sessions are needed for optimal results.
Laser Gum Contouring
Laser gum contouring is a procedure that uses dental lasers to reshape the gumline. It allows for the removal of more gum tissue than a standard gingivectomy.
Lip repositioning surgery
Lip repositioning is ideal for those who have a gummy smile due to a hyperactive upper lip. This minimally invasive surgery moves the lip downward, which reduces the appearance of excessive gum tissue, making your smile more proportionate.
Gummy Smile FAQs
If you have questions about the causes of and treatments for gummy smiles, your dentist will be happy to help. Below are a few of the most commonly asked questions about this condition.
Does an overbite cause a gummy smile?
The most common issues with overbite include gummy smile and protruding lips.
Does a gummy smile go away with age?
Typically, a gummy smile is likely to become more prominent with age due to changes in the mouth.
Are gummy teeth attractive?
While it may not be the ideal, a gummy smile doesn’t have to be considered unattractive as long as the teeth and gums are healthy. On the other hand, if there are some concerns regarding the appearance and health of the teeth and/or gums, it may not be the most attractive.
