Smiles can say a lot about teeth. For some people, a significant amount of upper gum tissue shows when they smile or laugh, making the teeth, lips, and gums look unbalanced. It is typically benign, but may be a source of self-consciousness for some, causing them to be reluctant to smile for photos or in person. The first step in deciding if treatment is worth pursuing is understanding what leads to a gummy smile.
What Causes Excess Gum Display?
A gummy smile has many potential causes – you can read more at https://www.pmc.ncbi.nlm.nih.gov/articles, ranging from gum tissue, to teeth size and position, to lip movement, to jaw development, or some combination thereof.
Sometimes the teeth themselves seem to be too short because there is too much gum tissue covering them. While the teeth are actually of normal size, they haven’t fully erupted. Sometimes the condition is congenital, or it’s due to altered tooth eruption.
Some other potential causes include:
- A short upper lip
- Hyperactive lip muscles that pull the lip upward too far
- Teeth that are small or worn down
- An overdeveloped upper jaw in a vertical direction
- Enlargement of the gums from irritation, systemic disease, or medications
- Variations in occlusion (how the teeth and jaws fit together)
It’s important to understand that any combination of features could lead to a gummy smile, and a clinical examination is required to find out which are at play.
Is It a Problem?
What is “too much” gum showing varies widely, so there is no fixed guideline. People’s smiles vary a great deal and some show a moderate amount of gums that look fresh and healthy. A problem exists when a person finds their smile unacceptable, or when the gum tissue is swollen or enlarged, which can cause problems for oral health (find out more).
A professional may evaluate the size and shape of the teeth, the state of the gum tissue, how the bite is aligned, the dimensions of the upper jaw, and the motion of the lips. Photographs and imaging may also help determine whether the issue is a gum tissue problem or a tooth or facial proportion issue.
Dental evaluation of gum tissue and smile proportions
Treatment Approaches
A gummy smile treatment should target the cause, not merely treat the symptoms. In many cases, it involves simple, minimally invasive procedures. More complex orthodontic or surgical treatments may be required in other cases.
Gum Contouring
Gum tissue that is hiding otherwise normal teeth can be reshaped to reveal more of the tooth surface. This may produce longer-looking teeth and a better-balanced smile line. Some patients also need some bone reshaping to stabilize the newly established gumline.
Gum contouring to reveal more of the tooth surface
Lip Muscle Treatment
If the upper lip pulls up too far, injections that temporarily reduce muscle activity can be used to weaken the lip muscle, limiting how far it rises. The effects are not permanent and further injections are needed every few months to maintain the desired result.
Another option in select cases is lip repositioning surgery. This surgical technique reduces the motion of the upper lip by surgically altering the tissue inside the mouth.
Orthodontics and Jaw Surgery
Tooth position may contribute to a gummy smile. Orthodontic treatment may be able to correct these issues and lead to a more balanced smile. Significant discrepancies in upper-jaw growth may necessitate jaw surgery, a more complex option that is considered only after extensive evaluation and treatment planning.
Restorations
Teeth that are short, worn, or very small may sometimes benefit from dental restorations, though it would be unwise to alter the shape of the teeth without assessing the state of the gums and the occlusion. Often a comprehensive treatment plan is more beneficial.
Other Considerations
While the goal of cosmetic improvement is understandable, there are additional considerations before undergoing treatment. Before electing to treat your smile, it’s important to inquire about:
- What is the primary anatomical reason for your gummy smile?
- Are the results temporary or permanent?
- How long does the healing process take, and will you experience discomfort?
- How will this impact gum health, and will you experience increased tooth sensitivity?
- Will you need multiple treatment sessions?
In some cases, a more conservative treatment option may suffice. For more complex procedures, the expected benefits should outweigh the cost, recovery time, and risk.
Ask before your treatment if digital smile planning or a temporary mock-up could be done. That would give you an idea of what the final results might look like. It helps you set realistic expectations for tooth length, gum symmetry, and facial balance. And it’s even more important if you are considering multiple procedures.
Achieving Harmony
Gummy smiles are rarely medically serious, and treatment is ultimately a decision for the patient to make. If you find the condition unsatisfactory, a thorough dental evaluation may uncover its underlying causes and allow you to choose from the available treatment options. Ultimately, any treatment should enhance your smile without compromising the health of your teeth and gums.
