What Causes a Gummy Smile and How Can a Gummy Smile Be Fixed?

A gummy smile, technically referred to as excessive gingival display, is when a person smiles and shows too much of their gums above the top of the front teeth. It can be a source of insecurity for some people and make their smile less aesthetically appealing. As an orthodontist, I’ve had patients visit the office concerned about a gummy smile and under the impression that it can’t be fixed. Fortunately, as with most orthodontic and dental issues, there are solutions available. Treatment options will depend upon what the underlying cause of the gummy smile is. Yet, once we pinpoint a cause, we can start on the path of creating a smile you’re proud to show off.

What is a Gummy Smile?

What is actually considered an excessive gingival display varies and studies have shown that people differ in their aesthetic perception of gummy smiles. Yet, most will rate a smile as appealing in cases where less than 3mm of gum tissue is exposed. What this means in simpler terms is that a smile is often considered gummy and rated unattractive when approximately 1/8 of an inch of gum tissue or more is visible.

Gummy Smile Causes

There are a number of conditions that can cause a gummy smile, however, they tend to boil down to a few main contributing factors:

1. The Jaw and Teeth: When the upper jaw is too long, it’s known as vertical maxillary excess and it can create a gummy smile. This is a skeletal issue. Worn teeth or teeth that are too long may also disrupt the ratio of gum to tooth.
2. Lips: The lips can play a role in excessive gingival display. When the top lip is too short it may fail to cover the gums and teeth properly or lip hypermobility can be a cause. This is when the upper lip is normal in length while a person’s face is at rest but is overly active and lifts up too high when they smile revealing excessive gum tissue.
3. The Gums: The problem can occur if gums are too long or enlarged (gingival hypertrophy). It could also manifest if the teeth don’t erupt fully which makes them appear shorter because excess gum tissue is covering the crown.

Gummy Smile Correction

Gummy smile treatment options depend on what’s causing it and how severe the problem is. If the upper jaw or teeth are only a little bit too long, sometimes braces or Invisalign alone or braces with temporary anchorage devices (TADS) can do the trick. When worn teeth are the culprits, orthodontic treatment followed by crowns can restore the appearance of the smile. If the cause is skeletal and moderate to severe, jaw surgery combined with orthodontic treatment may be the answer. This will create the most dramatic, stable results.

If the upper lip is too short or is hyperactive, surgery can be performed to lengthen it and limit the retraction of the muscles when smiling. Lip repositioning procedures paired with orthodontic treatment have started to become a viable alternative to jaw surgery in certain instances. There are other less invasive treatments like Botox injections, which paralyze the muscles and prevent the lip from lifting too high when smiling. However, the results of Botox are only temporary.

When a gummy smile is from large gums, a periodontist can remove the extra tissue. For teeth that haven’t fully erupted, crown-lengthening surgery will remedy the problem. In this procedure, gum tissue, bone, or both, are removed to expose more of the tooth and allow the gums to retract back to a desirable position.

If you’re interested in treatment for a gummy smile, you’ll first want to schedule a consultation with Aura Orthodontics. The key to success is receiving a diagnosis from a knowledgeable orthodontist. From there, we can discuss how to address the issue.  Whether it’s a matter of wearing braces or undergoing jaw surgery, we’ll work with you and any other specialists involved in your care for a comprehensive approach. Contact our Scottsdale, Guildford, or Abbotsford orthodontic clinics today and love your smile!