Gummy Smiles

What is a gummy smile?

Gummy smile, also known as excessive gingival display, is a smile that shows an excessive amount of gum under the upper lip. It is a common clinical condition that may cause aesthetic concerns for some patients.

What causes a gummy smile?

There are a number of abnormalities related to the teeth, lips, jaws or gums that may lead to the appearance of a gummy smile. A few of the most common causes include:

  • Abnormal delayed dental eruption causing the teeth to appear “short”
  • Hyperfunction of the upper liplevator muscles causing the upper lip to raise higher than normal
  • Excessive vertical growth of the maxilla (upper jaw bone) causing the gums to bulge out
  • Gums that are long or enlarged
  • Teeth that are small in comparison to the gums due to genetics or wear
  • An upper lip that is too short
  • Combinations of any of the above described factors

What non-surgical treatments are available?

Several treatment options have been proposed to enhance the smile display and to reduce exposure of the gums. The choice of treatment depends on the cause and the degree of exposure of the gums.

For mild and moderate cases, minimally invasive methods such as Botox and injectable fillers may be used. Botox may be used to temporarily paralyze the lip levator muscles, preventing the lip from lifting too high when you smile. Injectable fillers can be used to provide volume and length to the upper lip to help cover the gums.

What surgical options are available for gummy smiles?

If a patient is seeking permanent results, surgical treatment options may be considered. In patients with hyperfunctioning upper lip levator muscles, an option may be to surgically cut these muscles to reduce their pulling action. Dermal and fat grafts may also be used to augment the upper lip during this procedure. This treatment is a short surgical procedure that is completed under local anesthesia.

Orthodontics and periodontal surgeries can help with gingival (gum) display, lengthening the teeth to a more aesthetically pleasing level. This often leaves an unaesthetic scar on the gums. In severe cases, where the previously described methods are not sufficient to correct the deformity, orthognathic surgery may be required to move the maxilla so it is more proportionate for an aesthetically pleasing smile.