Gummy Smile

A gummy smile is a condition in which an excessive amount of gum tissue shows when a person smiles, making the teeth appear shorter or the gums overly prominent. It can affect facial balance and self-confidence even when tooth alignment and color are otherwise normal. The degree of gum display varies from mild to pronounced and can be assessed visually and clinically by a dental professional.

Understanding the specific pattern of gum exposure is the first step toward selecting an appropriate treatment. Evaluation considers lip position, gum display at rest and during smiling, tooth proportions, and jaw relationships. A tailored plan addresses the primary cause rather than only the appearance.

Several anatomical and developmental factors can cause a gummy smile, including overgrowth of gum tissue, a high lip line or hyperactive lip elevator muscles, and vertical maxillary excess where the upper jaw is positioned lower than normal. Small or short clinical crowns can also make gums appear more prominent even when the jaw position is normal. Multiple factors often coexist, so a comprehensive assessment is necessary.

Other contributors include altered passive eruption, where the gums fail to recede to their normal position after tooth eruption, and certain muscle attachments that lift the lip higher during smiling. In some cases genetic growth patterns or prior orthodontic movement influence the presentation. Identifying the root cause guides whether soft tissue, muscle, orthodontic, or surgical therapies are recommended.

Diagnosis begins with a clinical examination of the smile at rest and during dynamic expression, noting the amount of gingival display, tooth proportions, and lip mobility. Photographic documentation and intraoral measurements help quantify gum exposure, while radiographs and study models can reveal skeletal or dental relationships. A thorough medical and dental history is also important to rule out systemic or medication-related causes of excess gingival tissue.

When skeletal discrepancies are suspected, the dentist may refer for cephalometric imaging or an orthodontic consultation to evaluate jaw relationships. Soft tissue assessments include measuring the distance from the lip to the gum margin and observing muscle activity patterns. This diagnostic information allows the treatment team to create a personalized plan with realistic aesthetic goals.

Treatment options target the underlying cause and can include conservative soft tissue procedures, minimally invasive muscle-modifying injections, orthodontic approaches, or surgical correction of jaw position. Gingival recontouring, sometimes performed with a laser, reshapes excessive gum tissue and exposes more of the tooth crown. For hyperactive upper lip muscles, temporary muscle-relaxing injections can reduce lip elevation during smiling.

When tooth proportions are short due to altered passive eruption, crown lengthening or restorative crown work may be recommended to improve tooth height. More complex cases involving vertical maxillary excess often benefit from orthognathic surgery in conjunction with orthodontics. The treatment plan is determined after discussion of risks, benefits, and expected outcomes with the dental team.

Gingival recontouring is a periodontal procedure that removes or reshapes excess gum tissue to expose more of the tooth surface and create a more balanced smile. It can be performed with traditional surgical instruments or with dental lasers, which may reduce bleeding and speed recovery. Ideal candidates are those whose gummy appearance is primarily due to excess soft tissue rather than skeletal discrepancies.

Candidates should have healthy gums free of active periodontal disease and sufficient tooth structure to allow for aesthetic improvement. The dentist will assess gum thickness, root exposure risk, and smile dynamics before recommending recontouring. In some situations, crown lengthening that includes repositioning of bone may be necessary to achieve stable, long-term results.

Muscle modification techniques, such as targeted injections to weaken the upper lip elevator muscles, reduce the degree of lip elevation when smiling and thereby decrease gum exposure. These injections are minimally invasive and provide temporary changes that can last several months, allowing patients to assess aesthetic benefit without permanent alteration. They are most effective for smiles driven primarily by hyperactive lip muscles rather than excess gum tissue or skeletal issues.

Because effects are temporary, repeat treatments are needed to maintain the result, and the dentist will tailor injection sites and dosages to each patient’s anatomy. Muscle-modifying injections can be combined with other procedures, such as gingival recontouring or orthodontics, to achieve a more comprehensive outcome. A consultation will determine whether this conservative approach fits the individual treatment plan.

Orthodontics may be recommended when tooth position or vertical tooth presentation contributes to a gummy appearance, as moving teeth can improve proportions and reduce gingival display. Orthodontic intrusion of teeth or alignment that improves crown-to-root relationships can have a positive aesthetic impact. Collaboration with an orthodontist ensures that dental movement supports long-term health and appearance.

Surgery is considered when skeletal factors, such as vertical maxillary excess, are the primary cause of a gummy smile and cannot be corrected by soft tissue procedures or orthodontics alone. Orthognathic surgery repositions the upper jaw to restore facial balance and often requires coordination between an oral surgeon and orthodontist. The dental team will discuss indications, expected recovery, and the multidisciplinary approach needed for predictable results.

During a consultation, the dentist will review your medical and dental history, take photographs and measurements of your smile, and perform a clinical exam to evaluate tooth and gum proportions, lip dynamics, and jaw relationships. Diagnostic tools may include radiographs, study models, and digital imaging to simulate potential outcomes. The discussion will focus on identifying the primary cause and presenting appropriate treatment options tailored to your goals.

The clinician will explain the benefits and limitations of each option, anticipated recovery, and the sequence of care when multiple specialties are involved. If referrals are needed to an orthodontist or oral surgeon, the office will coordinate those consultations to ensure a cohesive treatment plan. Patients are encouraged to ask questions about function, aesthetics, and realistic expectations during this visit at Saugeen Shores Family Dentistry in Port Elgin.

Recovery depends on the selected procedure: soft tissue recontouring often involves several days to a couple of weeks of healing with mild discomfort and careful oral hygiene, while muscle-modifying injections have minimal downtime and few activity restrictions. When orthodontics is used, treatment unfolds over months to years with routine adjustments and monitoring. Surgical interventions such as orthognathic procedures require a longer recovery period and close postoperative follow-up.

Aftercare generally includes gentle cleaning around treated areas, avoiding irritants, and following specific dietary or activity recommendations provided by the dentist or surgeon. The team will schedule follow-up visits to monitor healing and to plan any complementary restorative or orthodontic steps. Understanding and following the prescribed aftercare improves healing and helps achieve the intended aesthetic outcome.

Maintenance depends on the type of treatment performed; good oral hygiene and regular dental checkups help preserve soft tissue health after gingival recontouring or crown lengthening. For patients who receive muscle-modifying injections, periodic maintenance treatments may be needed to sustain reduced lip elevation. When orthodontic or surgical corrections are part of the plan, retainers and long-term follow-up support stable tooth and jaw positions.

The practice recommends routine professional evaluations to detect any changes early and to address periodontal concerns that might affect appearance. Lifestyle factors such as smoking and certain medications can influence gum health and should be discussed with your dental team. For personalized guidance on long-term care, the team at Saugeen Shores Family Dentistry can outline a maintenance schedule tailored to your treatment history and goals.