Do you feel that too much of your gums is on show when you smile? If more than approximately two to three millimetres of gum above the upper teeth is visible when you smile, this is referred to as a gummy smile.
It is not a health problem or a disease. For many people, however, a gummy smile is an aesthetic concern that can affect their confidence. The good news is that modern dentistry offers several options for improving its appearance — from simple non-surgical solutions through to surgical procedures.
In this article, you will find out why a gummy smile occurs, how it is diagnosed, and what treatment options are available today.
What Is a Gummy Smile?
When you smile normally, the upper front teeth are usually visible along with only a small strip of gum. If a larger portion of the gums is exposed, this is described as a gummy smile.
There is no precise threshold at which the issue must be addressed. Some people are comfortable with quite prominent gum exposure, while others may feel self-conscious even with minimal visibility. What matters most is how the patient themselves perceives their smile.
Why Does a Gummy Smile Occur?
A gummy smile can have several causes, which often occur in combination. Most commonly, it is caused by excessive activity of the muscles that lift the upper lip when smiling, exposing a greater portion of the gums. In some people, the upper lip is anatomically shorter or moves over a greater range when smiling, leading to the same result.
Another cause can be vertical overgrowth of the upper jaw (vertical maxillary excess), where not only more gum is exposed when smiling, but the overall facial proportions are also affected. In some cases, the teeth are not actually short — they are simply covered by a greater amount of gum tissue. This condition is known as altered passive eruption and is a frequent cause of the impression of having “small teeth.”
In exceptional cases, a gummy smile is also associated with the positioning of the upper teeth or the bite, and orthodontic treatment may then form part of the solution.
How Is It Diagnosed?
Before a suitable treatment can be proposed, the underlying cause needs to be established.
The examination typically involves:
- assessment of the face at rest and when smiling,
- analysis of the position and proportions of the lips, teeth, and gums,
- X-ray or CBCT scan where needed, particularly if a difference in upper jaw growth is suspected.
It is precisely this accurate diagnosis that determines which method will deliver the best result.
What Are the Treatment Options?
There is no single universal solution suited to every patient. The appropriate approach depends on the cause of the gummy smile, which is determined by the dentist during the initial examination.
If the cause is excessive activity of the upper lip, botulinum toxin injections can be used. These temporarily reduce the activity of the muscles that lift the upper lip when smiling, so that less gum is exposed. The effect usually becomes visible within a few days and lasts approximately three to six months, after which the treatment can be repeated.
If the teeth are covered by an excessive amount of gum tissue, gingivectomy — the surgical reshaping of the gums — may be an appropriate solution. In some cases, for a long-term stable result, the bone around the tooth also needs to be adjusted. This procedure is known as crown lengthening and allows a greater portion of the natural dental crown to be revealed.
If the gummy smile is related to tooth positioning or the bite, the dentist may recommend orthodontic treatment. In patients with significant vertical maxillary excess, orthognathic surgery may be considered — a procedure reserved primarily for more pronounced anatomical deviations.
In many cases, the best aesthetic result is achieved through a combination of several methods. For example, gum reshaping may be followed by teeth whitening, ceramic dental veneers, or botulinum toxin injections, so that the final smile looks as natural and harmonious as possible.
How Is Treatment Carried Out at m2stoma Brno?
Treatment for a gummy smile always begins with a thorough consultation and careful diagnosis.
The examination typically includes:
- photographic documentation and smile analysis,
- assessment of the teeth, gums, and their proportions,
- X-ray or CBCT scan where required,
- preparation of an individual treatment plan,
- surgical gum reshaping where appropriate, or recommendation of the next steps.
If you are also planning teeth whitening, ceramic dental veneers, or another aesthetic dental procedure, we plan the individual steps so that the result is a natural and balanced smile.
Frequently Asked Questions
Is gingivectomy painful?
The procedure is carried out under local anaesthesia, so you will not feel any pain during the treatment. Once the anaesthesia wears off, mild sensitivity or discomfort may occur for a few days. Healing typically takes approximately one to two weeks.
Is the effect of botulinum toxin permanent?
No. Botulinum toxin works temporarily and its effect usually lasts three to six months. If you are happy with the result, the treatment can be repeated.
Is the treatment covered by health insurance?
In most cases, this is an aesthetic procedure and is not covered by public health insurance in the Czech Republic (where healthcare is funded through statutory health insurance). The exact cost of treatment will be determined after the initial examination, based on the chosen approach.
Conclusion
A gummy smile is a common anatomical variation that can affect the appearance of a smile and one’s self-confidence. Modern dentistry today offers several effective ways to improve its appearance. The key to successful treatment is correctly identifying the cause, as this is what determines which method will deliver the best outcome.
If your gummy smile is something you would like to address, book a consultation at m2stoma Brno. We will assess the treatment options together and recommend a solution that suits both your expectations and your individual anatomy.