Gummy smile correction
Finding the cause of too much gum showing when smiling and reducing it orthodontically.
Does this sound familiar
Patients most often come for this with these words:
Too much gum shows when I smile
I press my lips together when I smile in photos
My teeth look short
My upper teeth show a lot even at rest
My upper lip rises very high when I smile
A gummy smile means more gum than usual shows above the upper teeth when smiling. For some it is barely visible, for others it is more noticeable. In itself it is not a reason to feel embarrassed or something that must be changed. But if it bothers you, it is possible to find the cause and choose a solution. Clinical reviews stress that the key to successful treatment is identifying the cause correctly.
The causes differ
| Cause | Who treats it |
|---|---|
| The upper teeth and jaw have grown too far down | Orthodontist, in severe cases with a jaw surgeon |
| The crowns of the teeth are short | General dentist, prosthodontist |
| The gum covers too much of the crown | Periodontist |
| The upper lip is more mobile than usual | The relevant specialist |
Often several of these causes are present together. More: gummy smile: what causes it.
Diagnosis
- How much of the upper teeth shows between the lips at rest
- The amount of gum in a natural and a broad smile, with photographs and video
- The ratio of tooth width to length
- The length and mobility of the upper lip
- The profile and vertical facial proportions, with an X-ray if needed
What an orthodontist can do
If the cause lies in the position of the teeth and jaw, orthodontic treatment is the main method. With the help of mini-screws the front teeth can be moved upwards to reduce how much gum shows and create a more harmonious balance between the teeth, gums and lips. A systematic review shows this method is effective without surgery.
How treatment goes
- Diagnosis and identifying the cause
- Plan: how far the teeth need to move upwards and what the smile arc should be
- Braces or aligners
- Placing mini-screws and the intrusion phase
- Finishing: the details of the smile
- Other specialists’ stage if needed
- Retention
What I pay attention to
The goal is not to hide the gum completely. A little gum showing is a natural part of a youthful, lively smile. Moving the front teeth too far upwards can make a smile look older. That is why I plan the amount of intrusion according to the smile arc.
What the science says
- Clinical review (2020): a gummy smile has several causes and treatment should be chosen only after a correct diagnosis.
- Systematic review (2021): intrusion of the front teeth with mini-screws effectively reduces a gummy smile without surgery.
- Systematic review (2016): laypeople are sensitive to how much gum shows when smiling.
What the result looks like
After a successful correction a little gum still shows when smiling, but it does not draw attention away from the teeth and lips. The smile becomes more balanced and the teeth show at their natural length. Some patients say they now smile in photos without pressing their lips together. That is exactly my goal: removing the need to hide the smile.
When it may not be suitable
- If the only cause is lip mobility, orthodontic treatment is not the main method
- If gum disease is active, it must be treated first
- With a severe vertical excess of the jaw, a surgical approach is discussed
Frequently asked questions
Can a gummy smile be corrected with braces alone?
If the cause is the position of the teeth and jaw, orthodontic treatment is the main method, often with mini-screws. If the cause is different, another specialist is needed too.
How stable is the result?
The vertical position of the teeth is maintained with retention. I plan retention specially.
How long does treatment take?
It depends on the cause and the overall orthodontic plan. I give the approximate duration after diagnosis.
Is it possible with aligners?
In some cases aligners can be used together with mini-screws. The decision depends on the diagnosis.
How many mini-screws are placed?
It depends on which teeth need to move. Often one or two screws on each side of the front teeth are enough.
Can a gummy smile be corrected with botox?
If the only cause is excessive lip movement, the relevant specialist may offer this method. If the cause is in the teeth, the effect is limited and temporary.
Read more
Scientific sources
The information in this article is based on the following peer-reviewed scientific articles and systematic reviews.
- Dym, H., & Pierre, R., 2nd (2020). Diagnosis and Treatment Approaches to a "Gummy Smile". Dental Clinics of North America, 64(2), 341-349. [PMID: 32111273] | [DOI: 10.1016/j.cden.2019.12.003]
- Alshammery, D., Alqhtani, N., Alajmi, A., Dagriri, L., Alrukban, N., Alshahrani, R., & Alghamdi, S. (2021). Non-surgical correction of gummy smile using temporary skeletal mini-screw anchorage devices: A systematic review. Journal of Clinical and Experimental Dentistry, 13(7), e717-e723. [PMID: 34306536] | [DOI: 10.4317/jced.58242]
- Parrini, S., Rossini, G., Castroflorio, T., Fortini, A., Deregibus, A., & Debernardi, C. (2016). Laypeople's perceptions of frontal smile esthetics: A systematic review. American Journal of Orthodontics and Dentofacial Orthopedics, 150(5), 740-750. [PMID: 27871700] | [DOI: 10.1016/j.ajodo.2016.06.022]