Gummy Smile: Can it be fixed?

Many patients come in with a complaint of a “gummy smile” and want to know if it can be fixed. The answer is yes, however a determination of what caused the gummy smile must first be diagnosed. Once a diagnosis is made the various treatment options for that specific case can be discussed.

Some causes of gummy smile (excess gingival display) are very common and the treatments can be easily accomplished. Many times, during development the front teeth don’t fully erupt and a portion of the tooth remains below the gum line. In these cases the teeth appear short but once the excess gum is removed they have a normal appearance and less gum shows with smiling.

The next most common occurrence is related to the skeletal or bony development of the upper jaw. If the upper jaw grows more than the lower you can get the typical “buck teeth” appearance with accompanying excess gum. Typically this can only be treated with orthodontics and in some cases orthognathic surgery where the jaw must be repositioned.

The lips can also contribute to a gummy smile. A hyper-mobile lip is when the muscles used for smiling pull too hard and causes the lip to go up higher than it should. A short upper lip is just that, and in that case the upper lip is not long enough to cover the upper teeth. These are less common and until recently not routinely treated. With the advent of Botox injections for numerous applications, success in treated lip related gummy smiles has been achieved.

What looks good can be very subjective. Studies have been done and there is a range of how much gum can show before a smile is considered unattractive. For women some gum showing is acceptable and often times desirable, ala Julia Roberts.  On the other hand what really matters is how you feel about yourself, for example Katie Couric the poster child for gummy smiles, did quite well with her smile.