Gummy Smile - Causes, Treatment & How to Fix a Gummy Smile

asian woman with beautiful smile

Price/Cost table

Type of treatment for gummy smileAverage Price/Cost USD
Fillers$300 - $400 per syringe
Botox$80 - $150
Dental veneers$300 - $8000 per veneer
Gingivectomy$250 - $700
Gummy smile surgery$300 - $10000
Lip repositioning$200 - $8500
Braces treatment$3000 - $6500

A gummy smile is when an excess of gum tissue shows in the upper lip when you open your mouth. It covers part of the crowns, creating the illusion they are shorter. In the medical world, it is known as an excessive gingival display. It is estimated that between 10% and 30% of people around the world have this upper jaw condition. Even though it is common, it can make you feel self-conscious regardless. The good news is there are various treatment options for it and we are about to reveal them in the paragraphs below. Keep reading to learn more.

What Causes a Gummy Smile?

Genetics seems to be the most common cause of gummy smile and here are some of the issues that can arise from that:

  • Overactive muscles in the upper lip
  • Short muscles in the upper jaw
  • A short upper lip
  • Overgrowth of the upper jaw bone
  • Downward upper teeth movement
  • Problems with tooth eruption in early childhood (altered passive eruption can often be combined with a hyperactive lip)
  • Hereditary gingival fibromatosis (HGF) - it occurs in rare cases
  • Gum disease: if you suffer from gum disease, the gums can begin to recede above the normal gum line which will expose more tooth structure; in turn, this will ruin the appearance of the smile
  • A Vertical Maxillary Excess (VME)

A gummy smile is considered normal and is not a medical condition. However, there is an issue with aesthetics and appearance that patients are concerned about. That's why they seek ways to minimise the appearance of excess gummy tissue and enhance the smile. There are different orthodontic treatment options to hide excessive gum tissues or put the teeth back into their correct position. But prior to that, a dentist or another oral health specialist has to examine the teeth in order to give a correct diagnosis. The approach they use will vary depending on the cause.

Gummy Smile Treatment Options

dentist treating a gummy smile with dermal filler or botox

Let’s have a close look at the most popular gummy smile treatments available these days in the US. They can make your smile more confident.

Hyaluronic Acid for too much Gum Tissue

If you have hypermobile lips, a temporary way to keep them at bay is to stick with hyaluronic acid fillers. Injected into the right spot, they can limit the muscle movement so that the excess gum tissue is not exposed. The treatment lasts about 8 months. If you want to maintain the outcome, you need to schedule top-up sessions.

Dental Veneers for Excessive Gums

ceramic veneers

This is a thin strip of material that is placed over a tooth to cover cracks and stains. The purpose is to improve the aesthetics of smiles by hiding part of the gums and highlighting more of the teeth. It is performed by a doctor like a dentist. A veneer is a great treatment option for gummy smile in that it can camouflage the top and bottom teeth, making them look taller. Basically, this is like a crown lengthening surgery but minus the actual jaw surgery.

Botox in the Upper Jaw as a Cure for Gummy Smile

botox treatment for gummy smile

Now, it may be hard to imagine how botulinum toxin can fix excessive gingival display in the upper jaw but it can actually help to keep the elevator muscles in the lips under control. A small study back in 2016 revealed that patients with gummy smile who got the Botox injection around the lips, noticed a huge difference in their smiles and gums after two weeks 1.

The great thing about it is that it is less expensive than other procedures that tend to fix gummy smiles, plus it is minimally invasive and there is virtually no downtime. 4 to 8 units of Botox are needed per treatment. It is said that the shots begin taking effect after a few days post-application. The only problem is, Botox is a temporary solution for too much gum tissue. It gets cleared by the body after 6-8 months and the procedure has to be repeated to sustain the results.

In the US, the treatment is done using a local anaesthetic to numb the desired areas. It may be administered in the gums and teeth or directly in the skin.

Oral Surgery (Gum Contouring) of the Upper Lip

Sometimes when there is too much gum tissue around the teeth, affecting the smile, nothing works but oral surgery. The operation is dubbed gingivectomy or gum contouring. In essence, it involves trimming the extra gum tissue to uncover more tooth surface and give way to a brand new smile 2. Needless to say, local anaesthesia is administered into the targeted area so that the patient is free of pain and relaxed all the way through the process.

Because this is an operation, it is normal to experience some bleeding, swelling, and discomfort in the targeted area for several days afterward. The results are evident right away but it’s going to take a while before the tissue heals and you look like your normal self.

Orthognathic Surgery for Gummy Smile

oral surgery for gummy smile

An excessive gingival display may be the result of an imbalance in the length of the upper and lower jaws. If that’s the case, only plastic surgery can fix that. The dentistry field dealing with that is called orthodontics. A lot of thought goes into the process because it is a complex procedure that may require the services of both a maxillofacial surgeon and an orthodontist at the same time. A general dentist will not be able to help.

In the US, general anaesthesia is used to keep the patient asleep. In order to balance the lower and upper jaws, the specialist will have to remove a portion of the upper bone alongside some of the gums. All the necessary adjustments will be made to give the patient a normal smile, teeth about the right length, and less visible gums.

With this gum and bone procedure, you should remain in the clinic for several days where you will be attended to and monitored until you are stable enough to be discharged. Once you are back home, you will have to wear elastics to help with the healing. They will keep your jaw and bone in alignment. You will see an instant improvement in your gummy smile.

Lip Repositioning Surgery for Gummy Smile

This is a procedure in which the upper lip is repositioned so that it allows for more teeth to be seen when smiling 3. It consists of trimming a thin strip of tissue from the lip and the surgeon works on the inside, always. Then, as the redundant tissue is eliminated, the rest of the lip takes on a lower position. The surgeon places sutures in the area to promote healing.

There is no need for general anaesthesia. A local anaesthetic is perfectly fine to use on the teeth and gums. The entire treatment lasts a maximum of 45 minutes and patients are eased into recovery. A hospital stay may be needed for this type of gummy smile treatment.

Other Treatments

When it comes to an altered passive eruption, altered active eruption, and other conditions that happen during childhood, it is important to mention that braces and temporary anchorage devices (TADs) can be a great treatment option 4. Dental braces are employed to straighten teeth and maintain the correct alignment. They may be able to provide relief from a gummy smile. A dentist or another doctor can recommend the right type of braces for your case and mouth. TADs serve to provide additional support to the teeth.

Sometimes only the top teeth need to be covered since a gummy smile caused by genetics usually affects the upper part of the gum. Whatever happens to your teeth and gums, know that orthodontics and dentistry have a solution. You just have to go to the right people to get it.

Cost of Gummy Smile Treatment

We talked about several treatments, so here is the price breakdown in the US*:

  • One round of fillers is estimated at $300 - $400 and up per syringe.
  • Gummy smile treatment with Botox runs between $80$150. It depends on the number of units needed to get the job done, which is based on the size of the area that will be covered.
  • In the US, dental veneers come in at a price of $300 - $8000 per item.
  • The cost of a gingivectomy is determined by the number of teeth involved and generally spans from $250 to $700.
  • Jaw surgery or orthognathic surgery often exceeds $10000, exclusive of surgeon fees, anaesthesia, and medication used. In some cases, it can cost a staggering $40000. However, surgical procedures are often covered partially or in full by your insurance plans.
  • Lip repositioning costs around $200$8,000.
  • Braces are around $3500 - $6,500.

*Prices on gummy smile treatments reflect ballpark figures and may vary from clinic to clinic and city/state.

Is Gummy Smile Covered by Insurance?

Unfortunately, the expenses of gummy smile correction are settled by the patient due to the cosmetic nature of the treatment. Like most other aesthetic procedures, no insurance company is likely to reimburse this one since it is not deemed medically necessary. If you are unable to make your own financial arrangements, you should discuss your payment options with your dental professional or oral surgeon. They may offer flexible plans to get you going.

And that wraps up the therapies for excessive gum tissue that you can get these days. All things considered, you should let trained dentists and other specialists evaluate your gummy smile condition and figure out the best treatment option based on your actual needs. A lot of times patients read something up on the Internet and get fixated on treatment because it seems the most appealing in their book. And then they show up at the dentist's insisting on that specific therapy when they are not even eligible for it.

There is no harm in requesting or refusing a procedure that has been suggested to you but at the end of the day, you should not forget that physicians are more knowledgeable and experienced than you and they know better. They will provide medical advice for your smile that you can go by if you want and no one can force you into an intervention. But there is no way you can demand a certain orthodontic treatment to fix your gummy smiling unless you meet the desired criteria.