October 2, 2019 | Tri Le Last updated March 26th 2025 If your family has a history of gummy smile, you may wonder if you will inherit this aesthetic concern, as well. Or if you have a gummy smile now, you may wonder where it came from and what to do about it. There are several factors that may contribute to a gummy smile, and a number of treatment approaches that could help, depending on the underlying cause. Read on to get an idea of how gummy smile originates and what to do to turn a gummy smile into a gorgeous smile. What is a Gummy Smile? Officially known as excessive gingival display, a gummy smile is a cosmetic condition in which there is an appearance of too much gum line when smiling. Sometimes, excessive gum tissue can make teeth appear shorter than normal. More than 3-4 millimeters of gum tissue showing is considered the general threshold for qualifying as gummy smile; 1-2 millimeters is considered typical. A dentist can diagnose a gummy smile with a simple measurement.Gummy smile is relatively common, particularly among women between the ages of 20 and 30, affecting an estimated 10 percent of adults in the U.S.. Cause #1: Genetics and Anatomy If you suspected your genetics might be involved, you were right. Traits that are passed down through generations such as smaller teeth, a larger jaw, and a short upper lip can predispose you to experiencing a gummy look when you smile. In fact, several causes you’ll read about below can be traced back to your genes and personal anatomy, and are therefore completely out of your hands. Cause #2: Poor Dental Hygiene That being said, one cause of gummy smile you certainly can control is your dental hygiene. Poor dental hygiene may contribute to conditions like gingivitis or periodontitis, which can influence the appearance of the gums over time. Here’s how it happens: You don’t brush and floss regularly. Plaque, a sticky film of bacteria, builds up on your teeth. Plaque hardens into tartar. The bacteria from plaque and tartar inflame the gums (gingivitis). Untreated gingivitis progresses to the point that the gums pull away from the teeth, forming pockets that become infected (periodontitis). Cause #3: Altered Tooth Eruption Tooth eruption is the process of teeth growing through the gums to become visible in the mouth. It happens in two stages, active and passive. In the active phase, the tooth moves into its proper chewing position. Passive eruption involves four stages of the gums moving toward the base of the tooth to reveal more of the crown: Stage 1: The gums are on the enamel (the outer layer of the tooth). Stage 2: Gums are partly on the enamel and partly on the layer covering the tooth root (the cementum) below the gum line. Stage 3: Gums are entirely on the cementum, with the gum line at the tooth’s natural neck. Stage 4: Gums have moved to the point that part of the tooth root is now showing. In a case of altered passive eruption, the gums fail to move past Stage 2. This leaves them too high on the tooth, which makes the tooth appear too short; in other words, creating a gummy smile. The first four front teeth in the middle of the upper jaw, called the maxillary incisors, may also over-erupt, or grow too far into the mouth, making the gums more prominent when smiling. This is called dentoalveolar extrusion.Altered tooth eruption is unique as a cause of gummy smile in that it may be the result of genetics or of lifestyle habits. For example, thumb sucking or extensive use of a pacifier in youth can disrupt the eruption process and lead to a gummy smile. Cause #4: Side Effects of Medication It’s not well understood why it happens, but certain drugs may cause excess gum growth, a condition known as gingival hyperplasia. Some medications have been associated with gingival hyperplasia in certain individuals. If you need to be on any of these types of medications and you’re concerned about developing a gummy smile, you can talk to your doctor about switching to an alternative with a lower risk of stimulating gum growth. Cause #5: Lip Position/ Hyperactive Upper Lip A 2023 study published in the Journal of Periodontology found that hypermobile upper lip (HUL) is “the most significant factor in determining excessive gingival display. HUL is a condition in which the upper lip is overactive, causing it to rise higher than usual when smiling, uncovering more of the gums. Over 8mm is considered the threshold for hyperactive upper lip. Cause #6: Jaw Misalignment & Bone Structure Just as the way teeth grow can impact your smile, the jaw’s development can also lead to gummy smile. If the jaw protrudes excessively, the teeth can erupt incorrectly and there can be misalignment between the top and bottom rows of teeth. Either of these can create the appearance of gummy smile. Gummy Smile in Children Gummy smile in a child may be an indication of one of the conditions mentioned above, such as jaw misalignment, but not necessarily. It’s common for children to grow out of a gummy smile as their mouths develop and permanent teeth come in. Am I a Candidate for Gummy Smile Treatment? If you have been diagnosed with gummy smile in an examination, you will likely be able to receive treatment if you have healthy gums without active periodontal disease or severe dental decay. In those cases, the decay should be treated before considering the aesthetics of gummy smile. Similarly, if you have functional issues with your jaw or hyperactive muscles around your upper lip, you may be able to receive treatment but these conditions might need to be addressed first. Gummy Smile Treatment Gum lift: Before and after patient comparison here at Bunker Hill Dentistry. Once the cause of your gummy smile has been diagnosed, your dentist will work with you to determine the most appropriate treatment based on the cause of your gummy smile. This could include: Gum contouring: For excess gum tissue, a soft tissue laser or scalpel can remove surplus gum tissue and reshape the gumline under local anesthesia. This can usually be done in one visit. Orthodontics: A treatment such as braces might be the optimal answer for gummy smile caused by teeth misalignment. Botox: Some providers may use Botox to help relax a hyperactive upper lip. Veneers: If short teeth are creating your gummy smile, veneers can make your teeth appear longer by reducing the visibility of your gums when you smile. Lip repositioning surgery: Lip repositioning surgery is one of the less invasive surgical options for gummy smile treatment. The dentist makes small incisions in the gums near the upper lip and repositions the lip to a lower position to help cover more of the gum tissue when you smile. This procedure is often performed under local anesthesia and may take about an hour, depending on the individual case. Orthognathic surgery: This is a more extensive procedure that involves repositioning jaw bones with plates or screws. It could be recommended if your gummy smile is caused by jaw misalignment. Ready to Fix that Gummy Smile? Learn more about our expert gum contouring services and how they can transform your smile. Explore Gum Contouring Services at Bunker Hill Dentistry Tri LeA practicing dentist since 1987, Dr. Le has been running successful dental practices in Texas with his wife Ann since 1990. A member of the ADA, AACD and AADSM, Dr. Le has also contributed to several leading dental journals.
