When patients seek improvements to their smile the first port of call is often the well-known interventions of alignment through Invisalign, tooth whitening, composite bonding and the placement of porcelain veneers. Whilst all are capable of improving your aesthetics, the dentists has to work within the restrictions of the existing tooth proportions and shapes.
The gums are the frame of the teeth. A beautiful smile is characterised by symmetry and proportion. The symmetry of the teeth themselves but also of the gums in terms of shape and position. The proportion of the teeth can have a profound impact on your outward appearance. If the teeth are too long teeth can appear too big and undesirably ‘masculine’ for your face. If the teeth are too small, it may lend to a ‘gummy smile’.
A Gummy smile is when your smile reveals more of your gums than you’d like. In clinical terms, it’s called excessive gingival display. As many as 10% of 20- to 30-year-old adults consider their smiles gummy. No exact definition exists for a gummy smile. In reality, it largely rests in the eye of the beholder and personal aesthetics however it is a fairly common cosmetic concern. Your perception of your gum line is commonly affected by the height and shape of your teeth and your lip shape when you smile. Generally speaking, 3 to 4 millimeters of exposed gum line is considered to be disproportionate, resulting in a gummy smile.
What causes a Gummy Smile?
Many times the teeth are the proper length, they are just covered by too much gum tissue. This condition is called altered passive eruption. To make the smile look better, excess gum tissue is removed to expose all the natural enamel underneath. If the teeth in the front of your mouth grew in too far, or overerupted, your gums might have grown too far as well. This condition is known as dentoalveolar extrusion. A gummy smile can also occur due to a condition called vertical maxillary excess. This is when the bones of your upper jaw grow longer than their typical length. A gummy smile can also happen when your upper lip is on the shorter side. And if your lips are hypermobile, meaning they move dramatically when you smile, exposing more of your gum line.
What treatments are there for Gummy smiles?
There are several treatments which can improve the symmetry of your teeth and gums as well as the proportion of your teeth.
Crown lengthening surgery: Also known as a ‘gum lift’ this procedure removes excess gum tissue and improves the symmetry of the teeth and gums. The result is a more harmonious smile that mimics nature. Crown lengthening may be performed as an individual procedure or more commonly as a part of a more comprehensive aesthetic treatment plan. If too much of your gums cover the surface of your teeth, we may recommend a procedure known as a gingivectomy. This is also known as gum contouring and involves the removal of extra gum tissue. Our periodontist surgeon will use a scalpel or laser to trim or reshape your gums to reveal more of your teeth’s surface.
Lip repositioning surgery: If your lips are the cause of your gummy smile, your doctor may suggest lip repositioning surgery. The procedure changes the position of your lips relative to your teeth. It’s done by removing a section of connective tissue from the underside of your upper lip. This will prevent the elevator muscles located in the area of your lip and nose from lifting your upper lip too high above your teeth. Our periodontist will make two incisions on the underside of your upper lip and remove a section of connective tissue from the area.
Botox: If moving your lips too far up over your gum line when you smile causes your gummy smile, you may have success with injections of botulinum toxin, also known as Botox. Botox is less intrusive than surgery but will require repeat injections every 3 to 4 months to maintain results.
Dr Mitul Shah is an experienced specialist in the field and his work has featured in the Daily Telegraph.
Meet the team
Dr Mitul Shah
After working in general practice in Oxfordshire, Mitul gained experience in oral and maxillofacial surgery and restorative dentistry at the Royal London Hospital, inspiring him to pursue a career in periodontics. Mitul has in depth experience managing complex gum health problems including recession, deformities, gummy smiles and other problems – especially with dental implants.