A gummy smile, also known as a high smile or excessive smile, refers to a condition in which a significant portion of the gum shows when smiling, leaving a considerable portion of the gums exposed in relation to the teeth. Although the amount of exposed gum varies from person to person, a gummy smile is generally considered to be one in which more than 3 mm of gum shows when smiling. It has an appearance of teeth that are too short, where more gum than tooth is visible. It can be an aesthetic problem and affect a person’s self-esteem.
Characteristics to know if you have a gummy smile:
- Show an excessive amount of gum when you smile.
- The gums appear disproportionately high in relation to the teeth.
- The gum line appears irregular or asymmetrical.
- Your teeth may appear shorter than normal.
Causes of gummy smile:
- Excessive tooth eruption: If your teeth erupt more than normal, it can cause your gums to show more when you smile.
- Hypertonicity of the levator labii muscle: When the muscle that controls the movement of the upper lip is hypertonic or hyperactive, it can excessively elevate the upper lip and show more gum than normal.
- Overdevelopment of the jawbone: An overgrowth of the upper jawbone can cause the gums to become elevated and show more when smiling.
- Altered passive eruption: In some cases, improper development of passive eruption, which is the natural process of gums migrating downward as teeth erupt, can cause this type of smile.
- Poor oral hygiene habits: not brushing teeth properly, not flossing and not visiting the dentist regularly can increase the risk of developing it.
- Genetics: The propensity to have receding gums and a gummy smile can be inherited. If someone in your family has this condition, you are more likely to develop it as well.
- Inflamed or receding gums: Chronic inflammation of the gums, known as periodontal disease, can cause gums to recede and leave teeth exposed. This can be caused by poor oral hygiene, lack of dental care, smoking or underlying disease.
How can we correct the gummy smile?
Botulinum toxin (Botox): applied to the levator muscles of the upper lip, it helps relax them and reduces excessive gum exposure.
Cosmetic periodontal surgery (gingivectomy): removes excess gum tissue and reshapes the gum line for a more balanced smile.
Hyaluronic acid in the lips: used in selected cases to modify how the upper lip rests and sits when smiling.
Orthognathic surgery: when the underlying cause is overgrowth of the jaw bone, the bones are surgically repositioned, improving overall facial aesthetics.
Altered passive eruption surgery: when passive eruption has not developed properly, surgery guides the gum migration so the teeth show correctly when smiling.
Which one fits depends on the cause, and that is what the initial assessment determines.
Tips to avoid a gummy smile:
Maintain good periodontal health: Take care of your gums and maintain proper oral hygiene. Brush your teeth twice a day, floss daily and make regular visits to the dentist for cleanings and dental exams.
Treat any underlying dental problems: If you have dental problems such as dental malpositions, short teeth or excessive eruption, it is important to treat them to correct the underlying cause of the gummy smile. Consult your dentist or orthodontist to discuss treatment options that are right for you.
Control the activity of the upper lip elevator muscles: Some people have excessive muscle activity in the upper lip, causing exaggerated elevation and a gummy smile. In such cases, botulinum toxin (Botox) treatments may be considered to relax the muscles and reduce gum exposure when smiling. Talk to a trained oral health professional to learn more about this approach.
Consider overall facial aesthetics: In some cases, a gummy smile may be the result of an overall facial imbalance. If you have concerns about the aesthetic appearance of your smile and face, you may want to consult a maxillofacial surgeon or a specialist in orthodontics and dentofacial orthopedics to evaluate your case and explore broader treatment options, such as orthognathic surgery.
Remember that each case is unique, and it is important to seek guidance and treatment from oral health professionals for a personalized approach tailored to your specific needs.
Frequently asked questions about the gummy smile
Is a gummy smile a health problem?
In itself it is an aesthetic matter, but some of its causes are not: inflamed or receding gums, for instance, do need treatment for health reasons.
Is the result permanent?
It depends on the treatment: surgical corrections are stable over time, while botulinum toxin and hyaluronic acid wear off and need to be repeated.
How do I know which treatment I need?
Only after an assessment: the same appearance can come from the muscle, the gum or the bone, and each cause has a different solution.
