Ways to Correct a Gummy Smile

“Gummy smile” — where excessive gum tissue dominates the visible smile line — is one of the more common cosmetic concerns we get asked about. Priya wrote this because the right treatment depends on the underlying cause, and a one-size-fits-all answer (usually “veneers”) often makes the problem worse, not better.

First — figure out the cause

“Gummy smile” can have at least four distinct causes, and the right treatment differs for each:

Altered passive eruption — the gum hasn’t fully retracted from the teeth as you grew. Teeth look short. Common; treatable with gingivectomy.
Vertical maxillary excess — the upper jaw sits too low relative to the upper lip. Skeletal cause; orthodontic or surgical correction.
Hyperactive lip elevators — the muscles that lift your upper lip are unusually strong, lifting too far when you smile. Treatable with anti-wrinkle injections.
Short upper lip — the lip itself is shorter than average. Lip-repositioning surgery is the considered option.

A 30-minute consultation with a clinician familiar with smile design should narrow the cause down quickly.

Treatment 1 — Gingivectomy (laser gum reshaping)

Best for: altered passive eruption — short-looking teeth with healthy gums.
Procedure: Diode laser reshapes the gum line, exposing more of the underlying tooth crown. Single visit, 30–60 minutes.
Recovery: 1–2 days mild tenderness. Minimal swelling.
Cost: $200–$500 per tooth, depending on extent.
Durability: Permanent if done correctly. Gums don’t grow back if the procedure addresses passive eruption rather than active inflammation.

Treatment 2 — Surgical crown lengthening

Best for: cases where significant bone reshaping is needed alongside the gum.
Procedure: Periodontist or oral surgeon reshapes both gum and underlying bone in a minor surgical procedure.
Recovery: 1–2 weeks for full healing.
Cost: $500–$1,500 per tooth area.

Treatment 3 — Anti-wrinkle injections (lip elevator)

Best for: hyperactive lip-elevator muscles — common when teeth are normal length but the lip lifts excessively.
Procedure: Small dose of botulinum toxin injected into the levator labii superioris alaeque nasi (the muscle either side of the nose). 5-minute appointment.
Recovery: Immediate. Mild bruising possible.
Cost: $200–$400 per session.
Durability: 3–4 months initially; intervals often lengthen with repeat treatment.

Treatment 4 — Lip repositioning surgery

Best for: short upper lip cases unresponsive to less invasive options, when patient wants permanent solution.
Procedure: Strip of mucosa removed from inside the upper lip, lip then re-anchored slightly lower over the gums. Outpatient surgical procedure.
Recovery: 1–2 weeks for healing; 4–6 weeks for full settling.
Cost: $2,500–$5,000.
Durability: Long-lasting. Some relapse over years possible.

Treatment 5 — Orthognathic surgery

Best for: severe vertical maxillary excess (skeletal cause). Major intervention.
Procedure: Le Fort I osteotomy — the upper jaw is surgically repositioned. Hospital stay required.
Recovery: 4–6 weeks initial healing; 3–6 months full recovery.
Cost: $25,000–$45,000.
Best handled: by oral and maxillofacial surgeons, not general dentists.

The “veneers will fix it” trap

Some clinics will recommend veneers to “make the teeth look longer” and reduce gum dominance. This is rarely the right answer for an actual gummy smile — it usually makes the proportions look worse, and veneer dominance is not the same as resolving excess gum show. Treat the cause, not the appearance.