How to fix a gummy smile (excessive gingival display)?

Dr Alistair Graham
Dr Alistair Graham

A smile is beautiful because it shows happiness, even if there are dental imperfections. 

But some people hesitate to grin because they’re worried their gums attract too much attention by taking up a lot of space.

You may have a “gummy smile” if more than 3mm of gum can be seen above your upper teeth (instead of the average 2mm). Many patients aren’t bothered by this, as it simply adds to their charm. 

However, some patients are self-conscious about their disproportionate display of gum, which is why Dr Graham is often asked to fix a gummy smile

And it’s not only because they want a balanced smile – there are sometimes health concerns too

Excessive gingival display can make it harder to clean your teeth, which increases your chances of developing oral problems such as:

Thankfully, there are both temporary and permanent solutions. Dentists can fix a gummy smile with surgical or non-surgical methods. 

We’ll talk more about treatment options, but first, let’s look at some of the causes of excessive gingival display.

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What causes a gummy smile (excessive gingival display)?

Genetics:

Your genes may cause excessive gingival display if you have small teeth, a large jaw or short upper lip.

Abnormal tooth eruption is another possible driving factor. This occurs when teeth don’t emerge properly during childhood (the gum overlaps tooth enamel, so teeth look hidden). 

A condition called hereditary gingival fibromatosis could also be the culprit, though this is rare. It’s characterised by a fibrous gingival overgrowth that covers the teeth and even causes speech problems in severe cases.

Changes in your body:

Hormonal imbalances that occur during puberty or pregnancy can enlarge your gums. This could be one reason why excessive gingival display is more common in young people, particularly women in their twenties and thirties. Some medical conditions can have a similar effect on the gums. 

Individual actions: 

Poor oral hygiene and mouth breathing can cause gums to extend too far over the teeth. In other cases, gingival swelling is a side-effect of particular medications (such as immunosuppressants).

A comparison of excessive gingival display before and after treatment

How to fix a gummy smile with braces or Invisalign (non-surgical)

Orthodontic appliances such as braces and Invisalign are a good solution for mild cases of excessive gingival display, especially when the problem is caused by an improper bite, abnormal tooth eruption or minor jaw issues.

These appliances reduce the appearance of your gums by moving teeth into a better position (more of the tooth length is then visible from the gums). This is a permanent solution, as long as the patient continues to wear a removable or bonded retainer to maintain correct tooth alignment.

More non-surgical treatments for excessive gingival display

Veneers or crowns:

These dental restorations cover the tooth and make it look longer, which minimises the appearance of gum. Veneers and crowns mimic the look and function of human teeth, so nobody can see that you’re wearing them. Veneers and crowns are bonded to the teeth, and last for an average 10 to 15 years before needing to be replaced.

Laser gum contouring:

A high-tech dental laser is used to gently remove extra gum tissue so the gum line moves back. It’s a minimally invasive way to reshape the gum line, and usually involves a local anaesthetic to numb the pain. This is a permanent solution. 

Muscle relaxant injections (gummy smile Botox):

Botox can be injected to limit movement in the upper lip, for patients whose gummy smiles are caused by hyperactive lips. This temporary treatment reduces the amount of gum that’s visible when lips are parted. The effects last for three to six months, so it’s not ideal if you’re looking for a permanent solution. 

Root planing and scaling:

Your dentist can deeply clean your gums with a scaling instrument that removes bacteria, if an infection has enlarged your gums. This is a non-invasive way to reduce inflammation that causes gums to swell up and stretch too far over teeth. 

Gummy smile botox therapy: popular treatments for excessive gingival display

How to fix a gummy smile with surgery

Crown-lengthening procedure (gingivectomy):

Dentists can surgically remove some gum tissue to lengthen the crown of the tooth (previously hidden behind the gum line). This permanent solution requires local anaesthetic, to reduce or eliminate any discomfort. 

Lip repositioning surgery:

It’s possible for dentists to surgically move your lip downward to cover more of your gums. Your face looks exactly the same after the procedure. The only difference is your lip doesn’t lift so high when you smile, so less gum is shown. This is a permanent solution with minimal risks, and it’s actually less invasive than it sounds (there are no scars after healing occurs).

Fix a gummy smile with Digital Smile Design (DSD)

The treatment for gummy smiles depends on what’s making your gums look disproportionately large.

Your dentist will discuss the best solutions and associated costs, after reviewing your case.

At Mona Vale Dental, we strongly recommend our patients examine a realistic preview of their new smile, before committing to any treatment. This mock-up is accurate to the smallest detail.

This helps us tailor the treatment based on patient feedback, so we can create a smile they’re proud to show off (no buyer’s remorse)!

How it works:

  1. Our team uses advanced digital technology to capture your precise facial and oral dimensions (including your natural expressions in motion).
  2. We create a 3D mock-up of the proposed smile and place this on your teeth, so you can see exactly what you will look like. You can take home photos and a video of the mock-up to ask your loved ones for their opinion.
  3. Don’t love what you see? Let us know and we’ll perfect the design with your feedback.
  4. A treatment plan is created around the final design. We physically replicate the natural-looking smile of your dreams, which has been tailored to your features and personality.

This innovative framework is called Digital Smile Design. We’re proudly accredited, having undergone extensive training in this specialised field (not many Australian clinics have). 

If you’d like to find out how we can add balance to your smile, please contact us to book an appointment or virtual consultation.

Digital smile design (DSD) technology helps us to fix a gummy smile

Health Insurance and Payment Plans

At Mona Vale Dental, we accept health fund rebates via HICAPS, so you’ll only pay the gap. If you don’t have insurance, we also offer interest-free payment plans, allowing you to pay gradually while enjoying your new smile immediately.

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