A common worry about a gummy smile is that fixing it means surgery. Often it does not. Many cases improve with a modest gum procedure, orthodontics or cosmetic work on the teeth, and the larger operations are kept for the causes that need them. The way to find the gentlest route that will actually work is to pin down the cause first.
A cosmetic choice, not a health problem
Showing a lot of gum is not harmful in itself. As long as the gums are healthy, treatment is entirely optional, and many people with a broad gum line are happy with it. The exception is gum that is red, swollen or bleeding, because enlarged, inflamed gum can make a smile look gummier. That needs treating for its own sake first, as our guide to bleeding gums explains.
Why the cause decides the treatment
The same amount of visible gum can come from gum still covering part of each tooth, an upper lip that rises higher than average, front teeth that have come down further than the rest (often with a deep bite), or an upper jaw that is longer in height. Our article on the causes of a gummy smile describes each one in detail. A treatment aimed at the wrong cause can leave the smile looking much the same.
Gum shaping for teeth hidden under gum
When the teeth are a normal length but gum covers part of them, reshaping the gum is usually the most direct fix. If only soft tissue needs to come away, this is a gingivectomy, often done in a single visit under local anaesthetic. If the bone also sits too close to the enamel edge, a little bone is reshaped as well (crown lengthening). Skipping that step when it is needed is a common reason gum creeps back after contouring, so an X-ray and careful probing beforehand matter.
Orthodontics for teeth that have come down too far
Where the front teeth have over-erupted, moving them up with braces or clear aligners can reduce gum display without cutting any gum at all. It takes longer than a gum procedure but treats the actual cause. Our guide to straightening teeth explains how braces and aligners work. Lumi Dental provides both; we are general dentists, and more complex bites may be referred to a registered orthodontist.
Options for a lip that lifts high
Muscle-relaxing injections into the lip-lifting muscles are the least invasive option for this cause, but they are temporary and need repeating, and they must be given by an appropriately trained registered practitioner. Some people use them as a trial before deciding on anything more lasting.
Lip repositioning surgery limits how far the lip can rise. It works, but it is not always permanent: a 2021 meta-analysis in the Journal of Esthetic and Restorative Dentistry (Dos Santos-Pereira and colleagues) found gum display was reduced at three and six months, with the effect fading over time and roughly a quarter of the improvement lost by twelve months. The authors suggested combining it with other treatment for a more stable result.
Jaw surgery for a long upper jaw
When the upper jaw itself is long, gum and lip procedures can only do so much. Correcting it fully involves orthodontics and jaw surgery in hospital under a specialist team. This is the most involved route and is usually only considered when the skeletal pattern is marked or there are other bite or breathing reasons to treat.
Gum work and cosmetic work, planned together
Gum contouring is often the first step before veneers or bonding, because an even gum line frames the teeth. If you are already thinking about a cosmetic change, it helps to plan the gum and the teeth together, as our guides to composite bonding and veneers and the smile makeover process explain. Our article on digital smile design covers how photographs and scans are used in that planning.
Questions we are often asked
Does treatment hurt?
Most options are done with local anaesthetic. Gum contouring usually brings a few days of tenderness. Crown lengthening and lip repositioning take longer to heal, and your dentist or surgeon will explain what to expect.
Will the gum grow back after contouring?
When the bone level is assessed and respected, the new gum line is usually stable. Regrowth tends to happen when bone needed adjusting but only gum was removed.
How long do the results last?
Injections wear off and need repeating. Gum reshaping, crown lengthening and orthodontics with retainers are intended to last. Lip repositioning can partly relapse, as the research above shows.
Finding the right starting point
If you have always been self-conscious about your gum line, the first step is finding out which cause is behind it. Our cosmetic dentistry team in Melrose Park can assess your smile and talk through the options, including referral where that is the better path. For an idea of costs, see our gummy smile cost guide and current offers, or book a consult.
