Frequently Asked Questions About Gummy Smile
What is a gummy smile?
A “gummy smile” is a smile that shows an excessive amount of upper gum tissue when you smile—typically more than 3–4 mm of visible gum above the upper teeth is considered “excessive” in aesthetic dentistry research (esthetic dentistry review). It’s not a disease, but a cosmetic concern that can affect confidence.
A gummy smile can be caused by several factors, including a short upper lip, hyperactive upper lip muscles, small or worn teeth, or a vertical excess of the upper jaw (maxillary excess).
What causes a gummy smile?
A gummy smile often results from one or a combination of anatomical and dental factors:
- Hyperactive upper lip muscles – The elevator muscles of the upper lip lift too high when you smile, exposing more gum. This is a common cause treated with neuromodulators like botulinum toxin (clinical review on gummy smile management).
- Vertical maxillary excess – The upper jaw is longer than average, so more gum is visible when smiling (orthognathic surgery overview).
- Altered passive eruption – Teeth are partially covered by gum tissue, making them look short and “square.”
- Short or thin upper lip – A naturally short upper lip may not cover the gums adequately.
- Tooth or bite problems – Overeruption of the upper teeth or certain malocclusions can also contribute.
Treatment is tailored to the underlying cause, which is why a proper clinical assessment is essential.
How is a gummy smile treated?
There are several treatment options, often used alone or in combination, depending on the cause and severity:
- Botulinum toxin injections (e.g., Botox®) – Small doses are injected into the elevator muscles of the upper lip to reduce their activity, so the lip doesn’t lift as high. Studies show this can significantly reduce gingival display for 3–6 months (prospective clinical study on botulinum toxin for gummy smile).
- Lip repositioning surgery – A minor surgical procedure that repositions the upper lip to limit how far it can move upward when smiling.
- Gingivectomy or crown lengthening – Removal or reshaping of excess gum tissue and sometimes bone to expose more tooth structure (crown lengthening overview).
- Orthognathic (jaw) surgery – For severe vertical maxillary excess, repositioning the upper jaw can correct the underlying skeletal problem (AAOMS orthognathic surgery guidance).
- Orthodontic treatment – Braces or aligners may be used when tooth position or bite contributes to the gummy appearance.
A consultation with a dentist, periodontist, orthodontist, or facial aesthetic specialist can determine which option (or combination) is best.
Is gummy smile treatment permanent?
It depends on the treatment:
- Botulinum toxin injections – Temporary. Results usually last 3–6 months before the muscle activity gradually returns and retreatment is needed (clinical data on duration of effect).
- Gingivectomy / crown lengthening – Often long-lasting or permanent, as gum and sometimes bone are reshaped. Good oral hygiene and stable bite are important to maintain results (periodontal surgery overview).
- Lip repositioning surgery – Can provide long-term improvement, although some relapse is possible.
- Orthognathic surgery – Generally considered a permanent correction of skeletal causes.
- Orthodontics – Results can be long-lasting but usually require retainers to maintain tooth position.
Your provider should explain the expected longevity of results for your specific case.
Who is a good candidate for gummy smile treatment?
You may be a good candidate if:
- You are bothered by how much gum shows when you smile
- You are in good general health and a non-smoker or light smoker
- Your gums and teeth are reasonably healthy (or you’re willing to address decay or gum disease first)
- You have realistic expectations about what can be achieved
For injectable treatments, candidates should not be pregnant, breastfeeding, or have certain neuromuscular disorders, in line with standard safety recommendations for botulinum toxin products (FDA botulinum toxin safety information).
A clinical exam, sometimes including photos, X‑rays, or digital smile analysis, is needed to identify the cause and select the safest and most effective treatment.
What happens during a gummy smile treatment appointment?
The process varies by treatment type, but a typical minimally invasive visit (e.g., botulinum toxin injections) may include:
- Consultation and examination – Your provider evaluates your smile, measures gingival display, and may take photos.
- Treatment planning – They explain options, expected outcomes, and costs, and obtain informed consent.
- Preparation – Makeup around the area is removed and the skin or gums are cleaned. A topical numbing cream or local anesthetic may be used depending on the procedure.
- Procedure
- For botulinum toxin, tiny injections are placed into specific upper lip muscles; the procedure usually takes 5–10 minutes and involves minimal discomfort (clinical technique description).
- For gingivectomy/crown lengthening, the dentist or periodontist reshapes gum (and sometimes bone) under local anesthesia.
- Aftercare instructions – You’ll receive guidance on smiling, oral hygiene, pain control, and when to return for review.
Most patients can return to normal daily activities immediately after non-surgical treatments.
What are the risks and side effects of gummy smile treatment?
Risks depend on the specific procedure, but may include:
Botulinum toxin injections
- Mild swelling, redness, or bruising at injection sites
- Temporary asymmetry or an uneven smile if dosing or placement is off
- Rarely, unintended spread of toxin causing weakness in nearby muscles (safety review of cosmetic botulinum toxin)
Gingivectomy / crown lengthening
- Post-operative discomfort or sensitivity
- Swelling or bleeding
- Temporary tooth sensitivity to hot and cold
- Infection or delayed healing, especially in smokers (periodontal surgery risks)
Lip repositioning or jaw surgery
- Swelling, bruising, and discomfort
- Infection, scarring, or relapse of results
- For orthognathic surgery, more significant surgical and anesthesia risks (AAOMS orthognathic surgery risks)
Choosing a qualified provider and following aftercare instructions reduces the likelihood of complications.
How much does gummy smile treatment cost in New York?
Costs in New York depend heavily on the cause of your gummy smile and the type of treatment:
- Botulinum toxin injections – Often priced per unit or per area; a gummy smile usually requires a small amount, so the fee is typically on the lower end of cosmetic injectable pricing.
- Gingivectomy / crown lengthening – Priced per tooth or per area; costs rise if bone reshaping is required.
- Lip repositioning surgery – Typically a one‑time surgical fee, which may include facility and follow‑up visits.
- Orthognathic surgery or orthodontics – More extensive and significantly higher in cost; sometimes partially covered by insurance if there is a functional bite problem (AAOMS orthognathic coverage discussion).
Because pricing varies between practices, an in‑person consultation is the most accurate way to receive a personalized quote in New York. Ask whether fees include follow‑up visits and potential touch‑ups.
Who can administer gummy smile treatment in New York?
Regulations vary by region, but in most jurisdictions treatments for a gummy smile should be performed by appropriately licensed healthcare professionals:
- Dentists or specialist dentists (such as periodontists or orthodontists) can diagnose and treat dental and gum‑related causes (gingivectomy, crown lengthening, orthodontics). They must hold a valid dental license and, for surgery, appropriate specialty training (American Dental Association scope guidance).
- Oral and maxillofacial surgeons are medical or dental specialists trained to perform jaw surgery for skeletal causes (AAOMS training standards).
- Physicians (such as plastic surgeons, dermatologists, or facial plastic surgeons) and dentists with additional training in facial injectables commonly administer botulinum toxin for gummy smile correction. They should have accredited training in facial anatomy, injectables, and complication management (safety recommendations for cosmetic injectables).
- In some regions, nurses, nurse practitioners, or physician associates may inject botulinum toxin under the supervision or delegation of a qualified doctor or dentist, depending on local law.
In New York, you should verify that your provider:
- Holds an active medical or dental license.
- Has specific training and experience in gummy smile correction (ask how often they perform the procedure).
- Uses approved products and operates in a properly regulated clinic setting.
How long is the recovery time after gummy smile treatment?
Recovery time depends on the procedure:
- Botulinum toxin injections – Minimal downtime. You can usually return to work immediately. Minor redness or swelling typically resolves within hours. Full effect is seen in about 1–2 weeks (clinical onset and duration data).
- Gingivectomy / crown lengthening – Mild to moderate discomfort for a few days; gums may take several weeks to fully heal. Soft foods and careful oral hygiene are recommended initially (periodontal surgery recovery guidelines).
- Lip repositioning surgery – Swelling and tightness of the upper lip for 1–2 weeks, with gradual improvement.
- Orthognathic surgery – More extensive recovery, often several weeks of swelling and restricted diet, with full healing over months (AAOMS recovery overview).
Your provider will give you tailored aftercare instructions and follow‑up appointments to monitor healing.
Can a gummy smile come back after treatment?
Yes, recurrence is possible, depending on the treatment:
- With botulinum toxin, recurrence is expected as the effect wears off; maintenance injections are needed every few months.
- With soft tissue procedures (like gingivectomy or lip repositioning), some relapse can occur if underlying habits, anatomy, or bite issues are not fully addressed.
- Skeletal corrections via orthognathic surgery are generally stable, though small changes over time are possible (long‑term stability studies in orthognathic surgery).
Discuss long‑term expectations and maintenance plans with your provider before committing to treatment.
Sources
- National Center for Biotechnology Information (NCBI) – Management of gummy smile: A literature review
- NCBI – Botulinum toxin type A for the management of gummy smile: Clinical study and technique
- American Academy of Periodontology – Crown lengthening patient information
- American Association of Oral and Maxillofacial Surgeons – Orthognathic surgery overview
- U.S. Food and Drug Administration – Information about botulinum toxin products
- American Dental Association – Cosmetic dentistry and scope of practice
Medically reviewed by Dr. Jennifer Chen, July 10, 2024