A gummy smile is when a large amount of gum tissue shows above your upper teeth when you smile. Most dental professionals consider it “excessive” when more than 3 millimeters of gum is visible, though the exact threshold is somewhat subjective. It affects roughly 10% of the general population and is slightly more common in women.
How Much Gum Is Too Much?
There’s no single number that separates a normal smile from a gummy one. The condition is graded by severity: mild cases show 2 to 4 millimeters of extra gum, moderate cases show 4 to 8 millimeters, and severe cases display more than 8 millimeters. Most people start noticing or feeling self-conscious about it somewhere in the mild range, but whether it bothers you is ultimately personal. A gummy smile is a cosmetic concern, not a medical one.
What Causes It
Several different things can create a gummy smile, and pinpointing the cause matters because it determines which treatment actually works. The main categories are muscle activity, jaw structure, tooth position, and gum tissue itself.
Overactive Lip Muscles
Three muscles work together to pull your upper lip upward when you smile: the levator labii superioris, the levator labii superioris alaeque nasi, and the zygomaticus minor. Each pulls in a slightly different direction. In some people, these muscles are hyperactive, yanking the lip higher than average and exposing gum tissue that would otherwise stay hidden. The teeth and gums themselves may be perfectly proportioned, but the lip simply lifts too far.
Excess Jaw Bone Growth
A condition called vertical maxillary excess means the upper jaw grew longer than typical during development, pushing the gum and teeth downward relative to the rest of the face. This creates more visible gum tissue even when the lip moves a normal amount. Mild cases can sometimes be addressed with orthodontics, but moderate to severe vertical excess often requires surgical correction.
Teeth That Haven’t Fully Erupted
Sometimes the teeth are actually a normal size but haven’t fully pushed through the gum tissue during development. This makes them look short and stubby, with gum covering part of the tooth’s crown. The problem isn’t too much gum in an absolute sense; it’s gum sitting where visible tooth should be.
Gum Tissue Overgrowth
In other cases, there’s genuinely excess gum tissue covering the teeth. This can happen naturally or as a side effect of certain medications. The underlying bone may be in the right place, but the soft tissue has grown over more of the tooth surface than it should.
Non-Surgical Treatments
For gummy smiles caused by overactive muscles, small injections of botulinum toxin (commonly known as Botox) can relax the muscles that pull the upper lip too high. The treatment targets a spot on each side of the nose where those three lip-lifting muscles converge. A dose of 2 to 3 units per side is typically enough for mild cases with less than 5 millimeters of gum showing. Higher doses are possible but come with more risk of side effects like a temporarily uneven smile.
The results are not permanent. Like Botox used for wrinkles, the effect wears off after a few months and requires repeat treatments to maintain. This makes it a good low-commitment option for people who want to test the waters before considering something permanent, or for those whose gummy smile is driven purely by muscle activity.
Gum Reshaping Procedures
When excess gum tissue is the problem, a dentist or periodontist can physically reshape the gumline. There are two main approaches, and which one you need depends on where the bone sits underneath your gums.
A gingivectomy removes only soft gum tissue. It works when the bone underneath is already at the right level and there’s simply too much gum draped over the teeth. Recovery takes about a week for most people, and many return to work or school within a day or two. The results are generally permanent.
Crown lengthening goes a step further, removing gum tissue and reshaping the bone beneath it. This is the better option when teeth appear short because the bone itself is sitting too high on the tooth. The reason this distinction matters: if a provider only trims the gums without addressing the bone, the tissue is likely to grow back. Reshaping the bone prevents that rebound and creates a lasting result.
Orthodontic Options
When the gummy smile comes from teeth that have drifted downward or a jaw that grew too long, braces or clear aligners combined with small temporary screws called anchorage devices can push the upper teeth upward into the jawbone. This “intrusion” pulls the gum line up with the teeth, reducing how much gum shows when you smile.
This approach works well for cases involving tooth position or mild vertical jaw excess, and it avoids surgery. The trade-offs are real, though: treatment time is longer than other options, the tiny screws can sometimes loosen and need replacement, and there’s a small risk of root shortening from the sustained pressure on the teeth. Long-term stability of the correction can also vary, meaning some relapse is possible over the years.
Jaw Surgery for Severe Cases
When significant vertical maxillary excess is the root cause, orthognathic surgery (jaw surgery) may be the only way to create a lasting change. The procedure repositions the upper jaw higher within the skull, which reduces gum display and often improves the overall facial profile. This is a major surgical procedure with a recovery period of several weeks and is typically reserved for severe cases where less invasive treatments won’t produce meaningful improvement.
Choosing the Right Treatment
The most important step is identifying why the gummy smile exists in the first place. A treatment matched to the wrong cause won’t work well. Botox does nothing for excess bone. Gum reshaping can’t fix a hyperactive lip. Orthodontics won’t help if the teeth are already in the right position but buried under too much tissue. Many gummy smiles actually have more than one contributing factor, which is why a thorough evaluation from a provider experienced with this specific issue, whether that’s a periodontist, orthodontist, or oral surgeon, tends to produce better outcomes than jumping straight to the most convenient option.
Severity also plays a role, but it’s less important than cause. A mild gummy smile from vertical jaw excess still points toward orthodontics or surgery, not Botox. Meanwhile, a moderate gummy smile from overactive muscles can respond beautifully to a few units of botulinum toxin. The treatment follows the anatomy, not just the measurement.