Gingival Esthetics (Gummy Smile): What You Need to Know

Gummy Smile is an excessive display of gingiva (usually >3–4 mm) between the upper lip and teeth while smiling. It can make teeth look short and affect smile satisfaction.

Gingival esthetics aim to optimize the tooth-gingiva ratio using surgical and non-surgical approaches.

Causes

1. Short Upper Lip
2. Vertical Maxillary Excess — complex cases may require orthognathic surgery.
3. Gingival Hyperplasia — due to medication effects or inflammation.
4. Short Teeth / Altered Passive Eruption — excessive gingival coverage of crowns.

Treatment Options

1. Gingivectomy

• Goal: Remove excess gingiva causing a short-tooth appearance.
• How: Under local anesthesia with scalpel or dental lasers; lasers may reduce bleeding and speed healing.
• Indications: Excess/uneven gingival levels.

2. Gingivoplasty

Reshapes gingival margins and papillae to an esthetic curve; often combined with gingivectomy.

3. Crown Lengthening (Gingivectomy + Osseous Recontouring)

Reflect the flap and reshape underlying bone to reduce relapse and improve stability when gingivectomy alone is insufficient.

4. Orthodontic Treatment

Adjusts tooth position/eruption with braces or aligners when indicated.

5. Botulinum Toxin (Non-Surgical, Temporary)

• Indication: Hyperactive elevator muscles causing excessive lip lift.
• Effect: Lasts 4–6 months and can be repeated.