What is a gummy smile?
It is normal for some of the upper gum to show in a broad smile, and the amount varies from person to person. When noticeably more gum shows and the person is bothered by it, the term “gummy smile” is used. This is not a disease; it usually comes up as an aesthetic concern. Even so, it is worth having it assessed, because the underlying cause may be related to bite problems or gum health.
There is no single right answer to “how much gum should show” in a smile; age, sex, facial structure and personal expectations all affect the assessment. For general information on smile proportions, see our blog post on the golden ratio and gum display.
Causes of a gummy smile
A gummy smile usually results not from a single cause but from a combination of several factors. To decide on the right approach, these factors first need to be told apart.
Tooth eruption and tooth length
- Over-erupted front teeth: If the upper front teeth, and the gum with them, sit lower than usual, more gum may show when smiling. This is often seen together with a deep bite.
- Gum covering too much of the tooth: In some people, the gum does not recede enough over the tooth after eruption; the teeth look short and the gum looks broad.
- Tooth wear: Teeth shortened by clenching or grinding can erupt further to compensate. See teeth grinding and clear aligners.
Lip-related factors
A short upper lip, or a lip that lifts higher than usual when smiling, can increase gum display. In this case, more gum may show even if the position of the teeth and jaws is normal. Lip-related causes are not directly changed by orthodontic treatment.
Vertical growth of the upper jaw
Excessive vertical growth of the upper jaw can make the lower part of the face look long and cause the gum to show markedly when smiling. This is a skeletal condition; for its assessment, see skeletal jaw problems.
How is it assessed?
At the examination, your orthodontist usually looks at the lip–tooth relationship at rest and when smiling, the length and tilt of the front teeth, the bite, gum health and facial proportions. Photographs and, if considered necessary, X-rays are recorded. This assessment aims to understand whether the gum display comes from the teeth, the gum, the lip or the jaw structure. For what happens at the first visit: first orthodontic examination.
The role of orthodontics
If a gummy smile is caused by the position of the teeth, orthodontic treatment may be one of the options:
- Intrusion of the front teeth: Moving over-erupted upper front teeth upward orthodontically is called intrusion. Because the gum can move together with the teeth, the amount of gum showing in a smile may decrease.
- Mini-screw support: In some cases, orthodontic mini-screws that provide temporary anchorage may be used for intrusion. Your orthodontist decides, based on the examination findings, whether a mini-screw is needed and where it would be placed; see what is an orthodontic mini-screw?
- Correcting a deep bite: If a deep bite goes with the gummy smile, correcting the bite may be part of the treatment plan.
These movements can be planned with fixed braces or, in suitable cases, with clear aligners. The amount of change that can be achieved differs by cause and by person; orthodontics alone may not eliminate every gummy smile.
Non-orthodontic options
When the cause of a gummy smile is lip movement, excess gum tissue or a marked skeletal structure, non-orthodontic options may also be considered. These include surgical procedures involving the gum, treatments aimed at lip movement and, in advanced skeletal cases, jaw surgery. Each has different suitability, limits and possible effects; these should be assessed separately with clinicians in the relevant field. In some cases, more than one approach may need to be planned together for the most suitable result.
Frequently asked questions
Is a gummy smile a health problem?
On its own it is mostly an aesthetic matter. However, associated conditions such as a deep bite, tooth wear or gum inflammation should also be assessed from a health point of view.
Can clear aligners correct a gummy smile?
In tooth-related cases, clear aligners may be an option; suitability and the change that can be expected are decided at the examination. Where the lip or jaw is the cause, clear aligners alone may not be enough.
Is a mini-screw needed in every case?
No. A mini-screw is an auxiliary tool your orthodontist may recommend depending on the tooth movement needed; it is not used in every treatment.
At what age can it be assessed?
It can be assessed at any age; however, because the face and lips keep changing during growth, some decisions may become clearer over time. See orthodontics for children.
For questions, you can call 0312 911 60 36 or use the form on the contact page.
This page is for general information only; diagnosis and the treatment plan are determined by an examination and your orthodontist's assessment.
