When you smile do you show more of your gums than you would like to? A gummy smile is when an excessive amount of gum tissue shows above the upper teeth when you smile.
Everybody has a different idea of how much is “too much”, but in general if two to four millimeters of gum shows above the upper teeth, we would consider it to be a “gummy smile”.
Gummy smiles can make people very self-conscious, as if their smile is less attractive than it could be. Sadly, they may even find themselves trying to smile less because of it.
Not everybody knows that not only can gummy smile be treated effectively but that it doesn’t have to be with painful or expensive surgery.
In this guide, you’ll learn how to correct the appearance of your gummy smile and how to improve your overall smile. All with no surgery.
What Causes a Gummy Smile?
Interestingly, gummy smile seems to be twice as common in women than in men, and we’re not really sure of the reason for this. There are a few possible causes of “excessive gingival display” or gummy smile and gummy teeth as it’s more commonly known.
In some people the teeth “erupt” in such a way that even though the teeth are actually of a normal length, they appear to be too short because they are covered by big gum tissue. In some other people, the teeth are small, whether because of genetics or just wear and tear on the teeth over the years.
In a condition known as “gingival hypertrophy”, it’s the gums themselves that are enlarged and too long. Sometimes it’s the upper jaw bone that’s the cause; the upper jaw bone grows excessively, causing a “bulge” underneath the gums that makes them show excessively when smiling.
Finally, the cause may be due to the upper lip. In some people the upper lip may be too short or narrow, and in some people there may hyperactivity of the upper lip muscles.
When the face is at rest it’s not noticeable, but when the lip is pulled upwards in a smile by these overactive muscles it’s actually pulled too high causing too much gum to be shown.
What is the Smile Line?
The “Smile Line” is also known as the “aesthetic zone”, and if you google this term you’ll quickly be overwhelmed with very scholarly articles where people try to measure pretty much every factor that goes into making a smile; the lip line, the smile arc, the upper lip curvature… that’s all well and good, but sometimes there’s no need to complicate things.
We all know a nice smile when we see one! That said though, there are a few key points to think about, including the appearance of the teeth themselves, the amount of upper lip elevation and the appearance of the lips, as well as the overall symmetry of the smile.
For our purpose of talking about a gummy smile, I’ll stick to the “lip line”. The lip line is the amount of front tooth that shows on smiling and is generally considered “ideal” when the entire front tooth is shown on smiling, with or without a small amount of gum above the tooth.
As mentioned about, a smile would be considered “gummy” if more than about two millimeters of gum shows above the tooth.
Things get even more complicated when we considered the difference between a “posed smile” and a “spontaneous smile”. A posed smile is what we do for cameras, whereas a spontaneous smile is natural and due to genuine emotion.
A spontaneous smile tends to be “bigger” and show more gum than a posed smile, which is also something that also needs to be taken into account.
What are Gummy Smile Surgery Treatments and Benefits?
The options for a gummy smile correction are variable and depend on the underlying cause. There are a number of surgical treatments which we will quickly discuss, these are procedures generally performed by a dental surgeon or a maxillofacial surgeon.
Firstly, the lip can be repositioned; it’s essentially cut from the inside and then attached closer to the teeth so that during smiling it can’t retract upwards as much.
Secondly the gums can be dealt with. This is called a gingivectomy and involves part of the gum being removed to show more of the teeth. This can be done with either a laser or a scalpel.
Next up is having an oral surgeon treat the teeth and can either involve braces or a splint to move the teeth into a more suitable position or can involve lengthening the appearance of the teeth with veneers or crowns to improve the “teeth to gum” ratio.
In the more dramatic cases, some people require combined jaw and dental surgery to correct the jaw protrusion underlying the gummy smile. In this procedure, part of the jaw bone may actually be shaved away. All of these procedures have their pros and cons, and if there’s an underlying structural reason for your gummy smile they may the best long-term option.
As with most surgical treatments they are invasive to a greater or lesser degree. That’s kind of the problem with all cosmetic surgical treatments; the overall effect may be longer lasting (if not permanent) but involves more risk and downtime.
What are Non-Surgical Gummy Smile Treatments and Benefits?
There are non-surgical alternatives that help to a greater or lesser extent and are much less invasive, not to mention far quicker.
As mentioned above one of these options is braces or splint to move the teeth a more aesthetically pleasing position. These surgical options are not only potentially painful, but are also quite time consuming, and braces and splints can take up to a year to have the desired effect.
The other options include simple procedures which can be done by a doctor in a cosmetic clinic. They include using lip filler to enhance the size and shape of the upper lip so that less gums show when you smile, as well as the use of anti-wrinkle injections to weaken the muscles that elevate the lips in smiling.
Ultimately the treatment modality that you choose depends on the severity of your gummy smile, the amount that it is impacting your life and your confidence, your budget, and your tolerance for invasive procedures.
It may be that you want to just start slowly and try a non-surgical treatment before moving on to other more permanent solutions.
Gummy Smile Correction and Anti-Wrinkle Injections
The use of anti-wrinkle injections is the mainstay of treating a gummy smile in cosmetic clinics, and to understand why, we need to understand the action of anti-wrinkle injections. The reason that anti-wrinkle injections work is because they weaken the action of specifically chosen muscles in the face that cause wrinkles when they contract.
We can take advantage of this muscle weakening action to treat a gummy smile too by decreasing the amount that the upper lip is lifted during a smile, meaning that less gum will be shown.
Orbicularis oris is the ring of muscle directly around the lips, and when it contracts it causes the lips to invert and appear thinner. Weakening this muscle causes the upper lip to “pop out” or “flip out” somewhat, enhancing the appearance of the upper lip.
You may have heard of this procedure under the name “lip-flip”, and it can be added to a treatment with lips fillers. In this case it serves largely the same purpose, namely showing more of the pink of the lip.
The other muscle which can be injected is the elegantly named Levator labii superioris alaeque nasi (LLSAN). LLSAN is also known as the “Elvis Presley muscle”, as it elevates the lip into the “snarl” that Elvis made famous (if you don’t know who Elvis was, ask your mum or dad).
Weakening this muscle with just the smallest amount of anti-wrinkle injections can causes the lip to raise just a few millimeters less and show slightly less gum, which can make all the difference to the appearance of a smile.
The treatment takes literally a minute and is just one tiny injection on either side of the face. Because this is usually an area which bleeds very little, there is really no recovery time to speak of, and you can go back to your usual activities immediately.
The anti-wrinkle injections used typically take between forty-eight hours to fourteen days to start to have an effect.
The main point to emphasize with these injections is my usual mantra of “start low and go slow”. This is quite an advanced and tricky area to treat and injecting too much medication can weaken the lips so much that you may have trouble lifting the lips.
In milder cases this can affect your ability to purse your lips and drink through a straw. For this reason, your injector should only start with the lowest possible dose, and then wait two weeks for the injections to take effect.
Your surgeon should review you at a two-week point and see how much your lip elevation and “gumminess” has decreased. If your injector needs to add more (again, the smallest doses possible) you can do so at this review. Caution is the key here!
Once you and your injector have established the correct dose for you at this review appointment, you can work from this dose in the future. These injections are tiny and ice is used to numb the area prior to injecting, so the pain experienced is minimal.
As opposed to surgical treatments, which are permanent, you will need to have your anti-wrinkle injections repeated every twelve weeks or so. On the plus side, as the doses involved are so tiny, the cost is minimal.
Fix Gummy Smile with Dermal Fillers
Another way in which cosmetic doctors can help with protruding gums is to enhance the upper lip with fillers. This adds volume to the upper lip and helps to cover more the gum during smiling. Lip injections are one of the most common procedures performed in cosmetic clinics, and usually take about ten minutes.
The filler used in the lips can be expected to last for about six to twelve months, depending on a lot of factors which include the filler type used and your own ability to metabolize or break-down the filler. The recovery time for lip fillers varies, as some people experience swelling in the lips for the first twenty-four to forty-eight hours, which then rapidly settles.
There are various ways to minimize this swelling including the use of ice packs, arnica cream, anti-histamines and sleeping upright on a few pillows for the first night or two.
What Skin Treatments Enhance a Gummy Smile Correction?
Gummy smile is for the most part caused by an interplay of factors involving the teeth, the jaw bone, the gums, the lips and the facial muscles which cause smiling when contracted. There is no involvement from the skin itself.
Will Treating a Gummy Line Affect Gum Tissue or Teeth Health?
As mentioned above the causes of gummy smile are multifactorial, and often involve the jaw, the gums and the teeth, as well as the lips. If you have a gummy smile that has been caused by an underlying structural issue with the teeth or jaw, you may also have an improper “bite” which may affect your oral health in the long run.
In these cases, it is recommended to seek an opinion from a dental specialist.
If you have a gummy smile, treatment with anti-wrinkle injections or dermal fillers to the lips may be a simple, quick and cheaper alternative to more invasive surgical procedures.