Hi, I’m Dr. Sutera from Aesthetic Smile Reconstruction in Boston. If you’ve ever looked in the mirror and felt like your smile shows more gum than teeth—you’re not alone. It’s called a “gummy smile,” and the good news is, there are several ways we can treat it. Let’s explore what causes a gummy smile, which treatments work best, what they cost, and how we personalize solutions for Gummy Smile right here in the Boston area.
What Is a Gummy Smile?
A “gummy smile” is when too much gum tissue shows above your top teeth when you smile—typically more than 4mm. While some people don’t mind it, others feel self-conscious, especially in photos or during conversations.
A gummy smile isn’t just a cosmetic issue. Sometimes, it can be linked to how your teeth, lips, and jaw are aligned. That’s why it’s important to figure out the exact cause before jumping into treatment.
What Causes a Gummy Smile?
There’s no one-size-fits-all answer. Several factors can lead to excessive gum show:
- Extra gum tissue covering the teeth (gingival overgrowth)
- Short or worn teeth, which make gums look larger
- An overactive upper lip, which rises higher than average when you smile
- A high lip line, exposing more gum than usual
- Overgrowth of the upper jaw (vertical maxillary excess)
- Genetics, which can influence jaw development, gum shape, and tooth size
Understanding the cause helps us select the safest, most effective solution.
How We Diagnose a Gummy Smile
At Aesthetic Smile Reconstruction, we start with a detailed consultation that includes:
- Clinical exam of your teeth, gums, and lips
- Digital photographs and smile analysis
- 3D imaging or X-rays, if needed
This helps us figure out whether your gummy smile is due to soft tissue, muscle activity, tooth length, or skeletal factors.
Once we know the “why,” we can walk you through the “how” of correcting it.
If you feel self-conscious about showing too much gum when you smile, you’re not alone. A “gummy smile” is typically defined as exposing more than 4mm of gum tissue when smiling. At Aesthetic Smile Reconstruction in Boston, we often see patients searching for alternatives to gum contouring. While gum contouring is a popular and effective solution, it isn’t the only option.
In my previous blog I covered gum contouring in detail. In this guide, I’ll break down five other common treatments that can help correct a gummy smile, including Botox, lip repositioning surgery, gum grafting, crown lengthening, and the pinhole surgical technique. You’ll learn the pros, cons, recovery times, and best candidates for each treatment. This way, you can make the most informed decision for your smile.
Botox for Gummy Smile Correction
What it is: Botox injections work by temporarily relaxing the overactive muscles in your upper lip—specifically, the levator labii superioris. These muscles are responsible for lifting the upper lip too far when you smile, exposing more gum tissue than usual. By softening their movement, Botox reduces how high the lip rises, which helps your smile look more balanced and natural.
Pros:
- Quick, in-office procedure
- No surgery or downtime
- Temporary and reversible
- Can be used with other treatments
Cons:
- Results only last 3–4 months
- Won’t fix issues caused by teeth, gums, or jaw
Recovery: Minimal to none. You may notice mild swelling or bruising at the injection site.
Best for: Patients with a gummy smile caused by a hyperactive upper lip muscle who prefer a non-surgical, low-commitment solution.
Gum Grafting
What it is: Gum grafting is a surgical procedure designed to treat areas where the gum tissue has receded and left tooth roots exposed. During the procedure, a small piece of tissue—often taken from the roof of your mouth or a tissue bank—is carefully placed over the area of recession and stitched into position. This newly positioned tissue helps protect exposed roots, reduces tooth sensitivity, and restores the natural gum line, improving both function and appearance.
Pros:
- Restores lost gum tissue
- Reduces sensitivity and risk of root exposure
- Improves both oral health and aesthetics
Cons:
- Invasive with longer recovery
- Discomfort at donor and graft sites
- More expensive than gum contouring
Recovery: 2 weeks or longer. Post-op care is important to protect healing tissue.
Best for: Patients with significant gum recession who also want to improve the appearance of their smile and reduce tooth sensitivity.
Lip Repositioning Surgery
What it is: Lip repositioning surgery is a minor surgical procedure that alters the position of the upper lip to reduce how much gum shows when you smile. The technique involves removing a small strip of tissue from the inside of the upper lip and then suturing it to a lower position. This limits how far the lip can move upward during smiling, making the smile appear more balanced and less “gummy.”
Pros:
- Offers a more permanent result than Botox
- Less invasive than jaw surgery
Cons:
- Surgical risks like swelling or infection
- Moderate recovery time
- Some relapse can occur
Recovery: 1–2 weeks. A soft diet and limited facial movements are usually recommended. Healing restrictions and final results typically take about 4 weeks post operatively.
Best for: Patients whose gummy smile is due to excessive upper lip movement and who are looking for a longer-lasting solution than Botox.
Crown Lengthening
What it is: Crown lengthening is a surgical procedure performed to remove excess gum tissue—and occasionally a small amount of bone—to expose more of the natural tooth surface. This can be done for aesthetic reasons, to correct a gummy smile, or for functional reasons, such as creating enough space for a dental crown or other restoration. By adjusting the gum and bone levels, the tooth appears longer, resulting in a more balanced and attractive smile.
Pros:
- Effective for gummy smiles due to excess gum and bone
- Can be combined with restorative dental work like crowns
- Improves aesthetics and function
Cons:
- More invasive than gum contouring
- Potential for swelling and post-op discomfort
Recovery: Around 2 weeks or more. You’ll need to follow specific hygiene instructions.
Best for: Patients with short teeth due to excess bone or gum tissue. Also used to prepare teeth for crowns or other restorations.
Pinhole Surgical Technique (PST)
What it is: The Pinhole Surgical Technique is a modern, minimally invasive treatment used to correct gum recession without the need for traditional grafting or sutures. Instead of cutting tissue or taking a graft from the roof of the mouth, a small pinhole is made in the gum, and special instruments are used to gently loosen and reposition the gum tissue over the exposed root. This method restores the gum line and protects the tooth root while enhancing the appearance of the smile.
Pros:
- No stitches or scalpel required
- Fast healing and minimal discomfort
- Immediate cosmetic improvement with natural-looking results
- Multiple teeth can often be treated in one session
Cons:
- Not recommended for severe gum recession
- Long-term effectiveness data is still growing compared to traditional grafts
- Requires specialized training and expertise, which may not be widely available
Recovery: Patients typically heal within a few days to a week. Some may experience slight swelling or sensitivity, but post-op discomfort is generally mild.
Best for: Patients with mild to moderate gum recession who want to improve their smile without undergoing a surgical graft. Ideal for those looking for a quick, low-downtime solution.
A Real Story: How Gum Contouring Changed Maria’s Smile
Maria, a college student from Cambridge, came to our office feeling shy about her smile. “I love to laugh, but I’d always cover my mouth. I didn’t like how much of my gums showed.”
After an exam, we found that her teeth were healthy—but hidden by extra gum tissue. In a 45-minute laser procedure, we reshaped her gumline. No stitches, no pain—and she walked out smiling.
A week later, she told us she couldn’t stop smiling in selfies. “This changed how I feel about myself. It’s a small change that made a big difference.”
Which Gummy Smile Treatment Is Right for You?
Choosing the best treatment depends on your specific anatomy, aesthetic goals, and tolerance for surgery or downtime. Botox offers a quick fix, but it’s temporary. Lip repositioning offers a more lasting change with a modest recovery. If gum recession is your main concern, gum grafting or PST may be a better fit. For more involved cases involving tooth structure or bone, crown lengthening may be necessary.
Not sure where to start? Schedule a personalized gummy smile consultation at Aesthetic Smile Reconstruction in Boston. We’ll guide you through your options and help you find the right fit for your smile and comfort level.
Sources: American Academy of Cosmetic Dentistry, ADA Clinical Guidelines, Aesthetic Smile Reconstruction patient cases
