Prominent gums when smiling are not always caused by excess gum tissue. Lip movement, tooth position and the structure of the upper jaw can also contribute. Similar appearances can have different causes, so treatment is selected accordingly. Visible gums alone are not a disease; a healthy smile that does not bother you may not need a procedure.
Which causes are considered?
Extra tissue covering the visible part of a tooth can make it look shorter than it is. There may instead be swelling related to inflammation or enlargement associated with certain medicines. Tooth eruption and position can also affect the tooth-to-gum proportions in a smile. These are different situations and should not be treated as the same problem.
Some people have a shorter upper lip or a lip that moves further when they smile. The vertical structure of the upper jaw can contribute to increased gum display. Several factors can occur together. One photograph does not always establish whether the appearance originates from the lip, gums or jaw.
What happens during the examination?
The dentist assesses the face at rest and while smiling. Visible tooth length, gum margins, the bite and tissue health are examined. Gum measurements and appropriate imaging may be used when necessary. The aim is to understand the cause, rather than simply measure how much gum is visible.
Explain whether the appearance has been present for a long time or has recently changed. Mention bleeding, swelling and any medicines you take. Do not stop a medicine yourself even if a medicine-related change is suspected. Any necessary review takes place between the dentist and the clinician who manages that medicine.
How do options differ according to the cause?
Gum health and visible tooth length
Where inflammation and deposits are present, controlling these comes first. For suitable anatomy, crown lengthening to expose more of the tooth may be considered. This should not be understood as simply cutting away gum: the relationship between gum and underlying bone must be respected in planning. The same operation is not appropriate for every tooth that looks short.
Tooth or jaw position
If tooth position is involved, an orthodontic assessment may be considered. Significant jaw structure concerns may require joint planning by orthodontic and oral and maxillofacial teams. Not every case of visible gums needs jaw surgery. The plan should be proportionate to the findings and expectations.
Lip movement
In selected cases, approaches targeting lip movement may be discussed. Some effects are temporary, whereas other approaches involve surgery. Suitability, risks and the possible need for repetition are assessed individually. Gum treatment alone cannot always address an appearance originating from the lip.
What should you discuss before deciding?
Ask which cause has been identified and how the proposed procedure addresses it. It should be clear whether existing healthy tooth tissue needs treatment. Crowning teeth is not an automatic solution for every cause of visible gums. You may also discuss choosing no treatment.
A visualisation or trial can help explain expectations but does not guarantee the final result. Healing, settling of the gum level and the sequence of any later restorations should be explained. Before deciding, ask about sensitivity, gum recession or changes in appearance over time.
Before the appointment, describe your main concern in one short sentence. “My teeth look short” and “my lip rises a lot” are different observations. Discussing a goal that suits your own face and oral health is more helpful than attempting to copy somebody else’s smile exactly.
Frequently asked questions
Does every gummy smile need treatment?
No. Visible gums alone are not a disease. Health findings and your preferences are assessed together.
Can a laser solve it for everyone?
No. The name of an instrument does not determine suitability. Lip- or jaw-related factors may not be corrected by gum reshaping alone.
Is crown lengthening the same as having a dental crown?
No. In suitable cases, crown lengthening involves reshaping gum and sometimes bone. A dental crown is a separate restorative procedure.
