A gummy smile can be reduced without surgery through several effective treatments, including targeted injections, laser gum reshaping, and orthodontic techniques. The right option depends on what’s causing the excess gum display in the first place, since a gummy smile isn’t one condition but a symptom of several different anatomical factors.
Most practitioners define a gummy smile as more than 3 to 4 mm of visible gum tissue above the upper teeth when you smile, though some use a lower threshold of 2 mm. A normal smile shows about 1 to 2 mm of gum. Once you’re at 4 mm or more, the appearance tends to become noticeably disproportionate.
Why Your Smile Shows Too Much Gum
Before choosing a fix, it helps to understand the underlying cause. There are four main reasons a smile shows excessive gum tissue, and each one responds best to a different treatment.
- A hyperactive upper lip. The muscles that lift your upper lip pull it too high when you smile. In a normal smile, the lip moves about 6 to 8 mm upward from its resting position. With a hyperactive lip, that movement can reach 10 mm, exposing far more gum than expected.
- Excess gum tissue covering the teeth. Sometimes the gums didn’t fully recede during tooth eruption (a condition called altered passive eruption), leaving extra tissue draped over otherwise normal-sized teeth. The teeth look short and the gum line looks heavy.
- Vertical maxillary excess. The upper jawbone grew longer than average in the vertical plane, pushing the gums and teeth downward and giving the lower face an elongated look. This is the most common structural cause.
- Overerupted teeth. The upper front teeth drifted too far downward from the jawbone, carrying gum tissue with them.
A hyperactive lip and excess gum tissue are the two causes most responsive to non-surgical treatment. Vertical jaw excess is harder to address without surgery, though orthodontic techniques can sometimes mimic the effect.
Botox Injections
Botox is the quickest, least invasive option and works specifically for gummy smiles caused by overactive lip muscles. Small amounts of botulinum toxin are injected into the muscles responsible for lifting the upper lip. The primary targets are the muscles alongside the nose that pull the lip upward and outward. By partially relaxing these muscles, the lip doesn’t ride as high when you smile, and less gum is exposed.
Results typically appear within two to three days and last up to about four months, though this varies from person to person. To maintain the effect, you’ll need repeat treatments roughly three times a year. Each session is fast, usually under 15 minutes, and the cost is relatively low compared to other options.
The trade-off is precision. An experienced injector will calibrate the dose to the severity of your gum display, using just enough to limit the lip elevation without flattening your smile entirely. When the technique is off, side effects can include an asymmetric smile, slight difficulty drinking through a straw, or a lip that droops and covers too much of the teeth. Bruising and mild swelling at the injection site are also possible. These effects are temporary since the treatment itself wears off, but they underscore why provider skill matters.
Hyaluronic Acid Fillers
A newer approach uses hyaluronic acid dermal fillers to physically restrict how far the upper lip can travel. This technique, sometimes called myomodulation, works on the same principle as Botox (limiting muscle movement) but through a mechanical rather than chemical mechanism. The filler is injected in layers beneath the muscle that lifts the lip, forming a cushion that compresses and stretches the muscle fibers. This prevents the muscle from fully contracting, so the lip can’t rise as dramatically.
Filler is typically placed deep against the bone and in the tissue layers near the nasolabial folds on each side. The result is a subtle reduction in lip elevation during smiling. Because hyaluronic acid fillers last longer than Botox (generally six months to a year or more depending on the product), this option requires fewer maintenance visits. It also adds a small amount of volume to the area, which can soften the nasolabial folds as a secondary benefit.
This technique is still relatively new compared to Botox, and fewer practitioners offer it. Finding someone experienced with this specific application is important.
Laser Gum Contouring
If your gummy smile is caused by excess tissue covering the teeth rather than lip movement, reshaping the gum line is the more direct solution. Laser gum contouring (a laser gingivectomy) uses a handheld laser to trim away overgrown gum tissue and reveal more of the tooth’s natural crown. Because the laser cauterizes the tissue as it cuts, bleeding is minimal and stitches are often unnecessary.
Healing takes about one week on average. The gums may be tender and swollen for the first few days, and you’ll likely need to stick to soft foods temporarily. Unlike Botox or fillers, the results are permanent. The removed tissue doesn’t grow back, so this is a one-time procedure for most people.
Whether laser contouring counts as “surgery” is a matter of semantics. It’s performed in a dental or periodontal office, usually with local anesthesia, and doesn’t involve cutting bone, general anesthesia, or a hospital setting. Most people seeking non-surgical options would consider it minimally invasive compared to traditional gum surgery or jaw repositioning.
Orthodontic Intrusion With Mini-Screws
For gummy smiles caused by teeth that have drifted too far downward, orthodontic treatment can push them back up into the jawbone, a movement called intrusion. Traditional braces alone don’t generate enough force for significant intrusion, but tiny titanium screws temporarily placed into the jawbone (called temporary anchorage devices, or TADs) provide a fixed point to pull against.
The concept has been used since the early 1980s, when a bone screw was first used to push upper front teeth upward by approximately 6 mm. Modern techniques use multiple mini-screws placed between tooth roots, sometimes combined with screws in the palate, to distribute the force evenly across the entire upper arch. When done across all the upper teeth, this approach can mimic the effect of a Le Fort I impaction, which is the traditional jaw surgery used to shorten a long upper jaw, but without actually cutting bone.
This is a longer commitment than injections or laser contouring. Treatment takes months to over a year depending on how much movement is needed, and you’ll be wearing braces or aligners throughout. The mini-screws are removed once treatment is complete. It’s best suited for cases where the gummy smile is combined with other bite issues that would benefit from orthodontic correction anyway.
Choosing the Right Approach
The best non-surgical fix depends almost entirely on the cause:
- Overactive lip muscles: Botox or hyaluronic acid fillers. Botox is the more established option with a longer track record. Fillers last longer per session but are newer and less widely available for this use.
- Excess gum tissue: Laser gum contouring offers a permanent fix in a single appointment.
- Overerupted teeth: Orthodontic intrusion with TADs can reposition the teeth and gums together.
- A combination of causes: Many people benefit from pairing treatments, such as Botox for lip movement plus laser contouring for tissue excess.
Costs range from a few hundred dollars for Botox (with the caveat of repeat sessions) to several thousand for orthodontic treatment or more comprehensive procedures. The initial evaluation is the most important step, because a provider who correctly identifies the cause will steer you toward the option that actually works for your anatomy rather than a one-size-fits-all approach.