Showing too much gum when you smile is common, and there are several effective ways to reduce it, ranging from a quick injection to surgical procedures with permanent results. The right approach depends entirely on why the extra gum shows in the first place. More than 3 to 4 millimeters of visible gum tissue above the upper teeth is generally considered a “gummy smile,” and the causes fall into a few distinct categories, each with its own best fix.
Why Some People Show More Gum
Four main factors cause excessive gum display, and you may have one or a combination of them.
A hyperactive upper lip is one of the most common culprits. The muscles that pull your upper lip upward are simply too strong or overactive, yanking the lip higher than average when you smile. A short upper lip works similarly but is structural rather than muscular. The average upper lip length in young adults is 20 to 24 mm; anything under 20 mm is considered short, and it may not cover the gums adequately during a full smile.
Vertical maxillary excess, or overgrowth of the upper jawbone in the vertical direction, is actually one of the most frequent causes overall. It pushes the teeth and gums downward, so even a normal lip can’t cover everything. People with this condition often have a noticeably elongated lower face. The fourth cause is altered passive eruption, where the gum tissue never receded to its proper adult position during tooth development. The teeth look short and square because too much gum sits over them, even though the teeth underneath are normal-sized.
Figuring out which of these applies to you is the critical first step, because each cause has a different solution. A dentist or oral surgeon can usually determine the cause with a clinical exam and sometimes an X-ray of the jaw.
Botox for a Hyperactive Lip
If your gummy smile comes from lip muscles that pull too hard, small injections of botulinum toxin can relax them just enough to lower your lip line. The primary target is a muscle that runs alongside the nose and connects to the upper lip. A typical dose is just 2 to 3 units per side, making it one of the smallest Botox treatments available. Studies show improvement rates around 84% at two weeks.
The results are temporary. You can expect the effect to hold strong for about three months, with a gradual return toward baseline over the following two to four months. Most people see some benefit lasting up to seven months total, but repeat injections are needed to maintain the look. Possible side effects include bruising at the injection site, a slightly elongated appearance of the upper lip at rest, and occasionally an asymmetric smile if the muscles on each side respond differently. When asymmetry happens, it can be corrected by adjusting the dose on one side at the next appointment.
Botox is a good option if you want to test the waters before committing to anything permanent, or if your gummy smile is mild.
Dermal Fillers as an Alternative
Hyaluronic acid fillers, the same material used for lip augmentation, offer another non-surgical route. Rather than relaxing the muscle, the filler physically gets in the way of it. A small amount injected deep near the base of the nose and along the nasolabial fold compresses and stretches the muscle fibers, preventing the lip from rising as high during a smile. This approach also adds subtle volume to the upper lip area, which can help cover more gum tissue.
Fillers last longer than Botox (typically 6 to 12 months depending on the product) and can be dissolved if you don’t like the result. Some practitioners combine fillers with Botox for a more complete correction.
Gum Contouring for Short-Looking Teeth
When the problem is too much gum tissue covering the teeth rather than the lip rising too high, removing or reshaping that tissue can make a dramatic difference. This is the go-to treatment for altered passive eruption.
The simplest version is a gingivectomy, where excess gum tissue is trimmed away to reveal more of the tooth crown. This works when the underlying bone is already positioned far enough from where the new gum line will be (at least 3 mm). Many practitioners now use a dental laser instead of a scalpel, which tends to cause less bleeding and a more comfortable recovery.
If the bone sits too close to the gum surface, a more involved procedure called crown lengthening is needed. This reshapes a small amount of bone in addition to the gum tissue, creating enough space for the gums to heal in the correct position without growing back. Your dentist or periodontist determines which approach you need based on the relationship between your gum line, the point where the tooth meets the root, and the bone crest. In the simplest cases, only soft tissue is removed. In more complex cases, the gum is lifted as a flap, bone is recontoured, and the flap is repositioned lower on the tooth.
Recovery from gum contouring is relatively quick. Soreness and sensitivity typically resolve within a week or two, though the final gum line may take a few months to fully settle into its new position. The results are permanent.
Lip Repositioning Surgery
Lip repositioning is a minor surgical procedure that limits how high your upper lip can travel when you smile. A surgeon removes a small strip of tissue from the inside of the upper lip (between the lip and the gums), then stitches the remaining edges together. This shortens the “vestibule,” the pocket of tissue connecting your lip to your jaw, and physically restricts the lip elevator muscles from pulling the lip as far upward.
The width of tissue removed is typically twice the amount of correction desired. So if you want your lip to sit 4 mm lower when smiling, roughly 8 mm of tissue is removed. The incision runs from premolar to premolar, and all the work is inside the mouth, so there are no visible scars.
Recovery involves moderate swelling and soreness for the first few days. Most people return to normal activities within three to four days, though intense exercise should wait about two weeks. The tissue continues to settle over several months, with final results visible around the six-month mark. The correction is permanent, and the outcome looks natural because the lip still moves, just within a more limited range.
Orthodontics With Mini-Implants
When the teeth and gums sit too low relative to the rest of the face, orthodontic treatment can physically push (intrude) the teeth upward into the jawbone, bringing the gum line with them. Traditional braces alone can’t generate enough force for this kind of movement without unwanted side effects on other teeth, so tiny titanium screws called temporary anchorage devices are placed into the palate or jawbone to serve as fixed anchor points.
Elastic forces connected between these screws and the braces slowly pull the teeth upward, sometimes by as much as 6 mm. The screws are removed once treatment is complete. This approach works well for people whose jaw structure is otherwise normal but whose teeth have drifted or erupted too far downward. Treatment time varies but typically takes many months as part of a broader orthodontic plan.
Jaw Surgery for Severe Cases
Vertical maxillary excess, the overgrowth of the upper jaw, is the one cause that sometimes requires orthognathic (jaw) surgery. This involves a procedure where the upper jaw is separated from the skull, repositioned upward by the necessary amount, and secured with small plates. It’s a major operation done under general anesthesia, typically requiring orthodontic preparation before and after surgery.
Jaw surgery is reserved for moderate to severe cases where the excess bone growth is the primary driver and less invasive options won’t produce an adequate result. The payoff is a permanent correction that also improves facial proportions, bite alignment, and sometimes breathing. Recovery takes several weeks, with full healing over a few months.
Choosing the Right Approach
The best treatment depends on the underlying cause and how much correction you need. Hyperactive lip muscles respond well to Botox or fillers as a first step, and lip repositioning offers a permanent alternative. Excess gum tissue over normal-sized teeth calls for gum contouring. Teeth that sit too low may benefit from orthodontic intrusion. And significant jawbone overgrowth typically points toward surgery.
Many people have more than one contributing factor. Someone with both a hyperactive lip and mild altered passive eruption might benefit from Botox combined with gum contouring, for example. A thorough evaluation by a periodontist, orthodontist, or oral surgeon who regularly treats gummy smiles will clarify which combination of treatments makes sense for your specific anatomy.