cosmetic-dentistry
What Is a Gummy Smile and How Is It Treated?
Last reviewed: May 2026 · Haute MD Editorial Team
A gummy smile is characterized by excessive display of gum tissue above the teeth when smiling — typically defined as more than 3-4mm of gum exposure. It can be caused by excess gum tissue covering the teeth (making them appear short), a hyperactive upper lip that rises too high when smiling, excess development of the upper jaw, or a combination of factors. Treatment options range from minimally invasive (Botox to limit lip elevation) to surgical (gum contouring, crown lengthening, orthognathic surgery for severe skeletal cases).
Causes of a gummy smile
Altered passive eruption: excess gum tissue covering more of the tooth crown than normal. Hyperactive upper lip: lip elevates more than average when smiling, exposing excess gum. Vertical maxillary excess: the upper jaw has grown too far downward. Short upper lip. Gingival hyperplasia: medication-induced or genetic gum overgrowth.
Treatment options by cause
Gum contouring or crown lengthening: for excess gum tissue (altered passive eruption). Botox injection into the upper lip elevator muscles: reduces lip elevation when smiling — temporary (3-4 months), but a non-surgical option with minimal recovery. Orthodontics or orthognathic surgery: for skeletal causes (vertical maxillary excess). Lip lowering surgery: a more permanent surgical alternative to Botox for hyperactive lip.
Frequently Asked Questions
Can Botox fix a gummy smile?
Yes — Botox injected into the levator labii superioris muscle limits how high the upper lip rises when smiling, reducing gum exposure. Results last 3-4 months and must be maintained with repeat injections. It is a highly effective, minimally invasive option for gummy smiles caused by a hyperactive lip.
Is a gummy smile covered by insurance?
Treatment of a gummy smile is considered cosmetic and is generally not covered by dental insurance. Crown lengthening for functional reasons (to provide adequate tooth structure for a crown) may qualify for coverage.
What is crown lengthening?
Crown lengthening is a periodontal surgical procedure that removes excess gum and bone tissue to expose more of the natural tooth crown. It is performed by a periodontist and is the most definitive treatment for gummy smiles caused by altered passive eruption.
How many units of Botox are needed for a gummy smile?
Typically 2-4 units of Botox per side (4-8 units total) are used for gummy smile correction, making it one of the most cost-effective Botox treatments. Results last 3-4 months.
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