Dental
Gum Contouring and Gummy Smile Correction: Options and Results
Haute MD Editorial Team
A gummy smile — defined as excessive gingival (gum) display when smiling, typically more than 3-4mm of gum tissue visible above the upper teeth — affects approximately 10-15% of adults and is more common in women. Multiple causes produce gummy smile: excess gum tissue covering the teeth (altered passive eruption — the most common cause, treated with gum contouring), short upper lip with normal tooth and gum proportions (treated with Botox or lip lowering), hyperactive lip elevator muscles (treated with Botox), vertical maxillary excess (the upper jaw is too tall — treated with orthognathic surgery), and combinations of these. Identifying the cause determines the correct treatment.
Laser gum contouring — the most common correction
For gummy smiles caused by excess gum tissue covering the teeth (altered passive eruption), laser gum contouring reshapes the gumline by removing excess tissue to expose more of the tooth crown. The procedure uses a dental laser (diode or Er:YAG) that simultaneously cuts and cauterizes tissue — minimizing bleeding and reducing healing time compared to traditional scalpel contouring. Local anesthesia is used — the procedure is painless. Healing takes 1-2 weeks with mild discomfort. Results are permanent — gum tissue does not typically regrow. Cost — $1,000-$3,000 for a full upper arch contouring.
Botox for gummy smile — the fastest and most reversible option
When the gummy smile is caused by a hyperactive upper lip elevator muscle (levator labii superioris) that pulls the lip too high when smiling, Botox injections into this muscle reduce the amount of gum exposed on smiling. The procedure takes 5-10 minutes with minimal discomfort. Results last 3-4 months. This is the most appropriate first-line treatment for patients with normal tooth-gum proportions and normal jaw structure — when the gummy smile is purely a muscle mobility issue. It is also useful as a diagnostic test — if Botox produces a satisfying result, it confirms the cause and gives patients experience with the correction before committing to permanent procedures.
When surgery is needed
Vertical maxillary excess (VME) — when the gummy smile results from the upper jaw being too tall, repositioning it (LeFort I osteotomy with impaction) is the only definitive correction. This is orthognathic (jaw) surgery performed by an oral and maxillofacial surgeon. It produces the most dramatic and durable results for VME cases but requires 6-8 weeks of significant recovery and a period of soft food diet. Crown lengthening (osseous surgery) — when excess gum tissue is accompanied by excess underlying bone, laser contouring alone is insufficient — the bone must also be recontoured to produce stable long-term results and allow proper veneer or crown placement.
Frequently Asked Questions
Is gum contouring permanent?
Laser gum contouring for altered passive eruption is generally permanent — the excess tissue does not regrow in most cases. However, if the underlying cause is not fully addressed (excess bone not contoured, incomplete gingival removal), some regrowth or relapse can occur. Botox gummy smile correction is temporary (3-4 months). Orthognathic surgery is permanent.
How much does gum contouring cost?
Laser gum contouring costs $1,000-$3,000 for a full upper arch treatment. Single-tooth contouring costs $200-$600. Botox for gummy smile runs $300-$600 per treatment (3-4 month duration). Crown lengthening (surgical with bone recontouring) costs $1,000-$3,000 per area. Orthognathic surgery for VME costs $20,000-$40,000 and may be partially covered by insurance when functional benefit is documented.
Does gum contouring hurt?
The procedure is performed under local anesthesia — patients feel no pain during treatment. Post-procedure soreness and sensitivity last 1-2 weeks. Laser contouring produces less post-operative discomfort than traditional scalpel contouring due to the cauterizing effect of the laser. Over-the-counter pain relief (ibuprofen) is typically sufficient for post-procedure management.
Who is the best doctor to see for a gummy smile?
A periodontist (gum specialist) for laser gum contouring and crown lengthening. A cosmetic dentist experienced in laser soft tissue procedures for mild contouring. A dermatologist, plastic surgeon, or dentist trained in facial aesthetics for Botox gummy smile correction. An oral and maxillofacial surgeon for orthognathic surgery evaluation. A thorough evaluation by a dentist who can identify the underlying cause is the starting point — the appropriate specialist follows from the diagnosis.
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