Treatments

Gummy smile

Cause first — then the plan.

A gummy smile means that when you smile, more gum shows than you find comfortable. It is an aesthetic classification, not a disease. At MEDISMILE Budapest we assess teeth, gingiva, lip movement, bite and — when needed — the skeletal proportions of the upper jaw together, because the visible gum share can have more than one cause. Treatment follows the cause; there is no single method for every case.

What makes sense is decided after examination, diagnosis and your personal goals — not by trend.

At MEDISMILE Budapest, planning starts with a personal examination; options, limits, risks and alternatives are explained before treatment is agreed.

To medical framing and sources

Treatment spectrum

01 · Definition

01

What “gummy smile” means

When smiling, a larger share of gum may be visible — subjectively or by clinical assessment. There is no universal millimetre threshold that alone defines the diagnosis for every face. Whether a change is wanted depends on your goals, facial proportions and the findings.

Medical framing

02 · Causes

02

Why the cause decides

Possible contributors include gingival excess or altered gum contour, tooth shape and eruption, tooth position, upper-lip length and mobility, maxillary skeletal position, or combinations of these. Naming a fixed short list of “three causes” oversimplifies the picture — examination shows which level drives the visible share.

Medical framing

03 · Diagnostics

03

How we examine

At MEDISMILE we look at face and lip movement, teeth and gingiva, bite and proportions in one session. Imaging or further skeletal assessment is added only when the clinical picture warrants it. Options, limits, risks and alternatives are explained before any treatment is agreed.

Medical framing

04 · Dentistry

04

Dental options when teeth shape the smile

When tooth form, position, abrasion or the tooth-to-gum relationship shapes the smile, aligners, additive or minimally invasive veneers, or a broader restorative / full-mouth plan may be part of the concept. These steps change tooth shape and proportion; they do not automatically correct a purely muscular, gingival or skeletal cause. Planning therefore starts with a joint assessment.

Medical framing

05 · Gingiva & surgery

05

Gingival and soft-tissue options

When excess or uneven gingiva contributes, gentle recontouring may be considered — including gingivectomy or surgical crown lengthening when biology, bone level and periodontal health allow. Suitability depends on clinical crown height, biologic width and the planned restorations. At MEDISMILE these steps sit under OMFS-led assessment.

Medical framing

06 · Lip & face

06

Upper lip and facial aesthetics

A very mobile upper lip can raise the visible gum share during smiling. Botulinum toxin may temporarily reduce lip elevator activity when examination supports that indication — it is time-limited, dose-dependent and not a permanent correction of the underlying anatomy. Product choice and counselling follow medical assessment; off-label use only when explicitly discussed. Lip repositioning surgery is offered when soft-tissue findings and goals fit that option.

Medical framing

07 · Skeletal / OMFS

07

Skeletal factors and OMFS scope

An increased gum display when smiling can involve not only teeth and gingiva but also lip movement, bite and the skeletal proportions of the upper jaw. Oral and maxillofacial specialty training joins medical and dental diagnostics, so MEDISMILE can include more complex anatomical relationships in planning. Orthognathic (jaw-repositioning) surgery itself is not performed in-house: we provide assessment, coordination with the operating team and aftercare when that pathway is appropriate.

Medical framing

08 · Limits

08

Limits and alternatives

Not every visible gum line needs treatment. Wish, findings, effort, stability, risks and alternatives belong together. No method guarantees a specific millimetre result or lasting change without maintenance and individual biology. Personal examination decides — not a trend or a single product page.

Medical framing

This information is general. It does not replace personal examination, diagnosis or individual counselling on benefits, limits, risks and alternatives.

Medical framing and sources

Key points

  • Gummy smile is an aesthetic classification; treatment follows the individual cause after examination.
  • Dental, gingival, muscular and skeletal factors can combine — there is no single method for every case.
  • Veneers change tooth shape and proportion; they do not automatically correct every cause.
  • Orthognathic surgery is not performed in-house; assessment, coordination and aftercare are provided when that pathway is appropriate.

Risks and limits

  • No guaranteed millimetre result or permanence for every method.
  • Botulinum toxin effects are temporary and indication-dependent; product labelling must be counselled.
  • Gingival and soft-tissue surgery carry usual surgical risks (bleeding, infection, asymmetry, need for revision).
  • Not every visible gum line requires treatment.

Alternatives

  • No treatment / observation when findings and goals do not justify intervention.
  • Dental-only or soft-tissue-only pathways when a single level dominates.
  • Referral for orthognathic surgery when skeletal correction is indicated outside this practice.

Clinically reviewed by DR. MED. DR. MED. DENT. HANS KREHN ·

Sources

  1. 01PubMed · 2021 · Systematic reviewSurvival Rates for Porcelain Laminate Veneers: A Systematic Review
  2. 02PubMed · 2021 · Systematic reviewLong-Term Survival and Complication Rates of Porcelain Laminate Veneers in Clinical Studies: A Systematic Review
  3. 03EMA/CMDh · 2025 · Regulatory informationBotulinum toxin (except centrally authorised products): CMDh scientific conclusions and grounds for variation, amendments to the product information and timetable for implementation — PSUSA/00000426/202412
  4. 04EFP · 2023 · GuidelinePrevention and treatment of peri-implant diseases

General information. It does not replace examination or individual counselling. Outcomes are not guaranteed.

Clear answers

Frequently asked questions

What is a gummy smile?+

A gummy smile means that a clearly visible share of gum shows when smiling. It is not a disease but an aesthetic classification — whether and how a correction makes sense is decided by examination, the cause and your own goals.

Which causes can increase gum display when smiling?+

Gingival contour, tooth shape and eruption, tooth position, upper-lip length and mobility, maxillary skeletal position, or combinations. Examination shows which level drives the visible share — there is no fixed three-cause checklist.

Can veneers correct a gummy smile?+

Veneers can change tooth shape and proportion when those factors are part of the picture. They do not automatically treat a purely gingival, muscular or skeletal cause. That is why teeth, gingiva, lip movement and — when needed — skeletal relationships are assessed together.

When can a gum procedure be considered?+

When excess or uneven gingiva contributes, gingivectomy or surgical crown lengthening may be discussed after assessing biologic width, bone level and periodontal health. Suitability is individual.

What role does the upper lip play?+

A very mobile upper lip can raise gum display. Botulinum toxin may temporarily reduce elevator activity when indicated — time-limited and not a permanent anatomical correction. Lip repositioning is another soft-tissue option when findings fit.

When is an OMFS assessment useful?+

When soft tissue, bone or jaw relationships may be involved, oral and maxillofacial assessment joins medical and dental diagnostics. Orthognathic surgery itself is not performed at MEDISMILE; assessment, coordination and aftercare are.

Is the result permanent?+

That depends on the cause and the method. Soft-tissue recontouring and surgery aim for lasting anatomical change; botulinum toxin is temporary. No method guarantees a fixed millimetre result without individual biology and aftercare.

Personal assessment

What fits you?

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