Gummy smile: causes and how to fix it

Page updated October 22, 2026.

A gummy smile is when a lot of gum shows above the upper teeth when you smile, usually defined as more than about 2 to 3 mm (Cureus review). It's common, especially in women (Cureus review), and mostly a cosmetic concern. The right fix depends entirely on the cause: gum surgery, braces with small anchor screws, lip surgery, Botox or, for jaw causes, jaw surgery (Cureus review). Here is how to tell what's behind yours and what each treatment involves.

What counts as a gummy smile

Dentists call it excessive gingival display. A 2023 review describes it as more than 2 to 3 mm of gum showing when smiling, and reports a prevalence of 10.5% to 29%, with one cited figure of about 14% in women and 7% in men (Cureus review). Cleveland Clinic describes it as excess gum tissue that makes the teeth look short or "boxy" (Cleveland Clinic). Whether it bothers you is a personal question: it's a cosmetic concern unless the cause is also affecting your bite or gum health.

What causes it

A gummy smile can have more than one cause, which is why a dental evaluation comes first: treating the wrong cause won't fix the smile (Cureus review).

Gummy smile and braces

Braces relate to gummy smiles in two ways. First, braces and other orthodontic appliances can cause gum tissue to overgrow (Cleveland Clinic), and a periodontist can remove the overgrown tissue (Cleveland Clinic). Keeping the gums clean around brackets matters for gum health in general. See how to take care of braces.

Second, braces can treat some gummy smiles. When the upper front teeth sit too low, an orthodontist can use temporary anchorage devices, small screws placed in the bone (AAO), to move them upward (intrusion). A 2021 systematic review concluded these devices are an effective and practical option for reducing a gummy smile, though all four studies it found had a high risk of bias and it called for better trials (J Clin Exp Dent review). In the one clinical trial it included, the front teeth moved up by about 2.6 mm (J Clin Exp Dent review).

Gum surgery (gingivectomy)

A gingivectomy is the surgical removal of gum tissue, done by a periodontist with a scalpel or a laser under local anesthetic (Cleveland Clinic). Cleveland Clinic says it usually takes 30 to 60 minutes, you go home the same day, gums heal in about a week, and most people are back at work or school in a day or two (Cleveland Clinic). Avoid hard, crunchy food for at least a week and strenuous exercise for 48 hours; complications such as infection are very rare (Cleveland Clinic).

Lip repositioning and Botox

When the lip is the cause, two options are common. Lip repositioning surgery limits how far the upper lip rises. A 2024 review calls it minimally invasive, reports an average reduction of about 3.4 mm in gum display, and says it isn't advised when vertical maxillary excess is over 8 mm (Cureus review). Its effect can fade: gum display tends to creep back over the months after surgery, and in one comparison the modified technique alone relapsed completely within three months (Cureus review).

Botox injections relax the muscles that lift the lip. Results show in one to two weeks and last about 4 to 6 months, so injections have to be repeated, and the review doesn't recommend Botox when surgery is planned (Cureus review).

When it's the jaw

If the upper jaw itself is too long, orthognathic (jaw) surgery is the main treatment, though many people avoid it because it's complex and invasive (Cureus review). It's combined with braces before and after, usually over 2 to 3 years (Cleveland Clinic). Milder cases may be managed with lip surgery or miniscrews instead (Cureus review) (J Clin Exp Dent review). See jaw surgery cost and recovery.

What gummy smile treatment costs

We haven't found reliable published prices for gingivectomy, lip repositioning or Botox for a gummy smile, so ask each provider for a written quote. If braces are part of the plan, metal braces typically cost $3,000 to $7,000 and clear aligners $4,000 to $7,000 before insurance (CareCredit). Botox's cost repeats every few months, so compare the yearly total with a one-off procedure. Ask your plan whether it covers each option, and whether it treats a cosmetic procedure differently from one done for gum health.

Who to see

Start with your dentist or an orthodontist, who can work out the cause with an exam and X-rays. Gum surgery is done by periodontists (Cleveland Clinic), tooth movement by orthodontists, and jaw surgery by oral and maxillofacial surgeons. Many orthodontists offer a free first consultation (AAO); see free orthodontic consultations.