A gummy smile occurs when a larger amount of gum tissue shows when smiling. For some patients, this is caused by excess gum tissue covering the teeth. For others, it may be related to upper lip movement, jaw position, tooth eruption, muscle activity, or facial anatomy.
At New York Periodontics, gummy smile correction is carefully diagnosed before treatment is recommended. The most important step is determining why the patient shows too much gum, because the cause determines the best treatment.
Because multiple factors can contribute to a gummy smile, treatment must be individualized. Some patients need periodontal crown lengthening, some need lip repositioning, some need orthodontics, and others may benefit from a combined periodontal and plastic surgery approach.
A gummy smile may be caused by one or more of the following:
One way to correct a gummy smile is through a labial approach, performed from inside the mouth. This technique may involve repositioning the upper lip so it does not elevate as high when smiling. By limiting excessive upward movement of the lip, less gum tissue is displayed.
Because this approach involves the gum tissue, mucosa, muscle attachments, and the relationship between the teeth, gums, and smile line, a periodontist is often the ideal specialist to perform or guide this type of treatment.
A labial approach may be appropriate for patients whose gummy smile is related to:
This procedure is performed inside the mouth, so there is typically no visible external facial incision.
In some cases, gummy smile correction may be performed through a plastic surgery approach beneath the nose. This may be appropriate when the gummy smile is related to facial anatomy, lip position, nasal base anatomy, or soft tissue dynamics that are better addressed from an external or plastic surgical perspective.
Dr. Sarmiento works closely with plastic surgeons when a combined approach is needed. This collaboration allows the treatment plan to consider both the periodontal smile line and the overall facial esthetic result.
The goal is not only to reduce gum display, but to create a smile that harmonizes with the lips, nose, teeth, gums, and face.
Some gummy smile cases are best treated by one specialist. Others require collaboration. At New York Periodontics, we evaluate whether the concern is primarily dental, periodontal, muscular, skeletal, or facial.
When needed, Dr. Sarmiento coordinates with plastic surgery to help create the most esthetic and natural outcome possible. This is especially valuable when the gummy smile is not caused only by excess gum tissue, but also by upper lip dynamics or facial proportions.
Depending on the diagnosis, treatment may include:
Esthetic crown lengthening
Correction of altered passive eruption
Gum reshaping
Lip repositioning through an intraoral labial approach
Orthodontic therapy
Botox or muscle-modulating therapy in selected cases
Plastic surgery beneath the nose
Combination periodontal and facial esthetic treatment
The correct treatment depends on the cause of the gummy smile and the patient’s esthetic goals.
A gummy smile should not be treated with a one-size-fits-all approach. Removing gum tissue alone will not correct every gummy smile. Similarly, lip surgery may not be appropriate if the main issue is altered passive eruption or short clinical crowns.
At New York Periodontics, we carefully evaluate the teeth, gum levels, bone levels, lip movement, smile line, facial proportions, and planned cosmetic dental treatment before recommending a procedure.
Gummy smile correction can be one of the most transformative cosmetic periodontal procedures. When properly diagnosed and treated, it can reveal more natural tooth structure, reduce excessive gum display, improve smile balance, and enhance facial esthetics.
At New York Periodontics, Dr. Sarmiento combines advanced periodontal expertise with close collaboration with plastic surgery when needed. Whether treatment is performed through an intraoral labial approach, esthetic crown lengthening, or a combined facial esthetic plan, our goal is to create a beautiful, natural, and balanced smile.
