Gummy smile treatment from a specialist periodontist
What a gummy smile is, and what causes it
A gummy smile has three possible causes, and picking the wrong treatment for the wrong cause is how cosmetic gummy smile work fails. Crown lengthening is the answer when the gum itself sits low across the teeth. Lip repositioning fits when a hypermobile upper lip exposes more gum than the gum-line position warrants. Botox addresses muscular cases. PIHP performs crown lengthening, plans lip repositioning cases, and refers Botox to clinicians we trust. The diagnostic step at the consultation is what separates the three: smile photographs, gum-line measurements tooth by tooth, lip mobility at full smile, and a CT scan when the bone underneath needs to be seen. Most cases involve more than one driver, and naming the dominant one is what makes the treatment choice reliable.
your journey
The procedure step by step
Aesthetic consultation
Smile photographs are taken in repose and at full smile. Dr. Rodriguez listens to what the patient is actually trying to solve — usually a smile that reads gummier than they want it to — and the conversation is about the outcome, not about defaulting straight to surgery. The shape and proportion of the smile the patient is hoping for is the brief.
Cause analysis — gum, bone, or lip
The diagnostic step decides everything that follows. Gum-line measurements are taken tooth by tooth, lip mobility is assessed at full smile, the underlying bone is reviewed on CT scan when the case calls for it, and the skeletal pattern is taken into account. The output is a clear answer on which cause is dominant — gum-driven, bone-driven, or lip-driven — and which of the three treatment categories the case sits in.
Surgery for gum-driven cases, or referral when surgery is not the right answer
When the case is gum-driven, aesthetic crown lengthening is performed under local anesthesia. The gum tissue is reshaped to expose the right amount of tooth, and where the case calls for it the underlying bone is reshaped a small amount so the new gum line holds rather than creeping back. When the case is lip-driven, lip repositioning is the procedure that fits — we plan and discuss the case at the consultation and co-manage with a surgical colleague where that delivers the better result. When the case is muscular and Botox is genuinely the right tool, we refer to a clinician we trust rather than performing it ourselves.
Early recovery
For gum-driven cases treated with crown lengthening, the first week to ten days are about protecting the new gum line. Soft diet, careful home care around the surgical site, and a follow-up to confirm healing. Sutures come out at one to two weeks. Daily life is back to normal long before the deeper tissue remodeling has finished settling.
Final review and integration with restorative work
Aesthetic cases need longer than functional cases for the new gum line to settle into its final position — typically several weeks to a few months — before the result is locked in. Once the tissue is stable, the case is either signed off as the aesthetic outcome or handed to the restorative dentist for any veneers or other restorative work that was planned alongside.
why this practice
What gummy smile treatment achieves when it is planned properly
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A re-proportioned smile, more tooth and less gum
When the cause is gum-driven and aesthetic crown lengthening is the right tool, the gum line is elevated to expose the right amount of tooth — the smile reads longer, the tooth proportions read right, and the eye stops being drawn to a band of gum above the teeth.
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A durable result with the right approach for the cause
Picking the right treatment category for the cause is what separates a result that holds long term from one that walks back within a year or two. A gum-driven case treated surgically holds. A lip-driven case treated surgically does not address what was actually causing the gummy smile. Specialist case selection is the difference.
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Photographs and a treatment-plan visualization at consultation
The new gum or smile position is mocked up against the smile photographs so the proportions are agreed before any tissue is touched. The patient sees what the result is meant to look like, and the conversation about whether the plan is the right one happens before surgery, not after.
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Specialist case selection — including being told if surgery is not the answer
When the cause is lip-driven or muscular, surgery on the gum is not the honest answer. Patients arrive at PIHP and are told so when that is the right call, and routed to lip repositioning or to a Botox referral instead. That is the diagnostic depth a specialist consultation is paying for.
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Conservative scope — we do not push procedures we do not perform
PIHP does not perform Botox, and we do not pretend the surgical lane is the right answer for every gummy smile in order to keep the case in-house. When Botox is the better tool, the patient leaves with a referral to a clinician we trust. That conservative scope is part of what makes the diagnosis worth the consultation fee.
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Long-horizon thinking, not a today’s smile pitch
A gummy smile result has to look right and hold for the long horizon — 10, 20, 30 years, and through any restorative work that follows. PIHP plans the case on that timeline, with the gum, the bone, the lip, and any future veneer or crown work all taken into account before the first cut is made.
How we care
The three main treatment categories for a gummy smile
A gummy smile has more than one cause and more than one answer. The diagnostic step at the consultation is what tells us which of the three categories the case sits in — and which one we perform, plan, or refer.
Crown lengthening — for gum-driven cases
When the cause is the gum sitting low across the upper teeth, aesthetic crown lengthening is the gold-standard surgical option and the lane PIHP performs in-house. The gum line is elevated and the underlying bone reshaped where needed so the new position holds long term. This is the durable answer when the diagnosis points squarely at the gum.
Lip repositioning — for lip-driven cases
When a hypermobile upper lip is what is exposing too much gum at full smile, lip repositioning is the procedure that fits the cause. We plan and discuss this option at the consultation and co-manage with a surgical colleague where that delivers the better result for the case. We will tell you whether lip repositioning is the right path for your particular gummy smile rather than defaulting to surgery on the gum that the diagnosis does not call for.
Botox — what we do not do, and refer out
Some cases are best treated with Botox to soften the action of the muscles that lift the upper lip. PIHP does not perform Botox. Many providers offer it; we do not, because our specialty is the surgical and gum-tissue side. When a Botox approach is the right tool for a particular gummy smile, we are happy to recommend a clinician we trust rather than offering it ourselves.
The diagnostic step that decides
Smile photographs in repose and at full smile, gum-line measurements tooth by tooth, lip mobility assessed at full smile, and a review of the underlying skeletal pattern are all part of the consultation. Whichever category the case is in, the recommendation rests on a real diagnosis, not on a quick visual estimate of which procedure to sell.
What our patients say
- 5 out of 5 stars. “Speaking as a patient of Dr. Rodriguez for the past 18 months, I take the greatest pleasure in recommending the team at Perio Implant Professionals without reservation. I have received expert care and my oral health has never been better.” — Clive, Los Angeles
- 5 out of 5 stars. “My experiences with Perio Implants have always been exceptional. The entire staff is very professional, personable, polite and kind. Dr. Rodriguez is very skilled, knowledgeable, thorough and simply the best. I would definitely refer everyone to Perio Implant Health Professionals.” — Geri, Los Angeles
- 5 out of 5 stars. “I have been coming to PIHP for a few years now and from the first moment I called till this day, it is always a pleasurable, and professional experience. I have had deep cleaning as well as oral surgery performed here and everything is always well explained, in person as well as on paper. Great communication from the whole team. I ALMOST look forward to coming there.” — Michael, Los Angeles
- 5 out of 5 stars. “The entire team, with Dr. Rodriguez leading the way, has made my experience a very positive one. They are incredibly kind and caring when it comes to each individual patient, and they have been with me through quite some challenges.” — Rolando, Los Angeles
- 5 out of 5 stars. “They handle my regular care and oral surgery. Cannot imagine better care. Very professional, competent, always running on schedule, cheerful and friendly.” — Otto, Los Angeles
- 5 out of 5 stars. “I was skeptical before I got to the office, but from the moment I arrived all my questions were answered and explained very clearly. They told me all my options and made me feel at ease with the whole process.” — Hugo, Los Angeles
- 5 out of 5 stars. “Everyone in the office is super nice and friendly. They take really good care of their patients. Always on time with their appointments. Office is really neat and clean.” — Maria, Los Angeles
- 5 out of 5 stars. “Despite the reality that I never want to HAVE to see a periodontist, seeing these folx is the best it gets. Everyone is lovely, upfront, and comforting.” — Rebecca, Los Angeles
- 5 out of 5 stars. “Excellent and professional doctor and staff. You will be fortunate to have this doctor and staff take care of your dental needs. You will not be disappointed. Staff are very considerate and kind.” — Teresa, Los Angeles
- 5 out of 5 stars. “Great people abound in this office. Professional to the T, yet very personable and friendly. I actually enjoy going there because the customer interaction is so genuine.” — Tracy, Los Angeles
- 5 out of 5 stars. “Trustworthy, professional, yet very easy-going. Feel comfortable being treated by Dr. Rodriguez and by his staff.” — Yvonne, Los Angeles
- 5 out of 5 stars. “Gentle, totally state of the art procedures and technology. No more loathing and fear.” — Sharon, Los Angeles
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