I want you to feel clearer about what this treatment usually involves, what may affect your case, and how to protect the long-term health of your gums, bone, and smile.
Dr. Angel Rodriguez, DDS, CAGS, MSDDr. Angel Rodriguez wrote this guide to help you understand how this topic may apply to you, what usually affects the treatment decision, and what the next step could look like if you want specialist guidance.
A gummy smile is not a single condition. The visible excess of gum tissue at full smile can come from where the gum line sits, how high the upper lip rises, or the underlying jaw position. These three causes require different treatments, and applying the wrong one to the wrong cause is what makes gummy smile work fail.
The three causes of a gummy smile
Gum-driven: the tissue sits low across the upper front teeth, covering more of the crown than it should. The teeth look short and square because excess tissue is covering them. Aesthetic crown lengthening is the surgical option here.
Lip-driven: the upper lip rises too high at full smile. The gum line may be in a reasonable position, but the lip exposes more of it than is proportionate. Lip repositioning or Botox addresses this mechanism.
Bone-driven: the underlying jaw alignment positions the gum and teeth lower relative to the lip line. These cases typically involve orthodontic or orthognathic input alongside or instead of periodontal surgery. Most real cases involve more than one driver, which is why the diagnosis matters.
Treatment options
Aesthetic crown lengthening is the surgical option for gum-driven cases. The gum line is elevated to expose more natural tooth. In some cases, the underlying bone is reshaped so the new position holds permanently. This is the procedure PIHP performs for gum-driven gummy smile cases, and the result is permanent.
Lip repositioning limits how high the upper lip travels at full smile. It addresses lip-driven cases where the gum line is already in a reasonable position. Some cases benefit from a combination of crown lengthening and lip repositioning.
Botox is a non-surgical, temporary option that reduces lip mobility. Results typically last three to four months per treatment. PIHP does not perform Botox; when it is genuinely the right tool for a case, Dr. Rodriguez refers patients to a clinician he trusts.
The right treatment for a gummy smile depends on what is causing it.
Patients choose PIHP for diagnostic precision on cases like this. The assessment determines which category your case sits in and what realistic options look like.
Why the diagnosis decides the treatment
The same visible amount of gum display at full smile can come from different combinations of these drivers. The appearance alone does not tell you which is dominant. Picking the wrong treatment for the wrong cause is how gummy smile work produces a disappointing result.
A specialist evaluation determines which category or combination is at work before any treatment is planned. That means smile measurements, gum-line assessment, lip mobility, and in some cases imaging.
Understanding your situation
If this guide describes something close to what you are experiencing, the next step is understanding which cause is at work in your case. Cosmetic periodontal decisions deserve specialist-level clarity; a thorough assessment at PIHP can provide that.
Related guides
If you are still comparing options, these guides cover the next questions patients usually ask before requesting more info.
Return to the landing page if you want to request more info or get more specific guidance for your situation.