A smile that shows a lot of gum is common and entirely normal. It becomes a clinical question only when someone is bothered by it, and at that point the useful work is diagnostic: several quite different things produce the same appearance, and they need different treatments.
Anyone who proposes a treatment without first establishing the cause is guessing.
What counts as gummy
Roughly, showing more than three to four millimetres of gum above the upper front teeth when smiling broadly is where most people begin to notice it. That figure is a rough guide rather than a standard, and how noticeable it is depends on lip length, tooth proportions and how much the lip moves.
The causes
Altered passive eruption
The gum did not recede to its final position as the teeth erupted, so it still covers part of the enamel. The teeth look short and square, but the crowns underneath are full length. This is one of the more treatable causes, because the tooth is already there under the gum.
A hyperactive upper lip
The muscles raise the lip further than average when smiling, exposing more gum. The teeth and gums are entirely normal; the lip is simply doing more.
A short upper lip
Less lip to cover the gum at rest and in movement. Anatomical rather than dental.
Vertical maxillary excess
The upper jaw is longer vertically than average, positioning the teeth and gums lower in the face. This is skeletal, and it is the cause most likely to require orthodontic or, in marked cases, surgical management rather than gum treatment.
Over-erupted front teeth
The upper front teeth have erupted too far, bringing gum with them. Often associated with a deep bite, and generally an orthodontic problem.
Gum overgrowth
Some medications, including certain anticonvulsants, calcium channel blockers and immunosuppressants, cause the gum tissue to overgrow. Inflammation from poor cleaning also swells the gum. Both are addressed differently again, and the medication route should always be discussed with the prescribing doctor rather than simply cut away.
Sorting out which
The assessment looks at how much gum shows at rest, when speaking and when smiling broadly; the length and width of the tooth crowns; where the bone sits relative to the gum margin, usually measured under local anaesthetic or assessed on an x-ray; how far the lip travels; and the bite. A short crown with healthy bone points one way; a normal crown with a lip that travels 10mm points somewhere else entirely.
The treatments
Gum contouring
Reshaping the gum margin to expose more of the existing tooth. Appropriate where the gum is covering enamel that is already there. Usually done under local anaesthetic, with healing over a few weeks. Where the underlying bone also sits too high, bone must be recontoured at the same time, otherwise the gum simply grows back to where it was. This is the commonest reason a gum lift relapses.
Crown lengthening
The same principle applied more extensively, adjusting both gum and bone to establish proper tooth proportions, often as preparation for veneers or crowns.
Orthodontics
Where teeth have over-erupted or the bite is contributing, moving the teeth addresses the cause rather than the appearance. See Invisalign or braces.
Restorative work
Once proportions are corrected, veneers or crowns may be used to complete the shape and colour. Sequence matters: gum treatment first, then time for the tissue to settle, then the restorations. See porcelain or composite veneers.
Lip repositioning and surgical options
For hyperactive lips and skeletal causes there are lip and jaw surgical approaches. These are larger undertakings, carried out by appropriately qualified practitioners, and they are discussed as options rather than defaults.
Managing gum overgrowth
Where medication is the cause, the first steps are meticulous cleaning and a conversation with the prescribing doctor. Surgical reduction alone tends to recur while the cause remains.
The honest part
Not every gummy smile needs treating, and some causes cannot be changed without disproportionate intervention. A consultation that tells you the cause is skeletal and that the realistic options are substantial is more useful than one that offers a gum lift that will relapse within a year. It is also entirely reasonable to hear the cause and decide to do nothing.
What it costs
Gum contouring is quoted per case according to the number of teeth involved and whether bone recontouring is required, and is confirmed after assessment. Associated treatment at Civic Gentle Dental Care: handcrafted porcelain veneers start from $1,490 per tooth, composite veneers from $700, porcelain crowns from $1,800, and Invisalign ranges from $4,200 to $8,990. Interest-free payment plans for veneers and crowns are available through external providers, subject to their assessment and approval.
Current fees are on our price list, with more on gummy smile contouring and cosmetic dentistry in Canberra.
Common questions
Will the gum grow back after contouring?
If the underlying bone level was not addressed where it needed to be, the tissue tends to return toward its original position. That is why the assessment of bone level matters before treatment.
Is gum contouring painful?
It is done under local anaesthetic. Some tenderness for a few days afterwards is usual and manageable with over-the-counter pain relief.
How long before I see the final result?
The gum needs several weeks to settle, and longer where bone was recontoured, before restorations are made to the new margins.
Can anything be done if the cause is my lip or jaw?
There are options, but they are more substantial than gum treatment. Knowing the cause is what lets you weigh them properly.
Booking an appointment in Canberra City
Civic Gentle Dental Care is a dentist in Canberra City at Suite 8, Level 3/161 London Circuit, a short walk from the Canberra Centre. To arrange an appointment, call (02) 6247 0224 or send us a message through our contact page.
This article is general information only and is not a substitute for individual dental advice. Whether a treatment is suitable for you, and what it will involve, can only be determined after an examination by a dentist. Any prices mentioned are estimates drawn from our current price guide and are not a quote.