Gummy smile refers to the excessive display of gum tissue when you smile. It is considered by most people as an unpleasant appearance eventhough it is desired by some cultures.

It is important to understand that it is normal as a part of growth and development of the jaws and teeth that young children show more gums when they smile than older adolescents as the display of teeth and gums steadily decreases over time due to the lengthening of lips. Nevertheless, a trained orthodontist is able to detect a growth pattern associated with a gummy smile in a growing child and this allows an opportunity to correct the problem during the growth of the child (read more about Orthodontic Screening). Typically a gum display more than 2 millimeters upon smiling in an adolescent or adult is diagnosed as a gummy smile.

There are many causes of gummy smile:

1. Overgrowth of the upper jaw (vertical maxillary excess): this means that the upper jaw is growing relatively lower to the level of the upper lip. This growth pattern is more common in children with breathing problems caused by adenoids or any aother obstruction. If breathing problems are addressed early, the growth pattern may change to a normal pattern.
2. Short upper lip: individuals with short upper lips show more of their incisors at rest and more of their gums when they smile.
3. Hyperactive upper lip: some individuals tend to overstretch their lips when they smile because they have hyperactive tight facial muscles. This is more common in females.
4. Overgrowth of gum tissues: a chronic inflammation of gum tissue (gingivitis) may result in an overgrowth in gum tissues which cover the teeth and give the appearance of a gummy smile. Some medications (e.g. Phenytoin) can also result in gingival overgrowth.

Treatment of gummy smiles depends on the severity and cause of the problem:

1. Braces: orthodontic treatment especially in growing patients can result in a significant improvement of gummy smiles especially if orthopedics are also used (e.g. headgear treatment). Orthodontic treatment in older adolescents or adults to correct gummy smiles is usually more complicated and might not completely resolve the problem.
2. Braces followed by jaw surgery: cases of severe cases of gummy smile caused by a skeletal problem can be corrected by a combination of orthodontics and jaw surgery. This treatment results in drastic improvement and elimination of the problem.
3. Gum surgery to remove gingival overgrowth: if the gummy smile is caused by gingival overgrowth a surgical procedure to remove the excess gingival tissues can be performed to improve the smile appearance.
4. Botox (botulinum toxin) injections: Botox injections cause a temporary paralysis of muscles. A very minor injection in the upper lip reduces the lifting action of lip muscles thus reducing the display of gum tissues. Injections have a temporary effect and should be retaken every few months.