A patient sits down, covers her mouth with her hand, and says quietly, "My gums have always shown a lot when I smile. I hate having my photo taken. I don't think I've ever laughed freely in front of people." As we talk, I notice she keeps her upper lip tense, holding the smile back out of habit. You'd be surprised how many people come to us with exactly this worry.
A "gummy smile" simply means that a lot of gum shows when you smile. Because a smile is such a big part of how people see you, it's common to feel self-conscious about it. In this article, I'll explain what causes a gummy smile and when gum contouring, or another treatment, actually makes sense.
Do I need surgery for a gummy smile?
Dentists usually call it a gummy smile when more than about 3 mm of upper gum shows in a full smile. But the first thing I tell patients after examining them is this: you don't automatically need surgery or any procedure at all.
There are several possible causes, and they often overlap. The upper jaw may have grown longer than average. The gum tissue may cover more of the teeth than it should. Or the muscles that lift the upper lip may simply be very strong, so the lip rises higher than usual when you smile.
If your jaw, teeth and gums are all within the normal range and the issue is an overactive lip muscle, there's no reason to cut the gums. A small amount of Botox can relax that muscle, reduce how much gum shows, and soften the smile. It's far less of a commitment than surgery, with almost no recovery time. On the other hand, if the cause is the gums or the bone, Botox alone won't fix it and can leave your smile looking stiff. That's why getting the cause right comes before choosing any treatment.
Looking at the teeth, gums and lip movement together to find the real cause.
When is gum contouring the right choice?
Sometimes the problem isn't the muscles at all. As adult teeth come in, the gums are supposed to move up to their final position. In some people, they never fully do, and part of each tooth stays covered. These patients often think their teeth are short and square, but in many cases the full-length teeth are there, just hidden under extra gum.
That's where gum contouring (gingivectomy) can help. We carefully reshape the excess gum to show more of each tooth and even out an uneven gum line. The goal isn't just to remove gum. It's to get a natural balance between teeth and gums.
There is a limit, though. How much gum can be removed safely depends on where the underlying bone sits and on a zone of tissue every tooth needs to stay healthy. Results vary from person to person. If the bone sits too low, trimming the gum alone may not last because the gum can grow back. In that case, we may also need to reshape a small amount of bone (crown lengthening).
Can gum contouring be combined with veneers?
Yes, and it's fairly common. Even after contouring, some patients still have teeth that are naturally small (peg laterals), uneven on the surface, or discolored. Contouring alone won't give them the result they're hoping for.
In those cases, we can even out the gum line first and then add veneers. A good number of patients who ask us about no-prep veneers at our Apgujeong clinic actually want both: a better gum line and better-shaped teeth. When we do this, we try to keep as much natural tooth as possible and use thin ceramic veneers.
It isn't right for everyone, though. If your teeth are badly crooked or your bite is off, veneers can crack under chewing pressure. You may need orthodontic treatment first. Gum contouring and veneers are both good options, but it's worth going through all the choices with your dentist before deciding.
What does treatment involve, and how should I prepare?
If you decide to go ahead, here's how it usually works at our clinic. We start with X-rays and a 3D scan to measure the real length of your teeth, the bone level and the thickness of your gums. Then, under local anesthesia, we reshape the gum line with a laser or fine surgical instruments, following the plan we made in advance. You won't feel much during the procedure. Once the numbness wears off, your gums may feel tender or achy for a few days. Healing usually takes one to two weeks, and the gum line settles into its new shape during that time.
A few things will help you heal well:
- Tell us about your medications. This includes blood pressure and diabetes medication, and especially blood thinners such as aspirin or warfarin. Don't stop a blood thinner on your own for dental treatment. That can be more dangerous than the procedure itself. We'll coordinate with your doctor if needed.
- Be careful until the numbness wears off. It's easy to bite your lip, cheek or tongue without noticing, so it's best not to eat until the feeling comes back.
- Eat soft, lukewarm food for a week. Spicy, salty or very hot food can irritate the area and slow healing.
- Keep the area clean, gently. Brush around the treated gums without touching them directly, and use the mouth rinse we give you. Avoid smoking and alcohol for at least two weeks, as they slow healing and raise the risk of inflammation.
Going over aftercare and how to keep the gums clean while they heal.
The bottom line
I meet many people who have spent years quietly unhappy about their smile, sometimes to the point of holding back socially. But a gummy smile isn't a disease. If it doesn't bother you in daily life and you're happy with what you see in the mirror, there's no need to treat it.
If it does hold you back, it's worth getting checked to find out why. Good treatment starts with an accurate diagnosis. Muscles, gums and jaw structure each need a completely different approach.
At SU Dental, we won't recommend treatment you don't need. We'll start with the least invasive option and talk through what will keep your mouth healthy in the long run. If you're visiting Seoul and have been thinking about this for a while, come in for a consultation. You can message us on WhatsApp before your trip.
Frequently asked questions
Is gum contouring painful?
It's done under local anesthesia, so you won't feel much during the procedure. Afterward, your gums may be tender or achy for a few days.
Can the gums grow back after contouring?
They can if the underlying bone sits too low. To prevent that, we may also reshape a small amount of bone when needed.
How do I know if Botox alone will work?
Botox helps when your jaw and gums are normal but the muscle that lifts your lip is very strong. We check your teeth, gums and lip movement to find the real cause before recommending anything.
Can you remove as much gum as I want to make my teeth longer?
No. How much can be removed safely depends on your bone level and gum structure. We plan the new gum line around those limits so the result looks natural and stays healthy.