A gummy smile, showing more than 3 to 4 mm of gum tissue, has four main causes: gums that never fully receded off the teeth, a hyperactive upper lip, an upper jaw that grew slightly long, or gum overgrowth from inflammation or medications. Each cause has a different treatment, so diagnosis comes first.

Here is the part most cosmetic ads skip. A gummy smile is not one problem. It is four different problems that happen to look similar in a mirror. At PARCS Dentistry, we have seen patients come in ready to book gum contouring who actually needed a completely different treatment, and we have seen the opposite too. That is why we start with the diagnosis, not the drill.

What counts as a gummy smile?

Clinicians generally define excessive gingival display as more than 3 to 4 mm of gum tissue visible above your upper teeth during a full smile. Anything less is usually within the normal cosmetic range. The peer-reviewed periodontal literature uses this same benchmark, and it holds up well across face shapes and ages.

Try this at home. Take a phone photo in natural light, smiling as wide as you naturally would in a conversation. Measure the gum band above your two front teeth compared to the tooth height itself. If the gum band looks close to half the tooth length, that is worth a professional look.

One important note. A gummy smile is a cosmetic concern, not a disease. Your gums can be perfectly healthy and still show more than you would like.

Why do my gums show so much? The four main causes

We see four distinct causes in our office on the east Flamingo corridor, sometimes overlapping in the same patient.

1. Altered passive eruption. As your adult teeth came in during childhood, the gum tissue was supposed to migrate up (or down for the lower jaw) to expose the full tooth crown. Sometimes that migration stops early. The teeth are the correct size underneath. They just look short because gum tissue is still covering them. The American Academy of Periodontology recognizes this as one of the most common reasons for a gummy appearance.

2. Hyperactive upper lip. Your upper lip is pulled by a set of small muscles. In some people, those muscles pull harder or higher than average during a full smile. The teeth and gums may be perfectly proportioned. The lip is simply lifting too far and revealing more than it should.

3. Vertical maxillary excess. This is a skeletal cause. The upper jawbone grew slightly longer than typical during development, so the entire dental arch sits lower in the face. Gum show is dramatic here, and it often runs in families.

4. Gingival overgrowth. Sometimes the gum tissue itself is enlarged. This can come from chronic inflammation, mouth breathing, or certain medications. Calcium channel blockers for blood pressure, phenytoin for seizures, and cyclosporine for immune suppression are the three best-documented offenders in ADA and pharmacology literature.

Different cause. Different fix. Every single time.

How do we figure out which cause is yours?

The consultation is where the real work happens. We start with a clinical exam of your tooth-to-gum ratio and crown length. If your front teeth measure shorter than about 10 mm from gumline to edge, altered passive eruption climbs to the top of the list.

Next comes smile analysis at three positions: lips at rest, during normal speech, and during a full social smile. A hyperactive upper lip shows a dramatic difference between resting position and full smile. We take digital photos from several angles, and when we suspect a skeletal cause, we bring in CBCT 3D imaging to assess jaw proportions accurately.

We also review your medications and your gum health history. A patient who started a new blood pressure medication a year ago and noticed gums creeping down since then is telling us a very specific story.

What are the treatment options?

Here is where the diagnosis pays off. Each cause has a matching solution.

Altered passive eruption. We use laser gum contouring, sometimes called crown lengthening, to reshape the gumline and expose the full tooth. Dental lasers are recognized by the Academy of Laser Dentistry for soft-tissue procedures including gingival contouring. Results are visible immediately and healing is quick.

Hyperactive upper lip. Small doses of botulinum toxin relax the lip elevator muscles so they do not pull as hard during a smile. Dr. Kim completed AAFE training in botulinum toxin and dermal fillers, so this treatment is available in-house. The effect typically lasts 3 to 4 months before retreatment, according to aesthetic medicine literature. Some patients also choose a surgical lip repositioning procedure for a more lasting result.

Vertical maxillary excess. Mild cases can sometimes be camouflaged with orthodontics that intrude the upper teeth. More significant cases benefit from orthognathic (jaw) surgery combined with braces or aligners, done with an oral surgeon. This is the biggest commitment on the list, but it is the only true correction for a skeletal cause.

Gingival overgrowth. The first step is not surgery. It is fixing the source. We review medications with your physician, treat any underlying periodontal inflammation, and address mouth breathing when relevant. Once tissue is healthy, any residual excess can be contoured.

Sometimes the answer is a combination. When teeth are short from altered passive eruption and already worn or chipped, we may pair gum contouring with veneers so the final shape looks natural. That is a conversation, not a checkbox.

What should I expect at a gummy smile consultation?

A young marketing manager from Green Valley came to us last spring, 32 years old, self-conscious about pitching to clients on video calls. She had already priced out veneers at two other offices. Photos and measurements showed her tooth crowns were actually the correct length. Her upper lip was doing all the work. A conservative Botox treatment gave her the smile she wanted for less than a tenth of the veneer quote. That is why we measure first.

At your consultation, we take photos and measurements, listen to what specifically bothers you, and put together a written treatment plan with options ranked by invasiveness and cost. Financing and our in-house membership plan get reviewed upfront so there are no surprises. We serve patients from Paradise, Sunrise Manor, Henderson, and across the UNLV area, and many drive over from the Sunrise Hospital neighborhood because they want a second opinion before committing.

No pressure. No upsell. Just a real diagnosis.

Frequently Asked Questions

Is gum contouring permanent?

For altered passive eruption, laser gum contouring is long-lasting. The gum tissue does not typically grow back to its previous position once reshaped. That said, active gum disease or aggressive brushing can change your gumline over time, so good hygiene protects the result.

Does laser gum contouring hurt?

Most patients describe it as very manageable. We use local anesthetic to numb the area, and the laser seals as it works, so bleeding and swelling are minimal. Mild tenderness for a day or two is typical, and most people return to normal eating within 24 to 48 hours.

How long does Botox for a gummy smile last?

Botulinum toxin injections to the upper lip muscles typically last 3 to 4 months before the effect wears off and retreatment is needed. Many patients start with a treatment before a big event, then decide whether they want to maintain it long-term or pursue a more permanent option.

Can Invisalign fix a gummy smile?

Sometimes, yes. If the cause involves the position of the upper teeth, clear aligners can intrude the front teeth slightly and reduce gum show. Aligners will not change lip muscle activity or correct a skeletal jaw excess, so this only works for the right diagnosis.

How much does gummy smile treatment cost in Las Vegas?

Cost depends entirely on which cause you have and which treatment fits. Laser gum contouring for a few front teeth is one of the more affordable cosmetic procedures. Botox is priced per treatment session. Orthodontics or jaw surgery sits at the higher end. We give you a written plan with numbers at your consultation, no guessing.

If your smile shows more gum than you would like, we can tell you why, in plain language, before we recommend a single treatment. Call PARCS Dentistry at (725) 250-2840 to schedule a gummy smile consultation at our E Flamingo Rd office. Hablamos español. 한국어 가능.