Gummy Smile Treatment in Brookline, MA

The most common dental cause is altered passive eruption. During normal development, gum tissue recedes to sit just above the enamel margin as teeth erupt. When that migration does not complete, the tissue stays low, covering part of the crown, so teeth look short while their actual dimensions are normal.

A hypermobile upper lip is a muscular cause. The lip elevates further than average when smiling, revealing more gum regardless of where the tissue sits. Because the anatomy of the teeth is normal, removing tissue does not address it, and Botox to reduce lip elevation is the more logical treatment.

Vertical maxillary excess is skeletal: the upper jaw has grown further vertically than average, so the whole dentition sits lower relative to the lip. This is the cause that cosmetic procedures cannot correct, and honest diagnosis matters most here.

A balanced smile follows predictable proportions. Central incisors are usually around ten to eleven millimetres long with a width roughly eighty percent of that, and the highest point of gum on each tooth, the zenith, follows a consistent pattern across the arch.

When tissue covers part of the crown, that ratio shifts and teeth read as square rather than rectangular. Restoring the proportion through cosmetic gum contouring often changes the appearance of the smile more than whitening or veneers would, because it corrects the frame rather than the picture.

Where the bone crest sits too close to the enamel margin, tissue removal alone rebounds within months. In those cases the bone is recontoured at the same time, which is why a periodontist assesses the case before any elective reshaping.