# Can Orthodontic Treatment Fix a Gummy Smile? What Are Your Options? Publisher: Virtual Consultant Online Author: Virtual Consultant Online Published: 2026-08-27 Updated: 0001-01-01 Canonical URL: https://virtualconsultant.online/blog/can-orthodontics-fix-gummy-smile-uk Citation metadata: https://virtualconsultant.online/citation.json?url=https%3A%2F%2Fvirtualconsultant.online%2Fblog%2Fcan-orthodontics-fix-gummy-smile-uk A gummy smile — where a significant amount of gum tissue shows above the upper front teeth when you smile — is one of the most common aesthetic concerns patients bring to orthodontic consultations. It can make people feel self-conscious about smiling in photos or in social situations, and many wonder whether braces or aligners can help. The honest answer is: sometimes yes, sometimes no — and the difference matters enormously before you commit to treatment. This guide explains why gummy smiles happen, when orthodontic treatment can genuinely improve them, and what the other options are when orthodontics is not sufficient. Key takeaway Whether orthodontic treatment can fix a gummy smile depends entirely on the cause. Gummy smiles caused by teeth that have not erupted fully into position (dentoalveolar excess) can often be significantly improved by orthodontics alone. Gummy smiles caused by a long upper jaw (vertical maxillary excess) or an overactive upper lip muscle typically cannot be corrected by tooth movement alone and may require surgery, botulinum toxin injections, or a combination of treatments. A specialist orthodontic assessment — including X-rays and measurements — is the only reliable way to determine which cause applies to your specific situation. ## What Causes a Gummy Smile? A gummy smile is not a single condition — it is a symptom that can arise from several different anatomical causes. Identifying the cause is the essential first step before any treatment can be planned: Altered passive eruption: the teeth have not fully emerged from the gum — so a greater-than-normal proportion of gum tissue covers the crowns of the upper front teeth. The gum line sits lower on the tooth than it should. This is a dental cause and is often very amenable to treatment Dentoalveolar excess / over-eruption: the upper front teeth and the bone supporting them have erupted too far downwards, causing the gum line and the teeth to sit lower in the face than ideal. This can be an orthodontic cause — and may be correctable by intruding (moving upward) the upper front teeth Vertical maxillary excess (long upper jaw): the upper jaw bone itself is vertically too long, causing the upper lip to ride up when smiling and exposing more gum. This is a skeletal cause and typically requires jaw surgery (orthognathic surgery) for a meaningful correction Hyperactive upper lip: the lip elevator muscles are overactive, pulling the upper lip higher than average when smiling and exposing more gum tissue. The teeth and jaw may be completely normal — but the lip's range of motion is excessive. Botulinum toxin (Botox) injections can reduce the lip’s upward movement in these cases Short upper lip: when the resting length of the upper lip is short, it cannot cover the gum line when smiling. This is an aesthetic proportions issue that orthodontics does not change ## When Can Orthodontic Treatment Improve a Gummy Smile? Orthodontic treatment — whether fixed braces or clear aligners — can reduce the appearance of a gummy smile in specific scenarios: Orthodontics can help Over-erupted upper front teeth (intrusion mechanics can move teeth upwards) Large overjet combined with excessive gum display — correcting the overjet can improve gum show Deep overbite cases where the upper teeth have erupted downward to compensate Orthodontics cannot fix Skeletal vertical maxillary excess (long upper jaw) — jaw surgery needed Hyperactive lip — Botox or lip repositioning surgery more appropriate Short upper lip anatomy — a structural feature, not a dental one Low gum line from altered passive eruption — a periodontal (gum) issue requiring gum reshaping Wondering whether orthodontic treatment could improve your smile? A virtual assessment from a specialist orthodontist gives you a personalised view of your options before committing to anything. Start your free assessment → ## How Does Orthodontic Intrusion Work for Gummy Smiles? When a gummy smile is caused by over-erupted upper front teeth, an orthodontist can use intrusion mechanics — forces specifically designed to move the upper front teeth upward (into the jaw) rather than the usual direction of tooth movement. This physically repositions the gum line higher relative to the lip, reducing the amount of gum that shows when smiling. Intrusion of the upper incisors requires careful planning. The forces involved must be controlled precisely — too much force or incorrectly directed force can cause root resorption (shortening of the tooth roots). Temporary anchorage devices (TADs) — small titanium mini-screws placed in the jaw bone — are sometimes used to provide the stable anchor point needed to achieve effective intrusion without unwanted movement of other teeth. ## Non-Orthodontic Treatments for Gummy Smiles Crown lengthening / gingivectomy: a periodontal (gum) procedure that removes excess gum tissue and, where needed, reshapes the underlying bone to expose more of the tooth crown. Effective for altered passive eruption where the gum line is too low. Performed by a periodontist or oral surgeon under local anaesthetic Botulinum toxin (Botox) injections: small doses injected into the upper lip elevator muscles (levator labii superioris) reduce the muscle’s ability to pull the lip upward when smiling. The effect is temporary — typically 3 to 6 months — and the treatment must be repeated to maintain the result. Most appropriate for hyperactive lip causes Lip repositioning surgery: a permanent surgical procedure that reduces the range of upward movement of the upper lip by repositioning the attachment of the lip elevator muscles. Can provide a lasting reduction in gum show without altering the teeth or jaw Orthognathic surgery (jaw surgery): for vertical maxillary excess — where the upper jaw itself is too long — surgical repositioning of the upper jaw (Le Fort I osteotomy) moves the entire jaw upward, permanently reducing gum show. Requires pre- and post-surgical orthodontics. NHS funding may be available where functional indications exist 3–4mm The commonly cited upper limit of “normal” gum show at full smile — above this is generally considered a gummy smile 5 causes Different root causes for gummy smiles — each requires a different treatment approach, and some cannot be improved by orthodontics TADs Temporary anchorage devices used in some orthodontic intrusion mechanics — small titanium screws that provide stable force anchors Important Some patients with a gummy smile have a combination of causes — for example, slightly over-erupted teeth and a mildly hyperactive lip — and the best outcome may involve a combination of treatments. A specialist orthodontist is the best starting point: they can assess the dental and skeletal components and refer you to the appropriate colleagues (periodontist, oral surgeon, maxillofacial surgeon) if other treatment elements are needed. Getting a proper diagnosis before pursuing any treatment is essential — treating the wrong cause wastes money and time, and some interventions are irreversible. Get a Personalised Assessment Before You Decide A virtual assessment from a specialist orthodontist is the right first step if you are concerned about a gummy smile. You’ll receive expert guidance on whether orthodontic treatment could help your specific situation — before booking a paid consultation. Start Your Free Assessment → ## FAQs ### Can braces fix a gummy smile? Braces can improve a gummy smile when the cause is dental — specifically, when the upper front teeth have over-erupted (moved too far downward) and the orthodontist can use intrusion mechanics to move them back upward. This physically raises the gum line relative to the upper lip, reducing gum show when smiling. However, if the gummy smile is caused by a structurally long upper jaw (vertical maxillary excess), an overactive upper lip muscle, or simply a short upper lip, braces cannot change these features and other treatments — jaw surgery, Botox, or lip repositioning — are needed instead. A specialist orthodontic assessment with X-rays is required to determine the cause and the appropriate treatment. ### What causes a gummy smile? A gummy smile can be caused by several different factors: over-erupted upper front teeth (the teeth have moved too far downward, lowering the gum line); a long upper jaw bone (vertical maxillary excess), which is a skeletal cause; an overactive upper lip muscle that pulls the lip unusually high when smiling; a short upper lip that cannot cover the gum line; or altered passive eruption, where excess gum tissue has not receded to its normal level and covers too much of the tooth crown. Each cause requires a different treatment approach, which is why an accurate diagnosis is essential before pursuing any treatment. ### What is the best treatment for a gummy smile in the UK? The best treatment depends on the cause. For over-erupted upper teeth, orthodontic intrusion using braces or aligners — sometimes with temporary anchorage devices (TADs) — can be highly effective. For excess gum tissue covering the teeth (altered passive eruption), crown lengthening or gingivectomy performed by a periodontist can expose more of the tooth crown. For an overactive upper lip, Botox injections into the lip elevator muscles can temporarily reduce gum display. For a structurally long upper jaw, orthognathic surgery is the most effective permanent solution. Many patients benefit from a combination of approaches. A specialist orthodontist is the best starting point for a diagnosis and referral to the right colleagues. ### Can Invisalign fix a gummy smile? Invisalign and other clear aligner systems can address a gummy smile when the cause is dental — specifically, when orthodontic intrusion of the upper front teeth is appropriate. Clear aligner systems have improved significantly in their ability to deliver intrusion mechanics, though some cases still require fixed appliances or temporary anchorage devices (TADs) to achieve effective and precise tooth movement. Whether Invisalign is suitable for your specific gummy smile will depend on the severity, the cause, and your orthodontist’s clinical assessment of whether aligner mechanics can deliver the needed movement reliably. ### Can braces fix a gummy smile? Braces can improve a gummy smile when the cause is dental — specifically, when the upper front teeth have over-erupted (moved too far downward) and the orthodontist can use intrusion mechanics to move them back upward. This physically raises the gum line relative to the upper lip, reducing gum show when smiling. However, if the gummy smile is caused by a structurally long upper jaw (vertical maxillary excess), an overactive upper lip muscle, or simply a short upper lip, braces cannot change these features and other treatments — jaw surgery, Botox, or lip repositioning — are needed instead. A specialist orthodontic assessment with X-rays is required to determine the cause and the appropriate treatment. ### What causes a gummy smile? A gummy smile can be caused by several different factors: over-erupted upper front teeth (the teeth have moved too far downward, lowering the gum line); a long upper jaw bone (vertical maxillary excess), which is a skeletal cause; an overactive upper lip muscle that pulls the lip unusually high when smiling; a short upper lip that cannot cover the gum line; or altered passive eruption, where excess gum tissue has not receded to its normal level and covers too much of the tooth crown. Each cause requires a different treatment approach, which is why an accurate diagnosis is essential before pursuing any treatment. ### What is the best treatment for a gummy smile in the UK? The best treatment depends on the cause. For over-erupted upper teeth, orthodontic intrusion using braces or aligners — sometimes with temporary anchorage devices (TADs) — can be highly effective. For excess gum tissue covering the teeth (altered passive eruption), crown lengthening or gingivectomy performed by a periodontist can expose more of the tooth crown. For an overactive upper lip, Botox injections into the lip elevator muscles can temporarily reduce gum display. For a structurally long upper jaw, orthognathic surgery is the most effective permanent solution. Many patients benefit from a combination of approaches. A specialist orthodontist is the best starting point for a diagnosis and referral to the right colleagues. ### Can Invisalign fix a gummy smile? Invisalign and other clear aligner systems can address a gummy smile when the cause is dental — specifically, when orthodontic intrusion of the upper front teeth is appropriate. Clear aligner systems have improved significantly in their ability to deliver intrusion mechanics, though some cases still require fixed appliances or temporary anchorage devices (TADs) to achieve effective and precise tooth movement. Whether Invisalign is suitable for your specific gummy smile will depend on the severity, the cause, and your orthodontist’s clinical assessment of whether aligner mechanics can deliver the needed movement reliably. ## References - British Orthodontic Society — Gummy smiles: clinical overview for patients (https://www.bos.org.uk/patients) - BOS overview of the causes of gummy smiles, covering the distinction between dental, skeletal, and soft tissue causes, when orthodontic intrusion mechanics can reduce excessive gum display, when referral to a periodontist or oral surgeon is appropriate, and the role of combined orthodontic and surgical treatment for skeletal cases. - British Society of Periodontology — Crown lengthening and gingivectomy for gummy smiles (https://www.bsperio.org.uk/patients/) - BSP patient information on periodontal treatments for excessive gum display, covering the indications for crown lengthening and gingivectomy in cases of altered passive eruption, what the procedures involve, recovery expectations, and how periodontal gum reshaping differs from orthodontic intrusion in its mechanism and outcomes. - Journal of Clinical Orthodontics — Orthodontic management of excessive gingival display: a systematic approach (https://www.jco-online.com/) - Clinical review of orthodontic approaches to reducing excessive gingival display, covering the diagnostic process for distinguishing dental, skeletal, and soft tissue causes, the mechanics of upper incisor intrusion using temporary anchorage devices, the limitations of orthodontic treatment for skeletal causes, and the outcomes of combined orthodontic and surgical management. - British Orthodontic Society — Gummy smiles: clinical overview for patients (https://www.bos.org.uk/patients) - BOS overview of the causes of gummy smiles, covering the distinction between dental, skeletal, and soft tissue causes, when orthodontic intrusion mechanics can reduce excessive gum display, when referral to a periodontist or oral surgeon is appropriate, and the role of combined orthodontic and surgical treatment for skeletal cases. - British Society of Periodontology — Crown lengthening and gingivectomy for gummy smiles (https://www.bsperio.org.uk/patients/) - BSP patient information on periodontal treatments for excessive gum display, covering the indications for crown lengthening and gingivectomy in cases of altered passive eruption, what the procedures involve, recovery expectations, and how periodontal gum reshaping differs from orthodontic intrusion in its mechanism and outcomes. - Journal of Clinical Orthodontics — Orthodontic management of excessive gingival display: a systematic approach (https://www.jco-online.com/) - Clinical review of orthodontic approaches to reducing excessive gingival display, covering the diagnostic process for distinguishing dental, skeletal, and soft tissue causes, the mechanics of upper incisor intrusion using temporary anchorage devices, the limitations of orthodontic treatment for skeletal causes, and the outcomes of combined orthodontic and surgical management.