What Is The Best Way To Fix My Gummy Smile?

Q: Dr. Eppley, I have a gummy smile that I don’t like. I would like to achieve four things: 1) straighten gum line 2) reduce amount of gums shown when smiling 3) improve lip seal at rest and 4) reduce horizontal protrusion of upper lip area in profile. (least important) I have attached some pictures. Do you think my gummy smile is caused by vertical maxillary excess, or short upper lip, or hyperactive upper lip muscle or some combination? Will jaw surgery for vertical maxillary excess reduce my face length too much?

A: In looking at your pictures, I do think your gummy smile is a result of a combination of a short upper lip and some degree of vertical maxillary excess. The short upper lip is the bigger component of the problem however. The first step you need to do is consult with an orthodontist to find out if you are even a candidate for a maxillary shortening. This is going to require a model and x-ray analysis. It is impossible to anyone to say, based on these pictures alone, that you have a significant VME and whether it merits surgical shortening.  If it is determined that a maxillary osteotomy is not an option, then you may consider soft tissue management of the gummy smile through various upper lip techniques such as levator muscle release and mucosal V-Y lengthening.

Dr. Barry Eppley

Indianapolis, Indiana