Gum Lift


It has been estimated that 7 percent of men and 14 percent of women have an “excessive gingival display” or more commonly called a “gummy smile”.  One of the most dramatic and effective cosmetic tools available to reduce the amount of visible gum tissue is the “Gum-Lift”.  By gently removing excessive gum tissue, dramatic cosmetic improvements can be achieved.  If this procedure will benefit your overall appearance, and you choose to have this procedure, Dr. Fondriest carefully creates a design that is most appropriate for you and then supervises the procedure which is actually performed by one of the highly respected periodontists that supports Dr. Fondriest’s work.  “By removing this excessive gum tissue, we are able to reveal the correct proportion and

Gummy Smile

Before treatment: This patient recently had a poorly done smile makeover. Her entire mouth had been restored with unattractive crowns. The treatment was overly aggressive with very little planning. Major occlusal, periodontal, and cosmetic issues were not addressed. The patient did not have an understanding of what was wrong and was not happy with the results. She had communicated to her previous dentist that she did not like her “gummy smile” and the large boney defect above her upper right teeth. She was told that nothing could be done. The new dentistry did not help with either of her chief complaints. The reason for this patient’s gummy display was threefold: she had a short upper lip, super-eruption of her natural upper teeth due to bruxism, and she had some vertical maxillary excess as described above.

beauty of the underlying tooth”, says Dr. Fondriest. There are seven common causes of a gummy smile.  The simple gum lift is the most common treatment solution for the first 4 gummy smile causes listed below.

Gum Lift Planning

The planning process of raising or evening out the gum tissue is often a smaller part of the Artistic Smile Design. Supervision of the fast to heal surgery by the referring dentist is critical to an ideal outcome.  While many surgeons have cosmetic training, without having the plan for the long term from the regular treating dentist, the surgeon can only guess about what will look good in the smile.  If veneers are planned or any restorative care in the smile, the surgeon and restorative dentist must work as a team to deliver the exact shape and height of the gum to achieve the best overall results.

Gum Lift Treatment sequencing:

  1. A diagnosis as to which cause above is made and alternative options are explored
  2. The cosmetic dentist or prosthodontist will take models of your mouth, xrays, and video or photograph your smile.  The video or photograph will be used to evaluate the lip movements and to measure exactly how much the gum shows in your smile when talking and smiling.
  3. An optional orthodontic consultation is offen recommended if this can easily be fixed with braces
  4. Your dentist will create a treatment plan, make drawings of the desired surgical outcome on the photographs, and a surgical stent (a guide that fits in the mouth that helps the surgeon).  These will be sent to the periodontal surgeon with the radiographs before your appointment so the surgeon knows exactly the agenda.
  5. The perio-plastic surgery is done with simple novacaine in the periodontist’s office.  Usually, you can go to work the next day and it generally heals in a week.
  6. Frequently cosmetic veneers are done after the gummy smile has been corrected.

CAUSES OF A GUMMY SMILE and treatment choices

1)  Altered Passive Eruption

The teeth and bone are in the correct position but are covered with excessive amounts of gum tissue.  This is a common variation of normal called “altered passive eruption”.  Most common solution:  Gum lift

2)  Altered Active Eruption

Patient after gum lift has a normal smile

After treatment: This patient really wanted a healthy nice smile and was highly motivated to achieve her goals. The gummy smile was corrected by perio-plastic surgery and the bone defect on the upper right was improved by gum grafts and jaw ridge recontouring. The prior treatment, that was only 3 years old, had already caused the loss of 4 teeth that were replaced with implants. The short and squatty crowns were replaced with new Empress crowns with the appropriate length to width ratios.

Teeth are in the correct position but are covered with excessive amounts of both bone and gum tissue.  This is a common variation of normal called “altered active eruption”.  Most common solution:  Gum lift.

3)  Super-eruption of upper teeth due to bruxism

Tooth positions throughout life are in a dynamic equilibrium.  Tiny movements occur all of the time based on what is pushing or holding them in place.  If an opposing lower tooth is suddenly lost or shortened, the upper tooth will start moving down (super-eruption) until if makes contact with something or a retainer is made to hold it in position.  Some people grind their teeth so much that much of the tooth length is lost.  Nature has provided a mechanism to keep the teeth in contact called supereruption.  Super-eruption of the upper teeth due to tooth wear will bring the gum tissue along with the descending incisors causing a gummy smile.  Most common solution:  Gum lift

4)  Short Upper Lip

The upper lip is too short and doesn’t fully cover the teeth and/or gums.  The distance from the nose to the upper lip is shorter than normal.  Most common solution:  raise gum line

5)  Super-eruption of upper front teeth due to jaw relationship discrepancy and lack of orthodontic stability

The upper jaw is bigger than the lower jaw and the upper teeth drift lower because there is nothing to stop them.  As the teeth drift lower, the gum comes with them.  Most common solution:  Orthodontics with occasional surgical balancing of jaw proportions. Alternative solution: raise gum line and wear retainer

6)  Hyper-Mobile Upper Lip

Think of the upper lip as a curtain that covers or hides the teeth and gums beneath it.  This curtain rises up when you smile to reveal what is below.  The smile muscles for some people will pull the upper lip up higher than normal when smiling.  This is called “Hyper-mobility of the upper lip” and it allows more gum to show.  Most common solutions:  Botox or “lip tacking”.  Alternative solution: raise gum line

7)  Vertical Maxillary Excess

The upper jaw has a vertical dimension that is longer than it should be.  The distance from the floor of the nose to the chewing surfaces of the teeth is abnormally long.  This circumstance is called “vertical maxillary excess”.  Most appropriate solutions:  a)  Orthognathic surgery/orthodontics  b)  Perio-plastic surgery or raise gum line.


Another before and after example of a gum lift

Another before and after example of perio-plastic surgery

Another example of a patient who had crown lengthening

Another before and after example of a patient whom had gum surery to fix a gummy smile