What is a "gummy smile" and why does it happen?
When people say their teeth look too short or their smile looks "gummy," it usually means that too much gum tissue is covering the teeth. In many cases, the teeth themselves are actually a perfectly normal size — they're just hidden under excess gum tissue or bone.
This is exactly what was happening with our patient. When we measured her teeth, we found she was about 2 to 2.5 millimeters short of the ideal tooth length, which is around 10.5 to 11 millimeters for the front teeth. That small difference makes a big visual impact on your smile.
The solution: Crown lengthening surgery
Crown lengthening is a common periodontal (gum) procedure that removes excess gum tissue — and sometimes a small amount of bone — to expose more of the natural tooth. We like to think of it as uncovering the tooth that was always there.
For this patient, we needed to treat six front teeth — the two central front teeth, the two lateral incisors on either side, and the two canines. Treating all six together was essential to create a harmonious, balanced result. Treating only the front two would have created a noticeable mismatch between the teeth.
"Now even with the stitches you could see my teeth look like teeth. Oh my god, I'm so happy." — Our patient, right after the procedure
Step by step: what actually happens during the procedure
Before anything else, we measure carefully. Using a dental probe, we check how far the gum needs to be moved to reach the ideal tooth length. In this patient's case, the gum needed to come up about 2 millimeters to achieve that ideal 10.5–11 mm mark. We also plan for slight variation between the teeth — your canines and central teeth should sit at the same gum level, while the lateral teeth sit just about 1 millimeter lower. These small differences are what make a smile look natural and beautiful.
With the measurements marked, we carefully trim the gum tissue to the new, ideal level. The goal isn't just to cut — it's to sculpt the tissue so the final shape follows those natural, aesthetic curves that make a smile look balanced and proportional.
Here's where this case got a little more complex — and why expertise really matters. She had what we call a thick biotype, meaning she had a significant amount of dense bone just underneath the gum tissue. If we had only removed the gum tissue and stopped there, her body would have grown the gum tissue right back. So we gently reshaped a small amount of the underlying bone to the ideal level (about 3 mm from the anticipated gum margin), smoothing it so it tapered naturally.
Once the gum and bone are at the correct levels, we gently stitch the gum tissue back into its new position. The stitches hold everything in place while the tissue heals into its new, longer shape. The stitches dissolve or are removed quickly, and the gums heal beautifully.
Good news about thick bone: While a thick biotype added a step to the procedure, it's actually a very good thing to have. Patients with dense, thick bone are ideal candidates for dental implants if they ever need them in the future. So this is a "good problem to have."
The aesthetics behind the result
Great smile design isn't just about making teeth longer. It follows a set of rules about proportion, symmetry, and the relationship between teeth. A few principles we applied in this case:
- The height-to-width ratio of each tooth matters — teeth that are too short look wide and stubby.
- The gum levels aren't all the same height — a natural, beautiful smile has slight variation, with the laterals sitting a touch lower than the centrals and canines.
- Midline symmetry is critical — the two front teeth should mirror each other perfectly.
- The relationship between adjacent teeth matters — each tooth must harmonize with its neighbor.
All of these principles guided every measurement and every cut we made during this procedure.
After the procedure: what to expect
The great news is that your mouth heals faster than almost any other part of your body. Here's what recovery looks like:
- Diet for the first few days: Stick to soft foods. Soups, smoothies, yogurt, and soft pasta are your best friends. When you do eat something more solid, cut it up and chew only with your back teeth.
- Brushing: You'll be given an extra-soft toothbrush. Use it very gently, and only brush the teeth themselves — not directly on the stitches or gum tissue.
- Rinsing: Warm salt water rinses are incredibly helpful for healing. They keep the area clean and reduce inflammation naturally. Our team will give you specific instructions.
- Getting back to normal life: Most patients return to normal activities very quickly. We've even had a patient give a presentation the same evening as her procedure. The mouth heals remarkably fast.
Frequently asked questions
Does it hurt?
The procedure is done with local anesthesia, so you won't feel pain during the surgery itself. Afterward, some tenderness and mild soreness is normal, but most patients manage it comfortably with over-the-counter pain relief. Our team will give you specific recommendations.
Will my gums grow back?
When done properly — including reshaping the bone in thick biotype cases like this one — the results are long-lasting. That's why it's so important to work with an experienced periodontist or oral surgeon who knows to address the bone and not just the gum tissue.
How long until I see the final result?
You'll actually notice a big difference immediately. Even with stitches in place, you can see the improvement right away. The final healed result becomes fully visible as the gums settle into their new shape over the following weeks.
Is this procedure just for aesthetics?
Crown lengthening is done for both cosmetic and restorative reasons. Sometimes it's needed to expose enough tooth structure for a crown or filling. In this case, the goal was aesthetic — but the procedure is exactly the same.
Can I still sing or talk normally after?
Yes. Our patient actually asked this very question. While things might feel a little strange in the first day or two as everything adjusts, normal speaking, singing, and smiling resume quickly.
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