Gummy Smile Treatment in Dublin: Can Orthodontics Help Without Jaw Surgery?

16th September 2026

By Dr Erfan Salloum, Specialist Orthodontist | EBO & EBAO Diplomate | British Orthodontic Society Maurice Berman Prize Winner 2026

A gummy smile, clinically known as excessive gingival display, occurs when a larger amount of gum is visible above the upper teeth when smiling.

For some people, the teeth may appear too short. For others, the upper teeth and gums may sit too low when they smile.

At Lusk Orthodontics, one of the most important principles when assessing a gummy smile is that the appearance itself is not the diagnosis.

Different anatomical factors can produce a similar-looking gummy smile, and identifying the underlying cause is essential before deciding on treatment.

In selected patients, modern orthodontic techniques can significantly improve excessive gum display without jaw surgery. In other cases, however, the position of the upper jaw may be the primary problem, and orthognathic surgery may remain the most appropriate treatment.

What Causes a Gummy Smile?

There is no single cause of a gummy smile. Several factors can contribute, and more than one may be present in the same patient.

Common causes include:

• over-eruption of the upper front teeth;
• excessive gum covering the natural tooth crowns;
• a short or hypermobile upper lip;
• reduced clinical crown height;
• vertical overdevelopment of the upper jaw, known as vertical maxillary excess; or
• a combination of dental, gingival, lip and skeletal factors.

This is why treatment should start with a comprehensive orthodontic assessment rather than choosing a procedure based on appearance alone.

Can Orthodontics Correct a Gummy Smile?

In selected patients, yes.

When the upper front teeth have erupted further downwards than ideal, orthodontic treatment can move these teeth upwards. This movement is known as orthodontic intrusion.

As the teeth move upwards, the surrounding gingival tissues can also move with them, reducing the amount of gum visible during smiling.

The challenge is achieving genuine vertical tooth movement without creating unwanted movement elsewhere in the bite.

This is where temporary anchorage devices (TADs) can be particularly useful.

What Are TADs?

Temporary anchorage devices, commonly called TADs or orthodontic mini-implants, are very small titanium screws temporarily placed into suitable areas of bone.

They provide orthodontists with a stable anchorage point from which carefully controlled forces can be applied to specific teeth.

For gummy smile treatment, TADs may allow us to intrude the upper front teeth more effectively while reducing unwanted movement elsewhere in the dental arch.

TADs can be used alongside fixed braces and, in appropriately selected cases, clear aligners.

They are placed under local anaesthetic and removed once they are no longer required.

How Much Can the Teeth Be Intruded?

Orthodontic intrusion has biological and anatomical limits.

In suitable cases with a predominantly dental or dentoalveolar cause, a few millimetres of controlled intrusion can produce a noticeable change in gingival display.

However, attempting excessive intrusion can increase risks, including root resorption, and may adversely affect the bite or smile aesthetics.

Successful treatment is therefore not simply about moving the teeth upwards as far as possible.

We also need to carefully control the roots, tooth inclination, bite, gingival margins and smile arc throughout treatment.

What Is the Smile Arc?

The smile arc describes the relationship between the edges of the upper front teeth and the curvature of the lower lip during smiling.

This relationship is important when planning gummy smile correction.

Excessive or poorly planned intrusion can flatten the smile arc. Although this may reduce the amount of visible gum, it does not necessarily produce a more attractive smile.

Our objective is therefore not simply to show less gum.

The aim is to create an appropriate relationship between the teeth, gums, lips and face.

When Can Laser Gingivectomy Help?

Sometimes the position of the teeth is only part of the problem.

The gum itself may cover an excessive amount of the natural tooth crown, making the teeth appear shorter than they actually are.

When the periodontal anatomy is suitable, laser gingivectomy may be used to carefully remove a controlled amount of excess gingival tissue and reveal more of the natural tooth.

However, gingivectomy is not appropriate for every gummy smile.

Before removing gingival tissue, we need to assess factors including the amount of healthy gum present and the relationship between the gingival margin and the underlying bone.

Removing gum without appropriate diagnosis can potentially lead to periodontal problems or gingival recession.

Can TADs and Laser Gingivectomy Be Combined?

Yes.

Some patients have a combination of:

over-erupted upper front teeth + excessive gingival coverage.

In these cases, orthodontic intrusion using TADs may first improve the vertical position of the teeth. Laser gingivectomy can then be considered to refine the final relationship between the teeth and gums.

The sequence is important.

Because orthodontic intrusion changes the position of the gingival margins, we generally want the teeth close to their intended final positions before determining whether gingival treatment is required.

When Is Jaw Surgery Required for a Gummy Smile?

Not every gummy smile can or should be corrected orthodontically.

If the main cause is significant vertical maxillary excess, the underlying problem is skeletal: the upper jaw itself has developed too far vertically.

Orthodontics can move teeth within the jaws, but there are limits to how much orthodontic tooth movement can compensate for a significant skeletal discrepancy.

In these situations, orthognathic jaw surgery may provide a more appropriate and complete correction.

Avoiding surgery should therefore not be the treatment objective in itself.

The priority is to identify the underlying cause and determine which treatment is appropriate for that individual patient.

Can Clear Aligners Treat a Gummy Smile?

Clear aligners can form part of gummy smile treatment in selected patients.

However, when significant vertical intrusion is required, aligners alone may not provide sufficient anchorage or biomechanical control.

TADs can therefore sometimes be combined with clear aligner treatment to provide additional anchorage for the required tooth movement.

Whether fixed braces, clear aligners or another appliance is most appropriate depends on the individual bite and treatment objectives.

How Long Does Gummy Smile Treatment Take?

Treatment time varies considerably depending on the underlying problem and the amount of orthodontic correction required.

A relatively straightforward dental problem may require less treatment than a gummy smile involving several dental, gingival and skeletal factors.

Where comprehensive orthodontic treatment is required, treatment may commonly extend over approximately 18–24 months, although an individual estimate can only be provided following a full assessment.

Is Gummy Smile Treatment Permanent?

As with any orthodontic treatment, some degree of relapse is possible.

Following treatment, patients generally require long-term orthodontic retention. Depending on the case, this may involve bonded fixed retainers, removable night-time retainers or a combination of both.

Good periodontal health and appropriate long-term maintenance are also important.

How Do We Assess a Gummy Smile at Lusk Orthodontics?

A comprehensive assessment looks beyond the amount of gum visible in a photograph.

Depending on the individual patient, we assess:

• facial proportions;
• upper jaw position;
• vertical and transverse dimensions of the maxilla;
• upper incisor position;
• tooth and clinical crown dimensions;
• gingival architecture;
• upper lip length and mobility;
• the bite and occlusion;
• smile arc; and
• relevant radiographic findings.

Only after establishing why the excessive gingival display is occurring can we determine whether orthodontics, TAD-supported intrusion, gingival treatment, orthognathic surgery or a combination of approaches should be considered.

Gummy Smile Treatment at Lusk Orthodontics

At Lusk Orthodontics in North Dublin, we assess children, teenagers and adults across a broad range of simple and complex orthodontic problems.

For adults concerned about a gummy smile, our approach begins with diagnosis rather than assuming that one particular treatment will work for everyone.

Depending on the underlying anatomy, treatment may involve conventional orthodontics, clear aligners, TAD-supported intrusion, carefully planned gingival treatment or, where a significant skeletal discrepancy exists, interdisciplinary treatment involving orthognathic surgery.

About the Author

Dr Erfan Salloum, European Board-Certified Specialist Orthodontist

Dr Salloum is the Clinical Director of Lusk Orthodontics and has a particular clinical interest in adult and complex orthodontics, temporary anchorage devices (TADs), skeletal expansion, lingual orthodontics and interdisciplinary orthodontic treatment.

Want to Learn More About Gummy Smile Treatment?

If you would like to learn more about the diagnosis and treatment of a gummy smile, Dr Erfan Salloum has written a more comprehensive guide on his professional website.

The detailed article explores the different causes of excessive gingival display, TAD-supported orthodontic intrusion, laser gingivectomy, treatment limitations and when orthognathic surgery may be more appropriate.

It also includes clinical before-and-after cases demonstrating how different types of gummy smile can require different treatment approaches.

Read Dr Erfan Salloum’s complete guide to gummy smile treatment without jaw surgery and view clinical cases →

Considering Gummy Smile Treatment in Dublin?

If you are concerned about excessive gum display and would like to understand what may be causing it, the first step is a comprehensive orthodontic assessment.

The aim is not simply to reduce the amount of visible gum. The aim is to determine why the gummy smile is present, whether treatment is indicated and, if so, which approach is most appropriate for your individual teeth, gums, bite and facial anatomy.

To arrange an assessment at Lusk Orthodontics in North Dublin, please complete our online enquiry form and our patient care team will contact you to arrange an appointment.