1) Problems with the upper lip

✔ Upper lip being too mobile. Moving too much in the upward direction while smiling

✔ Upper lip too thin

It is the most common cause of gummy smile. The problem is that the upper lip does not cover the teeth sufficiently when smiling. Either the upper lip is too short, thin, or it moves too much upwards, making the teeth and gums too visible. Watch the video below to see how excessive upward movement of the upper lip causes a gummy smile. As you will see in the video, in Gelata (also called Abyssinian or baboon monkeys) monkeys, the upper lip can be displaced so much that the entire upper jaw can be exposed. This video shows very well how the gummy smile is formed with the movement of the upper lip.

In this case, the things that can be done are to plump the upper lip with filler injection or to restrict its upward movement. Botox can be applied to the muscles that pull the lip up, but this solution is temporary. Its effect lasts for 6 months. Lips can be thickened by injection of filler (hyaluronic acid filler). The effect of this lasts for up to 6 months.

The most radical and permanent solution is "Rubinstein-kostianovsky" surgery. This surgery is also known as "lip repositioning". This surgery is usually performed by plastic surgeons. The surgery should be performed under general anesthesia under operating room conditions. Extensive information about this surgery is given on the "Surgery" page. In fact, the focus of this site is Rubinstein-kostianovsky surgery. We do not treat the 2nd and 3rd causes that you will read below.

2) Problems with teeth and gums

✔ Short enamel parts of teeth

✔ Gums are too long and do not cover the lower part of the tooth

✔ Some medications taken cause hypertrophy in the gums

Problems related to teeth and gums fall within the field of dentists. Gums may have become hypertrophied. It covers the roots of the teeth. Or the visible white parts of the teeth may be short. In these cases, dentists may shorten the gums or enlarge the white parts of the teeth. These treatments are not within the scope of this website. If the cause of the gummy smile is related to the gums and teeth, these problems should be treated by dentists. In the drawing below you can see the shortening of the gums and the enlargement of the white parts of the teeth.

In these patients, "Rubinstein-kostianovsky" surgery is partially effective. Teeth and gums still need intervention.

3) Problems with the upper jaw bone

✔ Long face syndrome

The problem here is that the upper jaw is too high. Since the bone structure in the upper jaw is very long, the upper lip moves upwards a lot when smiling. This causes a gummy smile. In this case, what needs to be done is to shorten the upper jaw bone by removing a slice of bone from the middle. This surgery is performed by plastic surgeons who perform orthognathic surgery (trained in jaw surgery). This surgery is also outside the scope of this site.

It would not be appropriate to perform the "Rubinstein-kostianovsky" surgery on a patient with long face syndrome. There is a high probability of not getting any results. So, how can we be sure that the patient has long face syndrome? What needs to be done for this is to have the patient undergo cephalometric analysis. In this evaluation, a special head x-ray is taken for the patient. The feature of this x-ray is that the dimensions of the x-ray are exactly the same as the patient's head dimensions. Thus, measurements can be made on the film taken. Thus, measurements are made on the bone structure of the patient's head. In these calculations, it can be clearly seen whether the height of the upper jaw is normal or excessive. If the height measurement of the upper jaw is higher than normal, a long face diagnosis is made. As I said, this issue concerns oral surgeons and is out of our interest at the moment.