Can Clear Aligners Fix a Gummy Smile? What You Need to Know

A gummy smile — where a noticeable amount of gum tissue shows above the upper teeth when you smile — is one of the most common cosmetic dental concerns patients ask about. If you've been researching gummy smile treatment options, you may have come across claims that clear aligners can help. The reality is nuanced: aligners can address some of the causes, but not all of them. This guide explains what drives a gummy smile, when clear aligners may be part of the solution, and when other approaches are more appropriate.

Who This Guide Is For

This article is for UK patients who are self-conscious about excessive gum display when they smile and want to understand their options. It may be relevant if you:

• Feel that too much gum shows when you smile and want to explore ways to fix a gummy smile
• Are already considering invisible braces and want to know if they can help with gum display too
• Want a clear comparison of gummy smile treatment options before seeing a clinician
• Have heard about aligners for gummy smiles online and want an honest, balanced explanation
• Would prefer a non-surgical approach if one is available for your situation

Important: A gummy smile is almost always a cosmetic concern rather than a health issue. However, if you're experiencing gum swelling, bleeding, or pain alongside the appearance, that may indicate a gum health issue that needs clinical attention. This guide covers the cosmetic aspect — not gum disease.

Key Definitions in Plain English

What Is a Gummy Smile?

A gummy smile (the clinical term is excessive gingival display) is when a significant amount of gum tissue — generally more than 3–4mm — is visible above the upper front teeth during a full smile. There's no strict threshold that defines "too much" gum, as it's largely a matter of personal perception and aesthetics. Some people are bothered by 2mm of gum display; others are comfortable with more.

What Is Tooth Intrusion?

Intrusion is an orthodontic movement where a tooth is pushed upward (in the upper jaw) or downward (in the lower jaw) into the bone. When the upper front teeth are intruded, the gumline moves up with them, which can reduce the amount of gum visible when you smile. Clear aligners can achieve a degree of intrusion, which is why they may help with certain gummy smiles.

Other Terms You May Encounter

• Attachments: Small tooth-coloured composite bumps bonded to specific teeth during aligner treatment. They help the trays grip teeth and achieve more controlled movements, including intrusion.
• IPR (Interproximal Reduction): Carefully removing tiny amounts of enamel between teeth to create space for alignment. This is a routine part of many aligner treatments.
• Refinements: Additional sets of aligner trays produced after the initial series to fine-tune the result. Many cases need at least one round of refinements.
• Retainers: Custom-made devices worn after treatment to hold teeth in their new positions. Essential for maintaining any intrusion achieved.
• Tracking: How well your teeth are following the planned movement sequence. Poor tracking may require plan adjustments.
• 3D scan: A digital impression of your teeth using an intraoral scanner, replacing traditional moulds and forming the basis for treatment planning.
• Gum contouring (gingivectomy): A procedure where excess gum tissue is removed to expose more of the tooth crown, changing the gum-to-tooth ratio.
• Overbite (deep bite): When the upper front teeth overlap the lower front teeth excessively. Deep bites can sometimes contribute to the appearance of a gummy smile.

What Causes a Gummy Smile?

Understanding the cause is the single most important factor in choosing the right gummy smile treatment. A gummy smile isn't one condition — it's a visible result that can stem from several very different underlying causes. Often, more than one factor contributes.

Teeth-Related Causes

• Over-erupted upper front teeth: If the upper front teeth have come down too far from the gum (over-erupted), they bring gum tissue with them, creating excess display when you smile. This is one of the causes that aligners may help address through intrusion.
• Deep overbite: A significant overbite (where the upper teeth overlap the lower teeth excessively) can force the upper teeth downward, increasing gum show. Correcting the bite can sometimes reduce gum display as a secondary benefit.
• Small or worn teeth: If the visible portions of the teeth (the clinical crowns) are short relative to the gum tissue, more gum is visible proportionally. This may be due to wear, genetics, or altered passive eruption (see below).

Gum-Related Causes

• Altered passive eruption: A condition where the gum tissue didn't recede to its normal adult position during tooth eruption, leaving excess gum covering the upper part of the teeth. The teeth may be normal size underneath, but the gum coverage makes them look short and square. Gum contouring is typically the most effective treatment for this.
• Gum enlargement (gingival hyperplasia): Overgrown gum tissue — sometimes related to medications, genetics, or gum disease — can increase the amount of gum visible when smiling.

Lip-Related Causes

• Hypermobile upper lip: Some people's upper lip rises higher than average when they smile, exposing more gum. This is a muscular characteristic, not a dental one, and isn't directly treatable with orthodontics.
• Short upper lip: A naturally shorter upper lip doesn't cover as much of the teeth and gums at rest or when smiling. Again, this is a soft-tissue characteristic rather than a tooth-position issue.

Jaw-Related Causes (Skeletal)

• Vertical maxillary excess: The upper jaw bone (maxilla) has grown longer than average vertically, positioning the teeth and gums further downward. This is a skeletal cause and typically requires surgical correction (Le Fort I osteotomy) if the excess is significant.

What Clear Aligners Can Do (and What They Can't)

Clear aligners are primarily orthodontic tools — they move teeth. Their ability to address a gummy smile depends entirely on whether tooth position is contributing to the problem.

When Aligners May Help

• Over-erupted upper front teeth: Aligners can intrude (push upward) the upper front teeth, carrying the gumline with them. This can reduce gum display by several millimetres in suitable cases.
• Deep overbite contributing to gummy smile: If a deep bite is pushing the upper teeth downward, correcting the bite with aligners may reduce gum show as a secondary benefit. Aligners can use bite ramps and attachments to address deep bites effectively.
• Misalignment creating uneven gumline: If teeth are at different heights due to misalignment, straightening them can create a more uniform gumline appearance, which may reduce the perception of a gummy smile.
• Combined with gum contouring: In some cases, aligners are used to position the teeth optimally before (or after) a gum contouring procedure, achieving a result that neither treatment could accomplish alone.

When Aligners Won't Be Enough

• Excess gum tissue (altered passive eruption): If the gums themselves are covering too much of the teeth, moving the teeth won't change the gum-to-tooth ratio. Gum contouring is typically needed.
• Hypermobile or short upper lip: Lip characteristics are soft-tissue issues that orthodontics cannot address. Botox or lip repositioning surgery may be options for these cases.
• Vertical maxillary excess: When the jaw bone is the primary issue, aligners cannot change jaw height. Orthognathic (jaw) surgery may be discussed for significant skeletal contributions.
• Severe gummy smiles (8mm+ of gum display): Very prominent gummy smiles usually have skeletal or soft-tissue components that go beyond what tooth movement alone can address.
• Large intrusion requirements: Clear aligners can achieve a limited degree of intrusion (typically 1–3mm is predictable). If more intrusion is needed, fixed braces with temporary anchorage devices (TADs) may be more effective.

Alternatives to Aligners: Other Gummy Smile Treatment Options

Because gummy smiles have different causes, there are several treatment options — and the right one depends on what's driving the issue in your case. Here's a balanced overview of the main approaches.

Gum Contouring (Gingivectomy / Crown Lengthening)

A procedure where excess gum tissue is removed, sometimes with minor reshaping of the underlying bone, to expose more of the tooth and create a balanced gum-to-tooth ratio.

• Best for: Altered passive eruption, excess gum tissue covering normal-sized teeth
• Procedure: Usually performed with a laser or scalpel under local anaesthetic. Often completed in a single appointment.
• Recovery: Gums typically heal within 1–2 weeks. Some sensitivity is normal.
• Limitations: Only effective if the gummy appearance is caused by excess gum tissue. Won't help if the issue is tooth position, lip, or jaw-related.

Botox (Botulinum Toxin)

Injections into the muscles that control the upper lip can limit how high the lip rises when smiling, reducing the amount of gum displayed.

• Best for: Hypermobile upper lip (lip rises too high when smiling)
• Procedure: A quick, minimally invasive injection. Results appear within 3–7 days.
• Duration: Temporary — effects typically last 3–6 months. Repeat treatments are needed to maintain the result.
• Limitations: Doesn't change tooth or gum position. Temporary solution. Must be administered by a qualified, experienced practitioner. Can affect smile symmetry if placed incorrectly.

Lip Repositioning Surgery

A surgical procedure that limits the upward movement of the upper lip by restricting the attachment of the lip to the gum.

• Best for: Hypermobile upper lip in patients who want a more permanent solution than Botox
• Procedure: Minor surgery under local anaesthetic, typically taking 30–60 minutes
• Limitations: Not widely available. Results can be variable. Some relapse may occur over time.

Orthognathic (Jaw) Surgery

Surgical repositioning of the upper jaw to reduce vertical excess.

• Best for: Significant vertical maxillary excess (the jaw bone has grown too long vertically)
• Procedure: Major surgery under general anaesthetic in a hospital setting. Requires orthodontic treatment before and after.
• Limitations: Invasive, with a longer recovery period. Reserved for cases where the skeletal component is significant and non-surgical options are inadequate.

Veneers or Crowns

In some cases, placing veneers or crowns can lengthen the visible portion of the teeth, improving the tooth-to-gum ratio.

• Best for: Small, worn, or short teeth where the gum-to-tooth proportion looks off
• Limitations: Requires tooth preparation (removing some enamel). Doesn't change actual gum display — changes the visual proportion instead. Often combined with gum contouring for optimal results.

Combined Approaches

Many patients benefit from a combination of treatments. For example, aligners to correct tooth position and bite depth, followed by gum contouring to refine the gumline. A comprehensive assessment allows your clinician to recommend the most effective combination for your specific anatomy.

Step by Step: How Clear Aligner Treatment for a Gummy Smile Typically Works

Suitability Checklist: Could Clear Aligners Help Your Gummy Smile?

This is a rough guide only — a clinical assessment is the only reliable way to determine whether aligners are appropriate for your case.

When to Seek Advice

A gummy smile is typically a cosmetic concern, and there's no medical urgency to treat it. However, it may be worth booking an assessment if:

• You feel self-conscious about your smile and it's affecting your confidence or social interactions
• You've noticed your gum display has changed or increased over time
• You have other dental concerns alongside the gummy smile (misalignment, bite issues, crowding) that might be addressed at the same time
• You're experiencing gum swelling, bleeding, or tenderness — which may indicate a separate gum health issue
• You want to understand which of the available treatments would actually address your specific cause

A consultation with a dental professional who can assess the full picture — teeth, gums, lip, and jaw — is the most effective starting point. You can explore what the assessment process involves before booking.

Risks, Side Effects, and Limitations

Any treatment carries potential risks. Being informed helps you weigh the options and have productive conversations with your clinician.

Risks Related to Aligner Treatment for Gummy Smiles

• Limited intrusion range: Clear aligners can predictably intrude teeth by approximately 1–3mm. If more intrusion is needed, the result may fall short of expectations, even with refinements.
• Root resorption: Intrusion movements carry a slightly higher risk of root resorption (shortening of the tooth roots) compared to simpler movements. This is usually clinically insignificant but is monitored with X-rays.
• Relapse: Intruded teeth have a tendency to re-erupt (move back down) if retention is not maintained diligently. Consistent retainer wear is essential.
• Incomplete improvement: If multiple factors contribute to the gummy smile and only tooth position is addressed, the cosmetic improvement may be partial.
• Attachment visibility: Intrusion cases often require attachments on the front teeth, which may be slightly visible during treatment.
• Compliance dependency: As with all aligner treatment, results depend on wearing trays approximately 22 hours per day. Poor compliance can mean insufficient movement.

Risks Related to Other Gummy Smile Treatments

• Gum contouring: Temporary sensitivity, risk of uneven gumline if not performed precisely, potential for gum tissue to regrow partially in some cases
• Botox: Temporary results (3–6 months), risk of asymmetric smile if poorly placed, potential for difficulty with certain lip movements
• Jaw surgery: General anaesthetic risks, nerve-related numbness (usually temporary), recovery period of several weeks, need for orthodontic treatment before and after

How Long Treatment May Take

Treatment timelines depend on the approach used and the complexity of your case. These are approximate ranges only.

What Affects Treatment Time?

• How much intrusion is needed: Greater intrusion takes longer and may require more refinement rounds
• Whether bite correction is involved: Correcting a deep overbite alongside intrusion adds complexity and time
• Compliance: Wearing aligners for the recommended 22 hours per day is essential for staying on schedule
• Refinements: Most cases involving intrusion need at least one round of refinement trays, adding 2–5 months
• Combined treatments: If gum contouring or other procedures follow aligner treatment, total treatment time is longer
• Biology: Individual variation in how teeth respond to intrusive forces

Costs in the UK: What Drives Price

The following figures are approximate UK ranges and are not quotations. Costs vary by provider, location, and individual case complexity.

What Drives the Price?

• Case complexity: Cases involving significant intrusion, deep bite correction, and alignment typically fall at the higher end of aligner pricing
• Refinement rounds: More refinements mean more trays, more scans, and more appointments — check whether these are included in the quoted fee
• Combined treatments: If you need both aligners and gum contouring, these are typically separate fees
• What's included: Always ask whether the price covers refinements, retainers, and monitoring appointments
• Provider and location: Costs vary across the UK, with London typically at the higher end

For a broader look at aligner pricing, see our guide on invisible braces costs in London.

How to Keep Results: Retention and Aftercare

Retention is particularly important after any treatment that involves intrusion. Teeth that have been pushed upward have a natural tendency to re-erupt (drift back down) over time, especially in the early months after treatment.

Retention Strategy

• Fixed retainers: A thin bonded wire behind the upper front teeth provides continuous passive retention. This is commonly recommended after intrusion cases.
• Removable retainers: Clear plastic retainer trays worn nightly. These help maintain all tooth positions, including the intrusion achieved.
• Combination approach: Many clinicians recommend both fixed and removable retainers for cases involving intrusion, providing double protection against relapse.

Aftercare Tips

• Wear your retainers exactly as prescribed — this is critical for maintaining intrusion
• Clean retainers daily with a soft brush and lukewarm water
• Attend all follow-up appointments so your clinician can monitor tooth position stability
• If a retainer breaks or detaches, contact your provider promptly — gaps in retention can allow teeth to re-erupt
• Maintain good oral hygiene with regular brushing, flossing, and dental check-ups
• If you had gum contouring, follow your clinician's specific aftercare instructions for gum healing

Frequently Asked Questions

Can clear aligners fix a gummy smile?

Clear aligners may reduce a gummy smile when the cause is related to tooth position — specifically, over-erupted upper front teeth or a deep overbite. Aligners can intrude teeth (push them upward), which carries the gumline with them. However, gummy smiles caused by excess gum tissue, lip characteristics, or jaw structure typically require other treatments. A clinical assessment is needed to determine the cause and appropriate approach.

What causes a gummy smile?

Gummy smiles can be caused by several factors, often in combination: over-erupted teeth, a deep overbite, excess gum tissue covering the teeth (altered passive eruption), a hypermobile upper lip that rises too high, a short upper lip, or vertical excess in the upper jaw bone. The right treatment depends entirely on which factors are contributing in your case.

Is gummy smile treatment painful?

Most gummy smile treatments involve minimal discomfort. Clear aligner treatment may cause mild pressure for 1–3 days when switching to a new tray. Gum contouring is performed under local anaesthetic and may involve some tenderness for a few days afterwards. Botox injections cause brief, mild discomfort. Your clinician will discuss what to expect with any recommended treatment.

How much gum showing is considered a gummy smile?

There's no strict clinical threshold. Generally, more than 3–4mm of gum display above the upper front teeth during a full smile is considered a gummy smile. However, what matters most is how it affects you personally — some people are bothered by 2mm of gum show, while others are comfortable with more. It's a personal aesthetic preference.

Will my gummy smile come back after treatment?

There is some risk of relapse, particularly with intrusion-based treatments. Teeth that have been intruded can tend to re-erupt over time if retainers are not worn consistently. Gum contouring results tend to be stable but tissue regrowth is possible in some cases. Botox is inherently temporary and requires repeat treatments. Diligent retention is the most important factor in maintaining results.

Can Botox fix a gummy smile permanently?

No. Botox provides a temporary effect that typically lasts 3–6 months. It works by relaxing the muscles that elevate the upper lip, reducing how high the lip rises during smiling. Repeat injections are needed to maintain the result. It's most appropriate when a hypermobile upper lip is the primary cause of the gummy smile.

Is gum contouring safe?

Gum contouring is a well-established dental procedure with a good safety profile when performed by an experienced clinician. Risks include temporary sensitivity, minor bleeding, and the small possibility of uneven results. Laser-assisted techniques may reduce bleeding and healing time. The procedure should only be performed after a thorough assessment to confirm that excess gum tissue is the cause of the gummy appearance.

How do I know which gummy smile treatment I need?

The only reliable way to determine the right treatment is a clinical assessment that evaluates the teeth, gums, lip, and jaw. Your clinician will identify which factors are contributing to the gummy smile and recommend the most appropriate treatment — or combination of treatments — for your specific case. Self-diagnosis or online assessments cannot reliably identify the cause.

Can children have gummy smile treatment?

In most cases, gummy smile treatment is best delayed until after growth is complete (typically mid-to-late teens) because the gum-to-tooth ratio can change naturally during growth. If a child has an underlying bite issue contributing to gum display, early orthodontic assessment may be appropriate to monitor the situation and plan intervention at the right time.

How much does it cost to fix a gummy smile in the UK?

Costs vary significantly depending on the treatment type and complexity. Clear aligners typically range from £1,500 to £5,500+, gum contouring from £200 to £1,000+ per arch, and Botox from £150 to £400 per session. These are approximate ranges — actual costs depend on your provider, location, and individual case. Always ask for a detailed breakdown of what's included before committing.

Do I need aligners AND gum contouring?

Not necessarily — it depends on the cause of your gummy smile. If tooth position is the only issue, aligners alone may be sufficient. If excess gum tissue is the only issue, gum contouring alone may be the answer. If both factors contribute, a combination approach often achieves a better result than either treatment alone. Your clinician can advise on the best approach after a proper assessment.

Can a gummy smile affect my oral health?

A gummy smile is primarily a cosmetic concern and doesn't usually affect oral health directly. However, the underlying causes — such as a deep overbite or misaligned teeth — can have implications for tooth wear, jaw comfort, and hygiene. Addressing the alignment or bite issue with orthodontic treatment may provide both cosmetic and functional benefits.

Disclaimer: This article is for general information only and does not constitute dental or medical advice. Treatment needs, timelines, and costs vary by individual case. All cost figures are approximate UK ranges for reference and are not quotations. A gummy smile can have multiple causes, and treatment suitability can only be determined through an in-person clinical assessment by a GDC-registered dental professional. ProAligners provides clear aligner treatment — other gummy smile treatments mentioned in this article may be provided by other specialists.