Gum contouring is the reshaping of the gum line to alter how much tooth shows when a person smiles. It addresses one of the most common cosmetic concerns we see, which is teeth that look short or uneven because of where the gum sits.
For some patients, the difference is significant. For others, the gum isn’t actually the problem and contouring won’t fix what they thought it would. The first part of any consultation involves working out which group you’re in. Our gum care team in Essex will tell you honestly.
What gum contouring is, and isn’t
Gum contouring (sometimes called gingival recontouring or aesthetic crown lengthening) is a minor procedure that removes a small amount of gum tissue, and occasionally a small amount of underlying bone, to expose more of the natural tooth.
It’s appropriate for what’s called a “gummy smile”, where more than around 3mm of gum shows above the upper teeth at full smile, or for cases where the gum heights are uneven across the front teeth.
It isn’t a treatment for receding gums (which is the opposite problem), and it isn’t usually a fix for teeth that genuinely are too short due to wear or grinding. Those situations need different approaches.
The diagnosis matters more than the technique
A gummy smile can be caused by several different things, and the cause determines whether contouring will actually help.
| Cause | What’s happening | Is contouring suitable? |
|---|---|---|
| Altered passive eruption | Gum tissue covers more of the tooth than it should | Yes, contouring works well |
| Vertical maxillary excess | Upper jaw is positioned too low | No, requires orthognathic input |
| Hyperactive upper lip | Lip lifts excessively when smiling | Sometimes; lip stabilisation may be considered |
| Tooth wear | Teeth genuinely shorter due to grinding or attrition | No, contouring would worsen it; restoration needed |
| Uneven gum heights | Tissue varies between adjacent teeth | Yes, contouring evens them out well |
That table is the conversation we have at the consultation. We measure the lip line, the gum heights tooth by tooth, and the tooth proportions, then work out where the issue actually sits. It’s rarely just one factor. Usually it’s a mix.
How the procedure is carried out
Gum contouring can be done with a soft tissue laser, a high-frequency electrosurgery unit, or a conventional scalpel and surgical blade. All three are valid. The choice depends on the case and on what equipment the clinician is most experienced with.
Local anaesthetic is given to numb the area. The new gum line is marked out using a periodontal probe, taking into account the biological width (the band of tissue that needs to remain attached to the bone for stability). The excess tissue is then removed and the gum is shaped to follow the new contour.
If bone needs to be reduced as well, which is the case in around half the situations we see, that’s done through small access points and adds about fifteen minutes to the appointment.
The whole procedure usually takes between thirty and ninety minutes depending on how many teeth are involved. Most cosmetic contouring covers the upper six or eight teeth.
What recovery looks like
The first 24 hours involve some swelling and tenderness. Most patients manage with paracetamol or ibuprofen. We give you a chlorhexidine mouthwash to use twice daily for the first week, which keeps the surgical sites clean while normal brushing is uncomfortable.
The gum tissue takes around six to eight weeks to fully settle into its new shape. The early appearance, in the first two weeks, isn’t the final appearance. Patients sometimes panic at the two-week mark because things still look a bit raw.
By eight weeks, the contour has stabilised and the colour matches the rest of the gum tissue.
How long the result lasts
Properly done, gum contouring is permanent. The tissue doesn’t grow back to its original position. That said, gum tissue can recede later in life from other causes (aggressive brushing, periodontal disease, ageing), and that recession can occur whether or not contouring has been carried out.
For someone with healthy gums and a sensible cleaning routine, the result holds for decades. It’s not a quick procedure that needs redoing every few years. One round, properly executed, lasts.
Combining contouring with other treatments
A significant proportion of contouring cases happen alongside other cosmetic treatment, particularly veneers or bonding. The reason is straightforward: if the underlying tooth proportions are wrong, no veneer will look right until the gum line has been corrected first.
The usual sequence is contouring first, eight to twelve weeks of healing, then the restorative work. Skipping the wait is tempting but produces compromised aesthetics, because the gum continues to settle slightly during the healing window and the final tissue position can shift the visible margin of any veneer.
In our experience, patients who push to combine procedures into one visit are the ones who end up disappointed with the final result. The wait is worth it.
Risks and complications
Most patients heal without issue. The recognised risks are worth knowing about:
- Post-operative sensitivity, usually mild and short-lived
- Slight asymmetry in the final result, which sometimes needs a minor refinement appointment
- Recurrence of tissue overgrowth in patients with certain inflammatory conditions
- Black triangles appearing between teeth where the contour exposes wider interdental spaces
- Infection, which is rare and usually responds to a short course of antibiotics
The black triangle issue is the one we discuss at length at the consultation, because it’s the most common source of post-procedure dissatisfaction. If the tooth shapes are likely to produce noticeable triangles, we’d flag it before the procedure rather than after. The General Dental Council’s standards on consent require this kind of upfront discussion, and it’s a sensible standard regardless. More on what good informed consent looks like is available through the GDC standards for the dental team.
Who isn’t suitable
Some patients aren’t candidates. Active gum disease has to be treated and stabilised first. Patients on certain medications affecting gum tissue (some calcium channel blockers, ciclosporin, phenytoin) need special consideration. Patients with very thin biological width may need a different approach involving more bone reduction.
And anyone whose gummy smile is caused by skeletal factors rather than gum tissue position. Contouring won’t fix that, and we’d say so at the consultation. Honesty at the start saves disappointment later.
Booking a consultation
The consultation is the only way to know whether contouring is the right approach for your specific situation. We take photographs, measure the relevant landmarks, and discuss what’s realistically achievable before any treatment is planned. To book with us at Westcliff Dental Practice in Westcliff-on-Sea, call 01702 344 500 and our team will arrange a time that suits.
