Two concerns bring most aesthetic consultations to us: too much gum showing when smiling, and teeth that have gone darker over the years. Both are treatable, but both have several possible causes — and the cause dictates the treatment. Getting that diagnosis right is what separates a result that holds from money spent on the wrong procedure.
A gummy smile has more than one cause
A smile is usually described as gummy when more than about three millimetres of gum shows above the upper teeth. Why that happens varies.
Excess gum tissue covering part of the tooth is the most straightforward cause. The teeth are of normal length but partly hidden, so they appear short and square. Correction involves reshaping the gum line and, where needed, the underlying bone, to expose the natural tooth. This is a predictable in-clinic procedure.
A hypermobile upper lip — a lip that rises further than average when smiling — exposes more gum despite normal gum and tooth proportions. Treatment here addresses the lip, not the gums, and removing gum tissue would be the wrong answer entirely.
Short or worn teeth create the same visual effect from the opposite direction. If enamel has worn down through grinding or acid erosion, the teeth are genuinely shorter and the gum-to-tooth ratio shifts. Restoring tooth length with bonding or veneers corrects the proportion.
Skeletal causes — where the upper jaw has developed with excess vertical height — are a different category. Dental treatment can improve the appearance to a degree, but a genuinely skeletal case may need orthodontic or surgical input, and it is more honest to say so than to promise a result that dentistry alone cannot deliver.
Four causes, four different treatments. This is precisely why a photograph is not enough to plan from.
Discolouration: surface versus internal
The distinction that matters most is where the colour actually sits.
Extrinsic staining sits on the outside of the enamel, deposited by tea, coffee, tobacco, paan, supari and dark spices. It responds well to scaling and polishing, and then to professional whitening. Our scaling and polishing sits at PKR 4,000 – 8,000 and in-office whitening at PKR 18,000 – 30,000.
Intrinsic discolouration is within the tooth structure itself. Causes include tetracycline exposure during tooth development, fluorosis, trauma that has darkened a single tooth, and the natural yellowing of dentine as enamel thins with age.
Whitening has limited or no effect on intrinsic discolouration. This is the most common disappointment in aesthetic dentistry — a patient pays for whitening, sees minimal change, and concludes it failed. It did not fail; it was the wrong treatment for that type of staining. Intrinsic cases are addressed with composite bonding or veneers, which cover rather than lighten.
What whitening will not change
Existing dental work does not whiten. Crowns, veneers, composite fillings and bridges keep the shade they were made in.
This has a practical consequence for anyone with visible restorations on the front teeth. If you whiten your natural teeth, old fillings that previously matched will suddenly stand out. The correct sequence is to whiten first, let the shade stabilise, and then replace those restorations to match the new colour. Doing it the other way round means paying for the same restorations twice.
Sensitivity and safety
Whitening commonly causes short-lived sensitivity to cold. It settles within a few days and is managed with a desensitising toothpaste.
Over-the-counter kits and salon whitening are worth a caution. Gels applied without a fitted tray leak onto the gums and cause chemical burns, and unregulated concentrations can damage enamel. Whitening should be done with custom trays and clinical supervision, and it should not be done at all over untreated decay or active gum disease — the material reaching exposed dentine or inflamed tissue is genuinely painful.
Health comes before appearance
Every aesthetic plan we make starts with an examination of gum health, decay and bite. Veneers bonded over inflamed gums, or whitening applied over untreated cavities, produce a poor result and sometimes a painful one.
If scaling or fillings are recommended before the cosmetic work, it is because the aesthetic result depends on that foundation.
A realistic conversation
We will tell you what your particular cause responds to, roughly how long it takes, what it costs, and where the honest limits sit. Where a case needs orthodontic or surgical input beyond what we provide, we will say so rather than offer a partial fix.
Our consultation is PKR 2,000 – 3,500 and includes a full smile assessment with the options written down, so you can consider them without pressure. Results vary between individuals, and nothing in this article should be read as a guarantee of a particular outcome — an in-person examination is what makes a plan real.
Habib Dental & Aesthetic Clinic operates in strict compliance with the Pakistan Medical & Dental Council (PMDC) Code of Ethics. Information on this website is for educational purposes and does not constitute a guaranteed clinical diagnosis or promise of identical results. Treatment plans require an in-person clinical examination.
