It is well understood that “Beauty lies in the Eyes of the Beholder”. Gummy smile is not a medical problem as much as it is a personal issue of concern to some people, while it may not be of any concern to others. It appears on an individual when a person smiles and a large portion of the gums can be seen. An ideal smile will only have 2 millimeters of gum showing with the upper lip sitting just above the top teeth. Individuals that have 3-4 millimeters showing appear to have a gummy smile. There are several causes of having a gummy smile ;

• An overactive “hypermobile” upper lip- causes a gummy smile when the lip moves too much.
• A short thin upper lip- A short upper lip will not cover the upper teeth and the gingiva.
• Vertical maxillary excess VME- This happens when there is an overgrowth of the upper jaw
• Wear of teeth and compensatory eruption
• An excessive overbite (anterior over-eruption)
• Altered passive eruption- This happens when the teeth do not make it fully out of the gums.
• Altered active eruption- This happens when the teeth do not make it fully out of the bone.

Muscle relaxants (Botox anti-wrinkle injections) are the simplest gummy smile treatment option when the issue is related to overactive muscles surrounding the lips. When injected into the right area, they temporarily weaken the muscle, which lifts the lip too high, with the results lasting approximately 6 months. It is however proven, that once the procedure is performed at young ages and repeated few times, a neuromuscular adaption to the new lip position often happens eliminating the need for constant botox injection repetition.

You should think that botox use is the least invasive yet a short-term solution for a gummy smile management. There are many causes for a gummy smile and provided that the cause is an overactive upper lip muscle and/or an overextended upper jaw bones, botox use is very beneficial in such conditions and is in fact be the only non-surgical approach to the case management. Botox temporarily paralyzes the elevator muscles inside your upper lip to prevent those muscles from significantly lifting your upper lip to expose excessive amounts of gum tissue. Botox is not usually a permanent solution for a gummy smile , but usually requires repeated injections over time. Botox is also a good way to get a sneak preview of the results of other surgical procedures such as lip repositioning surgery.



Depending on the extent of the gums exposed, we will decide on the dosage of muscle relaxant required. The injections are then placed on both sides of the nose, to affect the muscles that move the lip. These muscles will be prevented from contracting as significantly, which causes the upper lip to relax and extend over the excess gum that shows when you smile.

Some patients may experience a slight sting during the injection, which is very mild and only lasts a couple of seconds. The skin may be red or bleed immediately afterwards, followed by a tingling or itching sensation for several minutes. Results will usually take several days to begin taking effect, with the full outcome taking up to 2 weeks to be completely evident. A review appointment is recommended at this stage to determine if another dose will be necessary to increase the effects.