Gummy Smile Botox: How Much Less Gum Shows?
Botox for a gummy smile relaxes the muscles that pull your upper lip too high. Here's how much gum display usually drops, how long it lasts, and which causes it can't fix.
Botox for a gummy smile reduces how much gum shows when the cause is an upper-lip muscle that pulls too high. A meta-analysis pooling 17 studies found gum display dropped by an average of 3.42 mm two weeks after the injection. The effect held for at least 12 weeks and drifted back close to where it started by around 24 weeks.
That same smile can have a different cause, though. If gum tissue covers part of your teeth or your upper jaw grew longer than usual, Botox moves the needle far less. So before anyone talks about units, it's worth figuring out why your gums show in the first place. In this article, we'll walk through the three causes, a simple mirror check, how much change to expect and for how long, the side effects people worry about most, and what to bring to a consultation at Beautystone, a dermatology clinic in the Hongdae–Hapjeong area of Seoul. This article introduces a treatment offered at the clinic.
Why Your Gums Show: Three Different Causes
Showing about 1 to 2 mm of gum when you smile falls within the natural range. Once it goes past roughly 3 mm, it's usually called a gummy smile, or excessive gingival display. A systematic review of orthodontic and surgical treatments describes the cause as skeletal, dental, or muscular, and often a combination of these.
- Muscle: When you smile, the upper lip normally rises about 6 to 8 mm. With overactive lip elevator muscles, it can rise more than 10 mm and expose the gums.
- Teeth and gums: A front tooth crown is typically 10 to 12 mm long. When the gum doesn't recede fully after the teeth come in, it can cover 2 to 3 mm or more, so the teeth look short.
- Bone: When the upper jaw has grown downward more than usual, people often show more than 5 to 7 mm of gum.
Botox can only change the first one. Three thin muscles that lift the upper lip meet at a point beside the nostril, and most studies place the injection at that meeting point to soften how high the lip pulls. It doesn't move bone and it doesn't change how much gum sits on your teeth.
A Mirror Check Before You Book
You can get a rough idea of which cause applies to you at home. Take a front-facing photo while smiling widely, and instead of measuring millimeters, look at what stands out.
| What you notice in the mirror | Cause to consider first |
|---|---|
| Your teeth look normal in length, but your upper lip curls up unusually high when you smile | Muscle, which makes you a likely Botox candidate |
| Your front teeth look short and square, and the gum line sits low over them | Gum tissue covering the teeth, so a dental assessment comes first |
| The lower third of your face looks long, and even a small smile shows a wide band of gum | Upper jaw bone, so an orthodontic or surgical consultation comes first |
Many people have a mix. In that case, it helps to find out how much of the gum display comes from the muscle. A systematic review in the dental literature notes that botulinum toxin can serve as a diagnostic tool and an add-on to other treatments, not only as a treatment on its own. Whatever shrinks after Botox is the muscle's share. Whatever remains comes from the gums or the jaw.
How Much Less Gum, and for How Long
The effect peaks two to four weeks after the injection. A systematic review of 13 prospective controlled trials reported starting gum display of 3.5 to 6.8 mm, which in most studies dropped to 3 mm or less, with effects lasting 12 to 24 weeks. The dose is matched to how much gum shows. In another systematic review and meta-analysis, the included studies used 1.25 to 7.5 units per side.
Compared with untreated control groups, that meta-analysis found gum display was about 2.51 mm lower at two weeks and about 2.24 mm lower at three months. Most of the change was still there at three months, but it does fade gradually. The meta-analysis of 17 studies mentioned above found the strongest results in gummy smiles of up to about 4 mm.
The area around the mouth moves constantly when you talk, eat, and smile. The same review notes that Botox may wear off faster here than in less mobile areas like the upper face. If you're planning around a wedding or photos, booking two to four weeks before the date is the simplest way to line up the peak.
Side Effects and Risks: Will My Smile Look Odd?
The common reactions are soreness at the injection site, mild swelling, bruising, and slight redness. An uneven smile, where one side lifts differently from the other, has also been reported. The meta-analysis stresses that anatomy such as upper-lip length should be assessed before treatment to avoid complications.
A little asymmetry is often there before any treatment. That's why Beautystone takes separate photos of a wide smile and a slight smile, measures how much gum shows on each side, and splits the units differently if one side lifts higher. Because the muscle recovers over time, the smile returns to its original shape as the effect wears off. Starting with a smaller dose and comparing photos at about two weeks is the safer way to begin.
The U.S. National Library of Medicine's drug information page for incobotulinumtoxinA asks patients to tell their doctor before treatment in these situations:
- You're pregnant, planning a pregnancy, or breastfeeding
- You have a condition that affects muscles or nerves, such as myasthenia gravis
- You've had a side effect from a botulinum toxin product before
- There's an infection at the planned injection site
It's rare, but if you develop trouble swallowing or breathing, or your speech becomes slurred in the days after treatment, don't wait it out. Get medical care right away. The same drug information warns that these symptoms can happen if the toxin spreads beyond the injection area.
What to Bring to Your Consultation
The first decision in this treatment is whether your gums show because of the muscle, your teeth, or your jaw. If you reach out before your visit, sending a few things ahead makes that call faster.
- Two front-facing photos in the same lighting: one wide smile and one slight smile
- Whether you're in orthodontic treatment or planning work on your front teeth
- When you last had Botox around the mouth, if ever, and what changed at the time
Once the cause is clear, the plan usually becomes simple: a measured first dose for a muscle-driven smile, or a referral to a dentist when the gums or jaw are doing most of the work.
The Bottom Line
Gummy smile Botox is a good fit when an overactive lip muscle is the main reason your gums show. It typically lowers gum display within two weeks, and the effect fades over roughly three to six months. If your front teeth look short or your lower face is long, a dental or orthodontic opinion should come first. Your own smiling photos are the easiest place to start that conversation.
Frequently Asked Questions
Q. Does one round of Botox reduce a gummy smile permanently?
A. No. As the lip muscles regain their strength, gum display gradually returns to its usual level, so keeping the effect means repeat treatment. When the cause is the upper jaw itself, the systematic review of orthodontic and surgical options lists jaw surgery as the approach with the most lasting results.
Q. It seems to wear off faster than my forehead Botox. Is that resistance?
A. Not necessarily. The muscles around the mouth move every time you speak, eat, or smile, and reviews note that the effect may be shorter in this area. True resistance is a separate question, so it's worth mentioning your past injection dates and how long each lasted.
Q. Can filler reduce a gummy smile instead?
A. A small study compared hyaluronic acid filler with Botox for this, but it only included 14 patients, so it can't settle which works better. Filler stays where it's placed, so many people start with Botox, which wears off, to see how much of the gum display is muscle-related.
Q. When should I come back to check the result?
A. Around two weeks after the injection is a good time, since the effect is close to its peak. Retake your photos in the same lighting and with the same expression to see whether any difference between the two sides remains.
