Yes: for gummy smiles caused mainly by overactive upper-lip muscles, Botox (botulinum toxin A) can reduce gum show quickly and without surgery. It will not correct a gummy smile caused by jaw structure or tooth position, so an accurate diagnosis matters first. Most patients see change within 1 to 2 weeks, with results lasting several months before a touch-up is needed.
TL;DR:
- Gum show during smiling suggests a muscle cause, but a provider should assess lip movement and rule out jaw, tooth, or gum issues.
- Providers often start with 2 to 2.5 units per side and reassess after two weeks; dosing units differ across toxin products.
- Research reports 3 to 5 millimeters less gum show within two weeks; results typically last 3 to 6 months, often fading around month four.
- Avoid rubbing the injection area and strenuous exercise for 24 hours, and seek urgent care for trouble swallowing, speaking, or breathing.
Table of Contents
- What causes a gummy smile and how to tell if yours is muscle-driven
- How botulinum toxin A reduces a gummy smile
- Typical dosing and injection technique in practice
- How much improvement to expect and how long it lasts
- Safety, side effects, and who should avoid treatment
- What to expect during the appointment and afterward
- Choosing Botox versus orthodontic or surgical correction
- Why our team's approach to Botox for gummy smile stands out
- A measured approach to treating gummy smiles
- Book a Botox consultation for your gummy smile
- FAQ
- Sources
What causes a gummy smile and how to tell if yours is muscle-driven
A gummy smile has several possible origins, and only one of them responds to Botox.
- Hyperactive upper-lip elevator muscles that pull the lip higher than it needs to go.
- Vertical maxillary excess, where the upper jaw itself is too long.
- Altered passive eruption, where gum tissue covers more of the tooth than it should.
- A naturally short upper lip.
- Tooth overeruption, where teeth have shifted further out of the gum line than normal.
The clearest clue is the difference between dynamic and static gum show: if your gums are hidden at rest but reveal several millimeters only when you smile broadly, the lip muscles are likely doing the work. A dentist or oral health provider can measure this gum display in millimeters and watch your lip movement to confirm the pattern, and cases involving jaw structure or tooth position usually call for an orthodontic or imaging evaluation before any injection is considered.
How botulinum toxin A reduces a gummy smile
Botulinum toxin A works by temporarily blocking the signal between nerve endings and the muscle, which weakens the targeted muscle's pull without removing tissue or altering bone. For a gummy smile, the muscles in question are the levator labii superioris alaeque nasi (LLSAN), the levator labii superioris (LLS), and sometimes the zygomaticus minor, all of which lift the upper lip when you smile. Weakening these muscles slightly keeps the lip from rising as high, which covers more of the gum line during a smile.
Because these muscles sit close together and near others involved in lip movement and speech, precise placement matters. Careful, conservative dosing limits diffusion into neighboring muscles, which is part of why providers favor small, targeted injections over broader treatment in this area.
Typical dosing and injection technique in practice
Dosing for gummy smile treatment tends to be conservative compared with other facial areas, since the goal is a subtle lift reduction rather than full paralysis.
- A commonly used starting dose is 2 to 2.5 units per side, with adjustments based on how much gum is showing.
- Some clinicians tie dosing to the millimeters of gum display measured at the first visit, using small, incremental amounts rather than a fixed dose for everyone.
- Providers choose between a single-point technique, often called the Yonsei point, and a multi-point approach depending on lip anatomy and muscle activity.
One widely cited clinical approach is to begin with a conservative small dose per side and reassess results at a 2-week follow-up before deciding whether more is needed. This start-low-and-titrate method helps avoid an uneven smile or unwanted lip weakness. Dosing units are not interchangeable between different botulinum toxin products, so any plan should be personalized by the treating provider rather than copied from another patient's protocol.
How much improvement to expect and how long it lasts
Botox for gummy smile produces measurable, well-documented change, though the effect is temporary rather than permanent.
A meta-analysis found an average gingival display reduction of about −3.22 millimeters at two weeks, with a still-significant reduction of roughly −2.24 to −2.70 millimeters remaining at three months. Separate clinical research reports similar outcomes, with reductions of about 3 to 5 millimeters visible within roughly two weeks of injection. Onset typically begins within 1 to 2 weeks, and the effect generally lasts 3 to 6 months, though many patients see gum show begin returning toward baseline by around 4 months. Because muscle activity and anatomy vary from person to person, some people need a touch-up sooner and others later, and repeat treatment is expected as part of maintaining results rather than a sign the first treatment failed.
Safety, side effects, and who should avoid treatment
Botox for gummy smile is generally well tolerated when dosed conservatively and injected by a trained provider, but it carries the same safety profile as botulinum toxin use elsewhere on the face.
- Common, temporary effects include mild bruising, swelling, or slight asymmetry in the smile.
- Less commonly, patients notice mild weakness when pursing the lips or forming certain sounds while the toxin is active.
- Rare but serious effects involve the toxin spreading beyond the injection site, which can affect swallowing or breathing.
The prescribing information for BOTOX Cosmetic advises patients to seek immediate medical attention if they experience difficulty swallowing, speaking, or breathing after treatment, even though these events are rare at recommended doses. Treatment is generally avoided in cases of known hypersensitivity to the toxin or active infection at the injection site, and anyone with a neuromuscular condition or who takes medications that affect muscle function should mention this at consultation.
Pro Tip: Bring a list of your current medications and any past reactions to injectables to your consultation so your provider can screen for interactions before treatment.
What to expect during the appointment and afterward
A Botox appointment for gummy smile correction is brief and requires little preparation.
- Your provider examines your smile, measures gingival display, and confirms the cause is muscle-driven.
- Injection sites are marked based on your lip anatomy, often including the Yonsei point or a small number of additional points.
- The injections themselves take only a few minutes and feel similar to a quick pinch.
- You receive aftercare instructions before leaving the office.
Afterward, avoid rubbing or massaging the treated area and skip strenuous exercise for about 24 hours to limit the toxin spreading beyond the target muscles; for additional non-invasive skin adjuncts and facial techniques, consider learning more about safe methods like gua sha. Visible change usually starts within the first 1 to 2 weeks, which is also when most providers schedule a follow-up to check results and decide whether a small touch-up dose is needed. The entire visit, including consultation, typically takes well under an hour, with no meaningful downtime afterward.
Choosing Botox versus orthodontic or surgical correction
The right treatment depends on what is driving the gummy smile and how much correction you need. Mild to moderate cases caused by hyperactive lip muscles respond well to Botox, which offers a reversible, low-commitment way to test whether reducing lip lift improves your smile before considering anything permanent. Cases rooted in jaw structure, altered gum eruption, or tooth position generally need orthodontic treatment, gum contouring, or surgical correction, since Botox cannot change bone or gum tissue position. For readers already weighing orthodontic adjustments or restorative work alongside a gummy smile concern, Botox can serve as a useful diagnostic trial while your care team evaluates whether a structural approach is warranted for lasting correction.
Why our team's approach to Botox for gummy smile stands out
We offer Botox in-house for cosmetic and therapeutic use, alongside same-day emergency appointments and a full range of general, cosmetic, and surgical dental services under one roof. Our approach to gummy smile cases follows the same measurement-first process described above, including prior clinical experience administering neuromodulators for dental indications like jaw tension. Kayle covers Botox, cosmetic dentistry, and smile correction topics for our blog, drawing on published clinical research to keep this guidance current. If you want a tailored assessment of your own smile, a consultation is the next step.
A measured approach to treating gummy smiles
In practice, the gummy smiles that respond best to Botox are the ones where measurement, not guesswork, guides the plan: how many millimeters of gum show, how the lip moves, and how much correction the muscle anatomy allows. We favor starting conservatively and reassessing at the two-week mark rather than chasing a dramatic change in one visit, because a slightly under-treated smile is easy to adjust and an over-treated one is not. That caution, paired with a proper diagnosis of the underlying cause, is what makes this a safe option worth discussing at a consultation.
— Kayle
Book a Botox consultation for your gummy smile
We provide Botox for gummy smile correction as part of our cosmetic dentistry services, alongside emergency appointments for urgent dental needs. A smile consultation is the starting point for any gummy smile case, since it confirms whether your gum show is muscle-driven before any injection is planned.
- Schedule a consultation to measure your gum display and discuss whether Botox fits your case.
- Ask about combining Botox with other cosmetic treatments if a structural cause is also present.
- Visit our services page to see our full range of cosmetic and general dental care and book an appointment.
This article is general information, not a substitute for advice from a qualified doctor. Consult a qualified healthcare professional about your own circumstances before acting on anything here.
FAQ
Can you fix a gummy smile with Botox?
Botox can reduce a gummy smile when the cause is overactive upper-lip muscles, typically producing visible improvement within about two weeks. It does not correct gummy smiles caused by jaw structure, tooth position, or gum tissue overlap, so a clinical exam should confirm the cause first.
How long will gummy smile Botox last?
Results generally last 3 to 6 months, with many patients seeing gum show gradually return toward baseline by around the four-month mark. Repeat treatment is standard for maintaining results rather than a sign the first round of Botox failed.
How much does it cost to get Botox for a gummy smile?
Pricing for Botox varies by provider and by how many units your case requires, so an exact cost depends on your consultation and treatment plan. We list Botox as part of our in-house services, with pricing provided on request after an assessment.
How many units of Botox are needed for a gummy smile?
Many providers start with a conservative dose of about 2 to 2.5 units per side, then reassess at a two-week follow-up before adjusting further. Exact dosing depends on your muscle activity and how many millimeters of gum show your provider measures at your first visit.
Sources
- Clinical study and follow-up on BTX-A for gummy smile
- Systematic review of treatments including BTX-A (J Clin Med)
- BOTOX Cosmetic prescribing information (highlights)