A smile that shows a wide band of gum can be charming on some faces and distracting on others. If you are self-conscious about a gummy smile, you are not alone. In facial aesthetics and cosmetic dentistry, gummy smile correction is one of the most frequent cross-disciplinary conversations I have with patients. The right plan depends on why your gums show, how much they show, and what you want out of treatment in terms of permanence, cost, maintenance, and risk. Botox can help in the right cases. So can dental and surgical options. The art lies in matching the cause to the correction and setting expectations with precision.
What “gummy” really means
Clinically, a smile is often labeled “gummy” when more than 2 to 3 https://www.youtube.com/channel/UCi60gNLWbMzJaeY9sOqewhQ millimeters of gingival tissue shows above the upper front teeth during a full smile. That number is not a hard rule. Lip length, tooth size, skeletal proportions, and the amount your upper lip elevates when you laugh all change the perception. Some people show 4 millimeters of gum and look radiant. Others feel overexposed with less. What matters is the blend of teeth, gums, and lips on your face.
Several mechanisms can cause excess gingival display:
- Hyperactive upper lip elevators. The muscles that lift your upper lip, including the levator labii superioris alaeque nasi and its neighbors, might pull higher than average. The teeth and gums are normal, the lip just lifts more. Short or thin upper lip. Even average muscle activity can reveal more gum if the lip is short. Altered passive eruption. The gums never receded to their mature position during development, leaving more gum covering the crowns of the teeth. Vertical maxillary excess. The upper jaw is vertically long, often visible as a longer lower third of the face and sometimes a gummy smile even at rest. Tooth wear and compensatory eruption. Shorter teeth from wear can look stubby, and the gums may appear dominant. Orthodontic factors. Proclined upper incisors or malocclusion can tip the balance.
Pinpointing which of these applies changes the conversation dramatically. A hyperactive lip behaves differently than a long upper jaw. Botox treats muscle activity, not bone length or gum position. Crown lengthening or orthodontics changes the architecture, not muscle pull. Sometimes we combine approaches.
When Botox makes sense for a gummy smile
Botox, or Botulinum toxin type A, reduces muscle activity temporarily. It is not a filler. It does not change gum tissue or tooth length. It softens the elevator muscles that pull the upper lip too far upward. In practice, precise placement into the “Yonsei point” region on each side, near the muscles that over-lift the lip, can lower the lip’s elevation by a couple of millimeters during a smile. That often makes the difference between “gummy” and harmonious.
The ideal Botox candidate has normal tooth size, normal gum margins, and a gummy smile driven primarily by hyperactive lip elevators. If you show 3 to 5 millimeters of extra gum from muscle pull alone, Botox can work well. If your gum display comes from vertical maxillary excess of 6 millimeters or more, the improvement from Botox may be modest. I always test this by asking patients to relax the upper lip while smiling, or I manually support the lip during a smile in front of a mirror. If that “mock” relaxation corrects the gummy show to your liking, neuromodulation is promising.
Technique, dose, and what it feels like
In experienced hands, injections take a few minutes. We typically use 2 to 4 small injection sites around the central elevator complex and often just lateral to the nostrils. Dose ranges vary, but for a first treatment I start conservatively, often 2 to 4 units per point of onabotulinumtoxinA. I would rather under-treat and adjust at a two-week follow-up than over-relax and risk a smile that feels heavy. Some clinicians add a tiny dose at the orbicularis oris if lip inversion or “bunny lines” complicate the picture, but that is case-specific.
Discomfort is brief and minimal. Most people liken it to a few pinpricks. You can return to work the same day. Avoid vigorous facial massage, heavy workouts, or saunas for the first 24 hours to reduce migration risk.
Onset begins within 3 to 5 days, with full effect at about two weeks. Results typically last 8 to 12 weeks for this area. Over time, some notice a slightly longer duration, but you should plan on maintenance every 3 to 4 months if you want to keep the effect.
Risks and trade-offs
The most common issues are mild bruising, swelling, or a day or two of tenderness. The bigger concern is over-relaxation that makes the upper lip feel heavy. You might notice a slight change in diction on certain words, or a flatter smile. This is temporary, though it can feel awkward for a month if it happens. To minimize this, precision matters. I tailor doses to your anatomy, start low, and reassess once the full effect declares itself.
If you have concurrent goals like Botox for forehead lines, crow’s feet, frown lines, bunny lines, a conservative approach lets us understand how each area affects your smile dynamics. Combining treatments can be done safely, but coordination is key so you do not trade one concern for another. People seeking botoxinjections for masseter reduction or a brow lift sometimes do not realize how these changes can alter the perceived proportions of the midface. The smile needs to be considered in that bigger frame.
Cost and access
Botoxcost varies by region and clinic. In major metro areas, expect a gummy smile treatment to range from 50 to 250 dollars per session if charged by area, or 10 to 20 dollars per unit if charged by unit. Total units for a gummy smile are often in the single digits to low teens. If you are searching botoxnearme, prioritize a clinician who treats gummy smiles routinely, not just foreheadlines or crow’s feet. Technical skill and aesthetic judgment matter more than price per unit.
When dental or surgical options are better
When your gummy smile stems from tooth and gum proportions or skeletal length, Botox is a band-aid at best. A robust evaluation with a dentist who understands esthetics, or a team that includes an orthodontist and a maxillofacial surgeon, can change the trajectory.
Altered passive eruption and crown lengthening
If your teeth look short and square, and the gumline sits too far down the tooth, you might have altered passive eruption. Here, the problem is not muscle activity but excess gum covering the anatomic crowns. Aesthetic crown lengthening reshapes the gum and sometimes the underlying bone to expose more tooth structure. The procedure is usually done under local anesthesia in one visit. Healing takes a few weeks, with the final gum position stable by about 6 to 12 weeks. Done well, the result looks natural and permanent.
A common pattern I see is someone in their twenties with 4 millimeters of gingival display and teeth that measure only 8 millimeters in visible height. After crown lengthening, visible tooth height might increase to 10 or 11 millimeters, which alone reduces the perception of gum and restores balanced proportions. If there is still a touch of over-elevation from the lip, a conservative botoxtreatment can finesse the last millimeter.
Orthodontics and bite-driven display
If protrusive upper incisors or a deep overbite contribute to your gummy smile, orthodontic treatment can intrude or reposition teeth to reduce gingival show. Clear aligners or braces can intrude anterior teeth by a millimeter or two in qualified cases. That does not sound like much, but in smile design, 1 to 2 millimeters can be transformative. This route takes months, sometimes a year or more, but it addresses the foundation rather than layering temporary solutions.
Vertical maxillary excess and orthognathic surgery
When the upper jaw is significantly long, no amount of lip relaxation will truly normalize the display. Patients often show gum even at rest. The face can appear elongated from the base of the nose to the chin. Orthognathic surgery shortens and repositions the upper jaw. This is a life-changing procedure for the right candidate, often paired with orthodontics. It comes with higher cost, more recovery, and real surgical risk. But for a skeletal issue, it is the only option that resets the system. A seasoned surgeon will guide you with imaging and simulation so you understand the gains and the commitment.
Lip repositioning surgery
This minor surgical option repositions and tethers the inner lip to limit elevation. It is less invasive than jaw surgery and more permanent than Botox. Results can soften with time, and recurrence can occur, especially in very strong lip elevators. In my experience, it works best for mild to moderate elevation without skeletal excess. Postoperative tightness lasts a few weeks, and meticulous suture technique helps avoid scarring that changes your smile’s character.
Matching the fix to the cause
Before choosing any path, a proper exam comes first. Photographs in rest and full smile, a mirror test to see how you feel when the lip is lightly supported, measurements of tooth height, and sometimes cephalometric imaging if skeletal imbalance is suspected. It is not uncommon for the correct plan to combine treatments. I might stage crown lengthening first, then reassess the smile before deciding whether to add Botoxforgummysmile. Or I might use Botox as a reversible trial to help someone visualize a less gummy smile before considering lip repositioning surgery.
I have seen clients arrive convinced they need surgery, only to find that a few carefully placed units of neuromodulator and some gingival recontouring solve 90 percent of the problem. I have also seen people cycle through monthly injections for years when their jaw proportions would be better served by orthodontics and surgery. The common thread is a diagnosis that starts with why the gums show, not just how to hide them.
What a Botox-first plan looks like
For a patient with hyperactive lip elevators and 3 to 4 millimeters of extra show, I map the muscles with palpation while the patient smiles and scrunches the nose. I mark two to four small sites, clean the area, then inject a conservative dose. I photograph before, at two weeks, and at three months. If the two-week result is slightly under-corrected, I add a touch more. If the smile looks perfect but feels too tight, we reduce the dose or skip the next session to let it fade.
With repeated treatments every 3 to 4 months, most people settle into a maintenance rhythm. The cost adds up over a year, which is worth comparing against a one-time periodontal or surgical solution if your cause is not purely muscular. This is where a frank conversation about botoxcost and long-term plans matters. Your comfort with ongoing maintenance versus something more definitive should drive the choice as much as the anatomy does.
Other Botox uses that may intersect your smile
People often arrive for Botoxforforeheadwrinkles, botoxforcrow’sfeet, or botoxforfrownlines and only later mention they dislike their gummy smile. Treating multiple areas can be done safely, but it requires a map of how each area interacts.
If you are considering botoxforbrowlift, understand that brow position can subtly alter midface perception. Botoxformasseterreduction or botoxforjawlineslimming changes the lower face width, which can make the midface seem longer or shorter by contrast. Botoxforchindimpling and botoxformarionettelines adjust lower lip dynamics, which can also shift attention upward during a smile. These are not reasons to avoid combination therapy, only reasons to choose a practitioner who balances the whole face.
None of this mentions the therapeutic uses, but they appear in many patient histories. Botoxformigraines, botoxforbruxism, botoxfortmj, and botoxforhyperhidrosis or botoxforexcessivesweating, including botoxforunderarmsweating, have no inherent conflict with gummy smile treatment. If anything, bruxism management and lower face relaxation can complement aesthetic changes. Just make sure dosing across all areas is coordinated. If you are on a complex schedule, keep one clinician in charge or ensure your providers share records.
Dental artistry matters as much as muscle relaxation
Even a perfectly modulated lip will not rescue a smile where the teeth are short, asymmetric, or worn flat. This is where a dentist with aesthetic training can make or break your outcome. If your enamel height is 8 to 9 millimeters where it should be 10 to 11, composite bonding or porcelain restorations can restore proper tooth proportions. If altered passive eruption hides enamel, crown lengthening can reveal the true tooth shape. If your incisal edges are uneven or chipped, a light touch with conservative restorations finishes what Botox started.
I have seen subtle changes transform not just the smile but the person’s comfort in front of a camera. For example, a 29-year-old professional with 4 millimeters of gingival show, altered passive eruption, and mild lip hyperactivity chose staged care. First, a periodontal specialist performed crown lengthening in the anterior sextant, which increased visible tooth height by roughly 2 millimeters. After healing, we added 6 units of neuromodulator across the elevator complex. Her smile moved from overly gummy to balanced, and the teeth—finally visible—carried the expression. Two years later, she maintains with a small touch-up every 4 months and has not needed further gum work.
Safety profile and realistic expectations
Botox carries an excellent safety record when administered correctly. Allergic reactions are exceedingly rare. The main risks are localized and temporary: bruising, mild swelling, headache, and, in this application, over-relaxation of the upper lip. Asymmetry can occur if one side takes more than the other, which is one reason follow-up photos matter. If you are on blood thinners, bruising risk is higher. If you are pregnant or nursing, postpone treatment. If you have a neuromuscular disorder, discuss risks with your physician before proceeding.
What Botox will not do: it will not lengthen teeth, recontour bone, fix a long upper jaw, or change your lip length. It will not permanently train your muscles. The effect fades predictably. If you expect permanence, look to periodontal or surgical options. If you prefer to try a reversible change that you can dial up or down, Botox is a good tool.
Cost comparisons and planning
A single gummy smile Botox session is usually less than a dental or surgical procedure, which is why many people try it first. Over a year, though, maintenance can match or exceed minor gum surgery depending on fees in your area. Aesthetic crown lengthening for the front six teeth might range from moderate to higher four figures depending on complexity and whether bone recontouring is needed. Orthognathic surgery combined with orthodontics moves into the five-figure space and requires months of commitment. botox near me Your decision should weigh not only dollars but also time, permanence, and your tolerance for change.
When patients search botoxnearme and compare clinics, I advise two questions: How many gummy smile cases do you treat monthly, and can I see before-and-after photos with similar anatomy to mine? For dental options, ask to review mock-ups or digital smile designs so you can preview proportions. If a provider cannot show work or explain why your gums show, keep looking.
The role of subtlety
With gummy smile treatments, subtle changes read naturally. Over-correction draws a different kind of attention. If 3 millimeters of gum show at baseline, lowering exposure by 2 millimeters often looks ideal while still allowing tooth show and lip mobility. Completely eliminating gingival display can make the upper lip feel static, which some find unnatural. The goal is balance, not maximal reduction.
This principle applies across aesthetic uses. Botoxforwrinkles, botoxforforeheadwrinkles, botoxforcrow’sfeet, or botoxforbrowlift all benefit from measured dosing and staged adjustments. The same restraint keeps botoxforbunnylines or botoxforliplines from stiffening your expressions. If you also seek botoxfornecklines or botoxforplatysmalbands, be mindful that the neck and lower face interact visually with the smile. Small, iterative steps make it easier to steer to the sweet spot.
A simple way to preview your result
Try the mirror test. Smile as you usually do, then place a clean finger gently under your nose where the philtrum meets the base of the nose and decrease the lip’s lift by a couple of millimeters. If that looks like your target, Botoxforgummysmile can likely get you there. If that still shows more gum than you want, or if relaxing the lip throws off the proportion of tooth to lip, you likely need dental work, orthodontics, or surgical planning to reach your goal.
A brief comparison to help you decide
- Botox for gummy smile: best for hyperactive lip elevators. Fast, reversible, low downtime, modest cost per session, ongoing maintenance every 3 to 4 months. Crown lengthening: best for altered passive eruption or short clinical crowns. One procedure, permanent change in gumline and tooth show, healing over weeks. Orthodontic intrusion or tooth positioning: best when incisor position or bite contributes. Months of treatment, durable correction. Lip repositioning surgery: moderate cases of muscular over-elevation without skeletal excess. Local procedure, more durable than Botox, variable longevity. Orthognathic surgery: significant vertical maxillary excess. Highest impact, highest commitment, permanent skeletal correction.
Keep in mind that combinations often work best. A conservative neuromodulator plan paired with periodontal sculpting can deliver a natural result with less maintenance than Botox alone and less downtime than skeletal surgery.
Final thoughts from the chair
Every face has its own rhythm and balance. The smile carries that rhythm more than any other expression. If your gums steal the show, there is almost always a path to a result that looks like you on your best day. The key is a precise diagnosis and a willingness to choose the solution that matches your anatomy and priorities, not the one that is most popular on social media.
If you are leaning toward Botox, look for a clinician who understands smile dynamics beyond the usual botoxforforeheadlines or botoxforsmilelines. Ask to start conservatively and to reassess at two weeks. If your exam points to gum or tooth structure as the primary driver, invest in an aesthetic dental consult. The confidence that comes from a smile that fits your face tends to spill into everything else, from the way you speak to the way you show up in photos. It is a small change with outsized impact when done with care.