Your smile is often the first thing people notice about you — it’s how you introduce yourself to the world. And it’s incredibly unique, with lots of variations that make it purely you. Only one problem: not everyone loves their quirks.
From whitening treatments to closing gaps, people often alter their teeth. But what about when your gums are the concern? You still have options, and if you are looking to reduce or eliminate a gummy smile, Botox treatment might offer the solution you need.
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What Is a Gummy Smile?
Is your smile gummy? Ask two dentists for a diagnosis and you might get two very different answers. That’s because there’s no established criteria for what constitutes a gummy smile — for the moment, at least. This leaves things up to interpretation, and each dentist, plastic surgeon, and med spa provider will see it their own way.
Yet most professionals agree that two millimeters of gum tissue showing when you smile is normal. More than that, and there’s a difference of opinions. Some feel that 2–4 millimeters is too much, while others consider it fairly standard. When more than four millimeters of gingiva shows while smiling, the overwhelming consensus is that this is a gummy smile.
Of course, things are always relative with aesthetic concerns. Two millimeters of gum showing might look great on someone with average-length teeth, but could dominate the smile of someone with shorter teeth. Plus, much of this is a matter of perception, and what really matters is how you feel about yours.
Is a Gummy Smile a Medical Concern?
Only two people have the answer to this question: you and your dentist. Excessive display of gingival tissue can stem from an underlying health condition, in which case, yes, it’s a bad thing — or at least a sign of a problem. But in most cases, a gummy smile is strictly a matter of appearance.
So if you love the way your gummy smile looks, great! And if you have fuller lips or longer teeth, more visible gum tissue might even be crucial to balancing your features. But if you often opt for closed-lip grins, or avoid smiling altogether, you might want to consider gummy smile treatment.
What Causes a Gummy Smile?
Most people’s gummy smile is encoded in their DNA: their genetics simply give them more exposed gum tissue than the average person, and most likely, plenty of their family members have gummy smiles, too.
Still, genetics isn’t the only factor. Other contributing factors include:
- Altered Passive Eruption: People with this condition have gums that cover parts of the tooth’s surface that they shouldn’t. It first appears when the teeth emerge.
- Dentoalveolar Extrusion: This orthodontic anomaly results in an over-eruption of the front teeth, causing the gums to grow excessively with them.
- Maxillary Excess: Another orthodontic condition, it causes an oversized upper jaw, making the gums look bigger.
- Gingival Hypertrophy: This condition causes excessive gum growth, making it longer and/or thicker than normal.
- Lip Size: People with thinner lips often look like they have more gum tissue when smiling, even if their gums are completely normal.
- Hypermobile Lips: When you have this condition, your lips have a greater range of motion than most, and they can pull back more when smiling.
- Medications: Some medications — such as seizure medications, immunosuppressants, and blood pressure controllers — cause gum tissue growth.
- Short Teeth: Some people are born with shorter teeth; others wear their teeth down over time. No matter the cause, shorter teeth make the gums look longer.
While gummy smiles may not be the norm, they are quite common. About 29% of the population has a smile that could be considered gummy.
Can Botox Correct a Gummy Smile?
Many treatments can address the aesthetic concerns related to a gummy smile. The problem is that most are pretty invasive, often requiring tissue removal, grafting, and other forms of surgery. They also make irreversible changes, which some people may not want.
Botox injections offer a non-invasive and temporary alternative. Botulinum toxin type A — the active ingredient in Botox and similar injectables — is a paralytic, meaning it weakens or paralyzes muscles or stops signals to a targeted nerve. While it’s most well-known for fighting wrinkles, it actually has several applications, including fighting migraines and muscle spasms.
Another use for Botox? Reducing the appearance of a gummy smile. When strategically injected, it can relax the muscles in the upper lip to limit how far they rise when you smile. As long as your doctor injects it correctly and uses the right amount, this should ensure a smile that still looks full and natural while covering more of the gum line.
The doctor will inject the Botox into the area between your nose and upper lip. They’ll usually make 2–4 small injections: one at the edge of each nostril and, sometimes, one into each of the smile lines. This targets the levator labii and zygomaticus major and minor muscles — which lift the upper lip when you smile. They’ll inject either one or two units in total, depending on the needs of the patient.
Benefits of Botox for Reducing Gummy Smile
- Treatment is quick, taking around 30 minutes from topical numbing to injection.
- There is no recovery period; as soon as you get the injections, you can go about life as usual.
- Botox injections are more affordable than surgical options — at least in the short term.
- If you find that you liked your gummy smile better, you just wait for the effects to wear off after a few months.
- Your plastic surgeon or med spa provider can easily adjust the dose and placement for the look you want.
Ideal Candidates for Gummy Smile Botox
Good candidates for gummy smile Botox treatment should have more than two millimeters of gum tissue visible when they smile. It works best when this excessive gingival display stems from a hyperactive or short upper lip, though it can help when there are other underlying causes, too.
However, if your gummy smile comes from abnormal tooth growth or a jaw condition, orthodontic or surgical treatment is best. You also shouldn’t use Botox if your gummy smile is related to medications. Patients need to be in overall good health and not have allergies to any of the ingredients in the injections.
How Often Do You Need Injections?
Gummy smile Botox treatment only uses 1–2 units of product. This is less than typical Botox treatments, but the small amount is essential for keeping the smile natural. The downside is that the effects wear off sooner.
Botox treatments usually last 6–12 months, but for gummy smiles, that range is closer to 3–6 months. Usually, the first treatments have shorter lifespans, and the longer you stick with them, the longer the effects last. Keep in mind that this varies between individuals, and your metabolism plays a big role in longevity. You can go into treatment expecting results to last about three months, but be ready to adjust those expectations as you go.
What to Expect After Botox Treatment
Unless there are unexpected complications, you won’t need to take any downtime after getting Botox for a gummy smile. However, there are some aftercare aspects to keep in mind for the first 24 hours after your treatment:
- Stay upright for at least two hours after the procedure.
- Do not touch the injection sites.
- No exercising beyond walking.
- Avoid heat and sun exposure.
- Sleep on your side or back, not your stomach.
- Only apply compresses as directed by your doctor.
- Expect slight bruising and hypersensitivity at the injection sites.
- Manage pain with OTC pain relievers, but avoid aspirin and NSAIDs.
Results are not immediate. Most people first notice changes about 2–3 days after their injection. Full results often take 14 days. Most providers will have you come back 2–3 weeks after injection and might offer an additional injection to fine-tune your smile.
Risks of Botox Treatment
Botox treatment is generally considered safe, but safe doesn’t mean risk-free. Discuss these risks during your consultation, and remember that using a reputable provider and disclosing your complete and honest medical history helps to negate most Botox risks.
Potential minor side effects of Botox for gummy smile include:
- Soreness and discomfort at the injection site
- Bruising and inflammation around the nose and lips
- Drooping upper lip
- An upper lip that appears larger or longer
- Asymmetry in the smile
- Nausea
- Impaired movement
Most of these side effects resolve on their own 24–72 hours after treatment, but they may linger for up to a week. Any longer than that and you should speak to your provider.
Serious Side Effects
It’s highly unlikely that you will experience any significant side effects from gummy smile Botox treatment, but it’s possible. If you notice any of the following after injection, seek emergency medical attention.
- Impaired breathing
- Difficulty chewing and swallowing
- Problems with speech
- Muscle weakness outside the treated area
- Vision changes
Other Treatment Options
You might find that Botox just isn’t the right option for your smile. No worries; there are plenty of other options. The right one for you depends on your gummy smile’s cause and your treatment preferences.
Lip Repositioning Surgery
Think of this as the surgical alternative to Botox. It alters the connective tissue on the underside of the upper lip, reducing the range of the elevator muscles. Your lip can still pull back when smiling, but it won’t go as high as it used to, hiding some of the gums without compromising your smile’s natural appearance.
Veneers
If you don’t have any underlying health issues to address, veneers can solve your aesthetic concerns. They can hide a small amount of gum tissue while making the teeth look longer, bringing things into balance. Just remember, they’re only an option for the upper front teeth. Depending on your smile’s width, they might not offer the coverage you need.
Temporary Anchorage Devices
Also known as TADs, these orthodontic appliances are screws a doctor will implant into your jaw. Orthodontists can use them on their own or pair them with other devices to change the position of your teeth. Like braces and aligners, this can change how the gums look, eliminating the appearance of a gummy smile.
Root Planing and Scaling
This treatment typically treats gum disease, so you typically can’t get it if you have only a gummy smile. However, it gives your dentist the option to make small changes to the gum line. Don’t expect a major difference, but it might be just enough to achieve your smile goals.
Gum Contouring Surgery (Gingivectomy)
This procedure changes the gum line the same way as root planing and scaling. However, you don’t need to have gum disease to get it, making it an option for pretty much anyone. An alternative is laser gum contouring, which uses a laser instead of a scalpel for greater precision.
Braces and Aligners
If your gummy smile stems from a misaligned bite or issues with jaw position, orthodontic treatment will correct it while improving your oral and overall health. If you have bite issues, it’s always best to correct them, so consider this an investment in more than your appearance — although that matters too!
Orthognathic (Jaw) Surgery
If jaw size or position is behind your excessive gingival display, orthognathic surgery might be the only advisable treatment option. This makes more significant changes than orthodontic treatment and you should only consider it when more conservative options won’t work.
Final Thoughts
If you are unhappy with how much your gums show when you smile, Botox might be the solution for you. Quick, non-invasive, and temporary, it gives you control over your smile aesthetics without forcing you into a long-term commitment.
It’s not right for everyone, but it comes with major benefits. Be sure to see your dentist first, though, to rule out any underlying conditions you need to address first.
Frequently Asked Questions
Does gummy smile Botox treatment hurt?
Your dentist or plastic surgeon will use a topical numbing agent on the injection site, although some people still feel a pinch and slight soreness after. However, it should not be authentically painful. If you feel like you are experiencing genuine pain, express this to your provider.
Can Botox make my smile worse?
It won’t reveal any more of your gums. However, it might cause your lips to cover more of your gums and teeth than you’d like. If you choose an experienced dentist or plastic surgeon for your treatment, though, this is highly unlikely.
Will I have trouble speaking and eating after treatment?
No, it isn’t like getting invasive dental treatment. The topical anesthetic won’t cause a lot of numbing, so function should remain the same. The changes from the Botox appear slowly over multiple days, giving you time to adjust, so you won’t likely notice a difference in movement.
Is the Botox for a gummy smile the same as the kind used for wrinkles?
Yes, they are the same product. However, the placement and amount are different. Don’t expect any anti-wrinkle benefits as a side effect of your gummy smile treatment.
Can Botox solve all gummy smile issues?
No. If you have an underlying medical condition — or any other cause besides the lip pulling back too much — you’ll need other treatments.
How much does Botox for a gummy smile cost?
It depends on how many units you need and how much your provider charges per unit. The Botox itself usually costs $10–$15 per unit, and doctor fees typically bring the total cost up to $80–$300 per treatment.
How long should I expect Botox for a gummy smile to last?
For most people, 3–6 months. The more times you get it, the longer the effects typically last.
How long does it take to see results?
You will see the first changes about 2–3 days after treatment. Full results typically take about 14 days.
What qualifies as a gummy smile?
There’s no universal standard. Generally, you need to have more than two millimeters of gum tissue visible when smiling, but the ratio between your gums and teeth also matters, so you’ll have to discuss it with your dentist.
Will my insurance cover Botox?
No, since Botox for gummy smile does not alter any medical conditions, it won’t be covered the way other treatments might.
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