Correcting a Gummy Smile
One morning one of my co-workers walked past me and
smiled. Something about her looked different. It was something
subtle. I couldn't put my figure on it, but her smile was brighter than
Well, it turns out that the previous week my co-worker
had Botox injections for a television segment my supervising physician had an
appearance on. The topic was "correcting a gummy smile."
A "gummy" or "gingival" smile is a term used to describe
a smile in which there is a show of the anterior gingiva above the teeth when
smiling. A smile tends to be more "gummy" for many reasons, such as the
size and shape of our lips, gums and teeth, as well as the muscles that are
involved in raising the upper lip when smiling.
As in her case, a gummy smile can be successfully
treated with a low dose of a neuromodulator, such as Botox or Dysport. Placed
in the proper muscle(s), the injection will help to reduce the gums from
The three lip elevator muscles converge on the area
lateral to the nasal ala, so this location tends to be the most common injection
site for this purpose. In the case of my co-worker, and many other patients,
the results were incredible. All of this was achieved with a very small
amount of Botox (5 units total).
The effect of Botox/Dysport can take several days, or
even up to a week or two, for full results. Once the full results are evident,
the upper lip will not rise as high when smiling and will reduce the amount of
the gum that is visible.
Keep in mind, injecting the lower face in this region
could affect your singing or playing of a wind instrument, using a straw or
spoon, etc., so this treatment is not for everyone. The treatment should
also be performed very conservative for this reason. Such injections
should only be performed by an experienced provider.
Neuromodulators, such as Botox and Dysport, are not
permanent solutions and typically last between 3-4 months. Surgical
correction would be a more permanent treatment, however may seem quite drastic
to patients who only have a mild condition.
I'm still in awe of how much this simple technique changed
the smile of my co-worker. We have always thought she was a beauty, but
she had always disliked the look of her smile and now is happy to smile with
Sometimes the most subtle aesthetic touches are the ones
that get noticed the most. Having someone say "you look great- what did
you do?" is truly one of the greatest compliments we can strive for in
If you truly have a gummy smile, Botox
is not the definitive
treatment for you. Although it may be temporary, it could distort your smile
slightly and create some asymmetry while you are at rest.