Gummy smile or excessive gingival display

The smile is to the vast majority of people the most pleasant and the most complex facial expression, through which we express our most beautiful experience – our joy.

A beautiful smile is based on three components: teeth, gums and lips.

An attractive smile should expose 3 mm of your upper gum. This distance is measured while smiling and covers gyn area between the lower part of the upper lip and the upper edge of the incisors.

When gum exposure is a reason for stress or when it limits your desire to laugh of smile, there is a way to treat this problem: botulinum toxin (Botox).

The botulinum toxin is used as a temporary treatment in for gummy smile, which is caused by hyperfunction of the upper lip elevator muscle, the upper lip and ala of the nose elevator muscle, or the zygomatic minor muscle. The botulin toxin is a bacterium isolated from Baccilus botulinum since 1897, but that only entered cosmetic use in 1990. The Botulinum toxin inhibits nerve impulse transmission to skeletal muscle fibers, causing a temporary paralysis of injected muscle fibers.

What should I expect?

The procedure is performed in the doctor’s consulting room, after a detailed discussion on possible health problems, expectations, and treatments performed. The injection is made with a very small needle (4 mm) near the nasal wings (ala of the nose). Discomfort is minimal and can be alleviated by applying a cream with pre-injection anesthetic. Possible side effects that may occur after the injection are minimal discomfort in the injected area, redness at the injection site, mild ecchymosis (bruising), headache.

Once the injection is done, you can go back to your normal schedule, which is why the botulinum toxin injection is known as the “lunch break procedure”.

It’s strongly recommended not to massage the injected area and not to lie horizontally for the first 4-6 hours after the procedure, as there is a risk for the injected solution to migrate.

The procedure takes effect 2 weeks after the injection and lasts between 4-6 months. This time frame depends on how toned your muscles are and other individual anatomical aspects.


  • Known hypersensitivity to botulinum toxin type A or any of the excipients of the preparation (human albumin, sodium chloride)
  • Myasthenia gravis
  • Eaton Lambert Syndrome
  • The infection at the proposed injection site
  • Amyotrophic lateral sclerosis
  • Peripheral neuromuscular disorders
  • History of dysphagia
  • Aspirin treatment

You can find more information about the botulinum toxin (Botox) here.