Botulinum toxin in the treatment of gummy smile


gummy smile
botulinum toxin
aesthetic medicine

How to Cite

Muszalska M, Przybylska P, Piwowarek M, Komisarek O, Matthews‑Brzozowska T. Botulinum toxin in the treatment of gummy smile. JoFA [Internet]. 2020 Jun. 30 [cited 2023 Mar. 29];3(1):61-6. Available from:


A gummy smile is an excessive exposure of the gums while smiling. There are four types: anterior- excessive gum exposure from canine to canine, posterior — excessive gum exposure in the lateral segment, mixed — combining the anterior and posterior components, and asymmetrical — with a disproportion between the right and left side. The causes of gingival smile include: skeletal defect, delayed passive tooth eruption, nasal septal dysplasia, and excessive muscle activity. A simple, fast and minimally invasive method of gummy smile therapy caused by excessive muscle activity is the supply of botulinum toxin type A to the muscles responsible for a given type of smile. A favorable aesthetic effect can be achieved with a good knowledge of application sites and individually selected doses. When determining the dose, which is described in the literature between 2 IU and 10 IU onabotulin per page, researchers take into account not only the type of corrected smile, the number of puncture points, but also gender and age of the patient.


Nayyar P, Kumar P, Nayyar PV, Singh A. BOTOX: Broadening the Horizon of Dentistry. J Clin Diagn Res. 2014;8(12):25–29

Przybylska P, Siniecki T, Matthews‑Brzozowska T: Uśmiech — jeden z istotnych elementów estetyki twarzy. J. Face Aesthet. 2019:2:101–110

Barbosa de Lima A. P, de Castro Ferreira Conti AC, Capelozza FL, de Almeida CM, Rodrigues APR. Influence of facial pattern in smile attractiveness regarding gingival exposure assessed by dentists and laypersons. Am J Orthod Dentofacial Orthop. 2019;155:224–33

Bernacka M, Łącka M, Matthews‑Brzozowska T. Przyczyny uśmiechu dziąsłowego — przegląd piśmiennictwa. Ortod. Prakt. 2018;2:51–56

Mazzuco R, Hexsel D. Gummy smile and botulinum toxin: A new approach based on the gingival exposure area. J Am Acad Dermatol. 2010;63:1042–51

Soykher MI. “Gingival (gummy) smile” — diagnostic value and treatment with botulinum neurotoxin. Cosmetic Medicine. 2017;2

Duruel O, Ataman‑Duruel E, Berker E, Tözüm TF. Ideal Dose and Injection Site for Gummy Smile Treatment with Botulinum Toxin‑A: A Systematic Review and Introduction of a Case Study Int J Periodontics Restorative Dent. 2019;39:167–173

Al Wayli H. Versatility of botulinum toxin at the Yonsei point for the treatment of gummy smile. Int J Esthet Dent. 2019;14:86–95

Jones IT, Fabi SG. The Use of Neurotoxins in the Male Face. Dermatol Clin. 2018;36:29–42

Moreira DC, Possidônio FS, de Souza FS, Kinoshita AMO, Silveira EMV. Application of botulinum toxin type A in gummy smile: case report. Rev Gaúch Odontol. 2018;67

Al‑Fouzan AF, Mokeem LS, Al‑Saqat RT, Alfalah MA, Alharbi MA, Al‑Samary AE. Botulinum Toxin for the Treatment of Gummy Smile. J Contemp Dent Pract. 2017;18(6):474–478.

Pedron IG, Alessandro Mangano A. Gummy Smile Correction Using Botulinum Toxin With Respective Gingival Surgery. J Dent Shiraz Univ Med Sci., 2018;19(3):248–252

Mostafa D. A successful management of severe gummy smile using gingivectomy and botulinum toxin injection: A case report. Int J Surg Case Rep. 2018;42:169–174

Chagas TF, de Almeida NV, Lisboa CO, Tavares DM, Ferreira P, Mattos CT, Mucha JN: Duration of effectiveness of Botulinum toxin type A in excessive gingival display: a systematic review and meta‑analysis. Braz. Oral Res. 2018;32;1–11

Kattimani V, Tiwari RV,Gufran K,Wasan B, Shilpa PH, Khader AA. Botulinum Toxin application in faceial esthetics and recent treatment indications (2013–2018) J Int Soc Prevent Communit Dent. 2019;9:99–105.