Gummy Smile Treatment: Gum Contouring and Botox

Short answer

A gummy smile is when noticeably too much upper gum shows when you smile. The cause may be excess gum tissue, teeth that look short, an upper lip that lifts too far or the structure of the jaw. Treatment is chosen according to the cause: gum contouring, crown lengthening, botulinum toxin (Botox), orthodontics or, for skeletal causes, a surgical assessment. The plan is made at the examination.

What is a gummy smile and what causes it?

A gummy smile is when more than a few millimetres of gum shows above the upper teeth when you smile. There is no single cause; often several factors play a part together.

The gum covering more of the tooth than it should (teeth look short)
The upper lip lifting too high when smiling
Excessive vertical growth of the upper jaw
The front teeth sitting lower than they should
Gum overgrowth due to medication or inflammation

How is the cause identified?

The right treatment depends on first identifying the cause, which is done through an examination, measurements and photographs. The same appearance can have different causes.

Photographs of the smile at rest and when smiling
Measurements of tooth length and width
Assessment of gum thickness and pocket depth
Checking the bone level with X-rays where needed
Assessment of upper lip length and movement

For example, if the teeth look short and the lip moves normally, the problem is usually the gum. If the teeth are of normal length but the lip lifts very high when smiling, the cause is lip movement. This distinction matters to avoid an unnecessary procedure.

How are gum contouring and crown lengthening done?

If the gum covers too much of the tooth, the excess tissue is reshaped with gum contouring (gingivoplasty or gingivectomy). The teeth then look longer and better proportioned.

If the underlying bone, as well as the gum, sits too close to the tooth, trimming the gum alone is not enough; the gum may return to its old position over time. In this case crown lengthening is carried out, in which the bone level is also adjusted.

Examination, smile photographs and measurements
Planning the new gum line
Procedure under local anaesthetic
Check-ups and monitoring of healing

Healing usually takes 1–2 weeks. During this time, soft foods, careful brushing and the oral care products recommended by your dentist are used.

Smile with a balanced, symmetrical gum line after gum contouring — A balanced gum line makes the teeth look better proportioned · Illustrative AI-generated image; not a patient.

How is a gummy smile treated with Botox?

Where a gummy smile is caused by lip movement, botulinum toxin (commonly known as Botox) is injected in small doses into the muscles that lift the upper lip. Once the muscles relax slightly, the lip lifts less when you smile and less gum shows.

It is not a surgical procedure; it is injected at a few points with a fine needle.
The effect usually starts within 3–7 days and becomes noticeable at around 2 weeks.
The effect lasts 3–6 months on average and can be repeated if you wish.
It is not used during pregnancy, breastfeeding or with certain neuromuscular conditions.

Before treatment, the dentist assesses whether the gummy smile really is caused by lip movement. If there is excess gum, Botox alone will not be enough. In the first days after treatment there may be slight asymmetry in the smile or a feeling of heaviness in the lip; these effects are usually temporary.

Botox or gum contouring?

The choice depends on the cause: Botox is considered if lip movement is the main factor, gum contouring if excess gum is the main factor. In some people both can be planned together.

Feature	Botox (botulinum toxin)	Gum contouring
Cause it suits	Upper lip lifting too high	Gum covering too much of the tooth
Type of procedure	Non-surgical injection	Gum reshaping under local anaesthetic
Onset of effect	3–7 days, noticeable at about 2 weeks	Healing 1–2 weeks
Duration	3–6 months on average, repeatable	Result usually permanent
When it is not used	Pregnancy, breastfeeding, certain neuromuscular conditions	Not done until active gum inflammation is treated

What is done for orthodontic and skeletal causes?

If the front teeth sit lower than they should, orthodontic treatment can reposition them upwards. Small orthodontic mini-screws are sometimes used to help with this.

If the gummy smile is caused by excessive vertical growth of the upper jaw, in other words it is skeletal, gum or lip procedures offer limited benefit. In this case jaw surgery (orthognathic surgery) may be considered together with an orthodontist and an oral and maxillofacial surgeon.

Jaw surgery is extensive treatment and is usually considered not only for appearance but when there are also bite and function problems. In milder skeletal cases, the appearance can be improved by combining gum procedures and Botox.

What if the gum is overgrown?

If the gum has overgrown due to inflammation or certain medications, that cause is dealt with first. Where overgrowth is due to plaque and tartar, gum treatment and good oral hygiene often make the gum shrink back noticeably.

Some blood pressure, epilepsy and immunosuppressant medicines can cause gum overgrowth. In this case any change of medication is made only by the doctor who prescribed it. Gum contouring is considered for any excess that remains after healing.

What to watch out for after treatment

After gum contouring, protecting the area in the first days speeds up healing. After Botox, you are advised not to massage the treated area or lie down for a few hours.

Avoid hot, spicy and hard foods in the first days.
Clean the treated area gently with a soft brush.
Use the mouthwash recommended by your dentist regularly.
Smoking delays healing; take a break if you can.
Do not miss your check-up appointments.

Can gummy smile treatment be combined with other cosmetic treatments?

Yes; once the gum line has been corrected and healing is complete, the smile can be planned as a whole. The dentist decides the order.

Teeth whitening to lighten the colour of the lengthened teeth
Porcelain veneers for shape and colour
Regular tartar removal to keep gums healthy

At our clinic in Oran, Çankaya, we can assess your smile and discuss the options that suit the cause with you.

Frequently asked questions

How long does gummy smile Botox last?

The effect usually starts within 3–7 days, becomes noticeable at about 2 weeks and lasts 3–6 months on average. It can be repeated if you wish.

Does gum contouring hurt?

The procedure is done under local anaesthetic. Mild tenderness may last a few days afterwards.

Will the gum grow back?

With properly planned gum contouring, the result is usually permanent. If the bone is too close to the tooth, crown lengthening may be needed; if there is gum overgrowth, the underlying cause is also addressed.

Does a gummy smile always need surgery?

No. Where it is due to lip movement, non-surgical Botox may be an option; where it is due to tooth position, orthodontics may be. Skeletal causes may need a surgical assessment.

How many sessions does gummy smile treatment take?

Gum contouring is usually done in a single session, followed by check-ups. Botox is a single session, but because the effect is temporary it may be repeated months later.

How long after gum contouring can veneers be fitted?

Veneers are fitted once the gum has fully healed. This time depends on the type of procedure and is decided by the dentist.