column (e.g. in newspaper)
2026.02.27
Can a gummy smile be improved with Botox? How long does it last? ｜Bianca's cosmetic dentist, Teppei Tsukuyama, explains!
He is a specialist in the treatment of gummy smiles, one of the most sensitive areas of esthetic dentistry. He practices, lectures, researches, and writes articles in Japan and abroad. He is the only Japanese dentist who is certified as an implant specialist in both the U.S. and Europe. He uses a multifaceted approach, including surgical treatment, orthodontics, and Botox injections, to address all concerns about the mouth. He is a dentist who can help patients achieve their “desired smile.
I am Teppei Tsukuyama, a part-time cosmetic dentist at Bianca Clinic.
Many people have this problem: "My gums stand out when I smile..." This condition is called a "gummy smile" and is one of the causes of a lack of confidence in smiling. This condition is called a "gummy smile" and is one of the causes of lack of confidence in smiling. One way to approach a gummy smile is with Botox injections. In this article, we will explain the causes of a gummy smile and the process of Botox treatment in an easy-to-understand manner.
What causes a gummy smile? Relationship between the skeleton, muscles, and gums
A gummy smile is a condition in which the upper lip is raised more than necessary when smiling, making the gums more prominent. In general, a gummy smile is often seen when the gums are exposed more than 3 mm, and in some cases it is related to the appearance of the smile. Gummy smile is one of the characteristics that give a cheerful impression. However, many people find it difficult to smile naturally because the gums are prominent every time they smile.
There are four main causes of gummy smiles
- Movement of the upper lip (muscle overactivity)
When the muscles that pull up the upper lip when smiling (the upper lip elevators) are overactive, the upper lip may be lifted higher than normal, exposing a large amount of the gums. This is also called "excessive upper lip elevation" and can cause a gummy smile even without skeletal or dental problems.
- Tooth size (dwarf teeth)
In the case of naturally small or short "dwarf teeth," the teeth and gums are out of balance, making the gum area appear relatively large. This makes the gums more noticeable when smiling.
- Tooth eruption position
When teeth do not fully erupt to their proper position and remain in a low position, the gums cover a larger area over the teeth. This is called "passive eruption defect" and contributes to a gummy smile because the length of the teeth appears shorter.
- Vertical overgrowth of the jawbone
When there is excessive vertical bone growth in the maxilla, the teeth and gums as a whole are positioned lower than normal. As a result, the gums are more likely to be exposed even when smiling slightly. This is a skeletal problem and is thought to be influenced by genetic factors.
As described above, a gummy smile is caused by a combination of multiple factors, including the skeletal structure, muscles, teeth, and gums, so the characteristics and causes of the appearance vary from person to person.
Reduce Gummy Smile Naturally! How Botox Treatment Works
There are several ways to approach a gummy smile, but Botox injections are the most popular because of their “ease” and “natural-looking” results. Here, we will explain how Botox controls the appearance of the gums.
How does Botox work? Mechanisms to reduce the appearance of gums when smiling.
Botox injections are procedures in which a preparation made from a protein derived from botulinum bacteria is injected. It relaxes muscle movement and is widely used in the medical field, including cosmetic medicine, to treat wrinkles, clenching, and hyperhidrosis (armpit hyperhidrosis). Among gummy smiles, it is effective for the type caused by muscle action. It is especially suitable for those who have overdeveloped muscles that pull up the upper lip, causing the lips to lift up more than necessary when smiling.
Injections are made into the muscles that function to lift the upper lip, such as the "upper lip elevator muscle" and the "upper lip nasopharyngeal muscle". This relaxes the movement of the muscles and reduces the exposure of the gums, resulting in a more natural looking smile. The injection sites are near the left and right laugh lines. In some cases, when symptoms are severe or when more change is desired, the procedure may be combined with "lip positioning," a surgery in which the mucous membrane between the upper lip and gums is removed to prevent the upper lip from being raised excessively.
No scalpel and short treatment time! Advantages of Botox Treatment
The major advantage of Botox injections is the ease with which they can be performed without the use of a scalpel. The procedure takes only a few minutes and does not require incisions or general anesthesia. Since there is almost no downtime, Botox injections do not interfere with work or daily life, making them the treatment of choice for those who want to try it for the first time. In addition, since the injection site is near the laugh lines, it can be expected to make the laugh lines less noticeable. Another advantage is that by approaching the gummysmile, the entire mouth area is balanced and the smile looks more natural.
Botox injections for the treatment of gummy smiles.
The effects of Botox injections are temporary and not permanent. In general, when do the effects of Botox injections in the treatment of gummy smile appear? Many people gradually feel the effects a few days to a week after the injections, and they last for 3 to 6 months. After that, the effect fades over time and the original condition returns.
Therefore, it is necessary to undergo the procedure periodically to maintain the effect of reducing the appearance of a gummy smile. The disadvantage is that it is not suitable for those who want to finish the procedure in a single session or want a semi-permanent effect.
There is also a rumor that Botox injections for gummy smile treatment "lengthens" the midriff. Although the midriff is not directly elongated, the movement of the upper lip when smiling is restricted by suppressing the movement of the facial muscles, which may make the midriff appear relatively longer. Those who are concerned about the length of the midriff should consider this aspect of the procedure.
Gummy smile can be improved! Please feel free to contact us for a consultation.
A gummy smile is not a "must-treat" condition. However, when a person's smile becomes awkward due to a complex around the mouth, even the charm of the original facial expression may be compromised. In addition to Botox injections, Bianca Clinic offers a variety of cosmetic dentistry treatments such as aesthetic crown lengthening and lip repositioning. After carefully listening to your concerns and conducting a medical examination, we will propose the most appropriate method according to your symptoms and wishes. We will provide you with thorough support so that you can receive treatment with peace of mind while aiming for a well-balanced, natural-looking smile.
If you are concerned about your gums when you smile or want to smile with more confidence, please feel free to schedule a consultation. We will work with you to find a solution that is right for you and help you regain confidence in your smile.
▶Counseling appointments are available atHere
