Correction of Gummy Smile using Botulinum Toxin

BOTOX is a neurotoxin used in the management of dystonia as it blocks Ach release resulting
in temporary muscle paralysis. It could be used for correction of gummy smile resultant from over
functioning elevator muscles of the upper lip.
The current study aimed to investigate botulinum toxin as a treatment modality of patients with
gummy smile.
This study enrolled 37 patients; gingival display was assessed as the vertical distance from the
gingival zenith of the upper central incisor to the upper lip inferior border.
Before Botox, the gingival display during smile ranged between 6-9 mm and 5–7 mm at the
incisor and buccal regions, respectively. One week after Botox administration, a significant
reduction in gingival display was observed. During smiling, the mean gingival display between
maxillary central incisors and upper lip was approximately 1.5± 0.2 mm. In addition, the gingival
display at the incisor and the buccal regions was ranged between 1.2 to 2 mm and 1-1.6 mm,
respectively.
Botulinum toxin injection is simple, effective, painless, conservative way for correction of
gummy smile, and achieving high patient satisfaction. It can be used for subjects with excessive
gingival display without invasive surgical procedures.