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J Contemp Dent Pract. 2017 Jun 1;18(6):474-478.

Botulinum Toxin for the Treatment of Gummv Smile.

Author information

Department of Prosthetic Dental Science, College of Dentistry King Saud University, Riyadh, Kingdom of Saudi Arabia, e-mail:;
College of Dentistry, King Saud University, Riyadh, Kingdom of Saudi Arabia.
Department of Dermatology, King Abdulaziz Medical City Riyadh, Kingdom of Saudi Arabia.
Department of Dermatology, College of Medicine, AL-Imam Mohammad Ibn Saud Islamic University, Riyadh, Kingdom of Saudi Arabia.
Department of Dermatology, Private Dental Clinic, Riyadh Kingdom of Saudi Arabia.



The aim was to evaluate the effect of botulinum toxin (Botox) injections as a conservative treatment for gummy smile.


An experimental in vivo study was conducted at a dermatology clinic in Riyadh in January 2016. The study included 23 female patients who ranged from 20 to 50 years and were treated with Botox injections due to excessive maxillary gingival display. The patients with short clinical crowns or long maxilla, those who were pregnant or breastfeeding, and patients with neuromuscular disorders were excluded. Patients received Botox type I, injected 3 mm lateral to the alar-fascial groove at the level of the nostril opening at the insertion of the levator labii superioris alaeque nasi muscle. Photos were taken of the patient's smile before and after the treatment and were then uploaded to the SketchUp program to calculate improvements in gingival display. The distance from the lower margin of the upper lip to the gingival margin was calculated pre- and posttreatment. The amount of improvement was calculated as (pre-Botox treatment - post-Botox treatment/pre-Botox treatment × 100). The mean percentage of the total improvement was analyzed.


A total of 23 female patients received treatment to improve their gummy smile. Improvement was clear 2 weeks after Botox injection. The mean percentage of improvement in the gingival display was 99.6%.


Botox type I is an effective conservative technique to improve gummy smile caused by muscular hyperfunction.


Patients' retention highly indicated that they were satisfied with the provided treatment by Botox injections. Improving the quality of life with least painful experience and immediate results was the major advantage for Botox type I.


Botulinum toxin; Botulinum toxin type I; Experimental in vivo study Gummy smile.

[Indexed for MEDLINE]

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