You show more gum than teeth when you smile. You have started smiling with closed lips in photos. You cover your mouth with your hand when you laugh. This is not vanity, it is a perfectly common anatomical variation that affects between 10 and 30 percent of the population to some degree. And there is a simple injection treatment that solves the issue without surgery.
A gummy smile, or high lip line, is one of those areas where a very small amount of botulinum toxin makes a significant difference. We are talking about 2 to 4 units per side, a treatment that takes less than five minutes, and a result that many clients describe as "finally I can smile again."
At Dibélle on Kullagatan 40 in Helsingborg, gummy smile treatment is one of the treatments where we see the most tears of joy. Not because the result is dramatic in absolute terms (we are talking about a few millimetres less gum exposure) but because the smile is so central to how we meet other people.
In this guide, I cover how a gummy smile arises anatomically, how the Botox treatment works, who it suits, and what you can expect from a treatment at our clinic.
What is a gummy smile?
A gummy smile is when you show more than 3 millimetres of gum above your teeth when you smile broadly. For some, it is barely noticeable. For others, it is the main focus of every smile, and it is often the first thing you see in a portrait or a selfie.
It is important to say: a gummy smile is not a disease. It is an anatomical variation, much like eye colour or lip shape. But for many, it becomes a source of insecurity, and it is entirely reasonable to want to do something about it.
What counts as "too much" gum?
There is no exact rule, but aesthetic dentistry uses the following guidelines:
- 0 to 2 mm of gum visible: considered a balanced smile
- 2 to 4 mm: mild gummy smile
- 4 to 6 mm: moderate gummy smile
- Over 6 mm: pronounced gummy smile
Botox treatment is most effective for mild to moderate gummy smile (2 to 6 mm). For truly pronounced cases, orthodontic treatment or surgery may be more appropriate, something I cover further down.
What causes a gummy smile?
This is where anatomy gets interesting, because there are several different causes of a gummy smile, and the treatment depends on which one lies behind your particular smile.
1. Hyperactive lip-lifting muscle (most common)
The most common cause by far is an overactive levator labii superioris, the muscle that lifts the upper lip when you smile. In some people, this muscle pulls the upper lip up so forcefully that the gum is exposed. This is precisely the muscle we treat with Botox.
More specifically, we target the levator labii superioris alaeque nasi (LLSAN), a muscle that runs from the side of the nose down to the upper lip. When it relaxes, the upper lip lifts less when smiling, and the gum is partly covered.
2. Short upper lip
If the upper lip is shorter than average (less than 2 to 2.5 cm from the base of the nose to the lip edge), more gum shows even if muscle activity is normal. Here Botox can help somewhat, but a combination with lip enhancement or a lip flip often gives a better result.
3. Vertical maxillary excess
If the upper jaw is longer than average, the teeth and gum project further down, which means more gum shows even with normal lip lift. This is a structural difference that cannot be corrected with Botox. Highly pronounced cases may require orthodontic or surgical treatment.
4. Short crown or passive eruption
If the teeth are unnaturally short relative to the gum (usually due to incomplete eruption during childhood), more gum shows. Dentists address this with a gingivectomy, a minor dental procedure where the gum is adjusted.
In the consultation, I look at your lip proportions and muscle activity to assess which cause is dominant in your case, and whether Botox is the right treatment for you.
How does Botox work for a gummy smile?
Botulinum toxin works by temporarily blocking the nerve signals to the muscles that lift the upper lip. The result is that the muscle does not pull as hard when smiling, the upper lip lifts less, and the gum is partly covered.
Injection points
For gummy smile treatment, we inject into a specific anatomical area called the Yonsei point, approximately 1 cm lateral to the nostril on each side. This is where the LLSAN muscle crosses several other muscles in the face, and precisely where a very small dose of Botox produces maximum effect on the lip lift without affecting other facial expressions.
At Dibélle we typically use 2 to 4 units per side, totalling 4 to 8 units. This is a very small dose in Botox terms. For comparison, we use 20 to 40 units for forehead lines and up to 60 units for jaw muscle reduction.
Onset and duration
The result starts to show within 3 to 7 days and reaches its full effect at 14 days. The treatment lasts 3 to 4 months, which is shorter than Botox in the forehead or between the eyebrows. This is because the small muscles around the mouth are very active and metabolise Botox faster.
For many clients, gummy smile treatment becomes something that is repeated 3 to 4 times a year, often alongside other Botox treatments.
What the treatment does NOT affect
It is important to understand that gummy smile treatment does not flatten the lip, does not remove the smile, and does not create a "frozen face." You will still be able to smile naturally, show your teeth, and express joy. The difference is that the upper lip is not pulled as high, and gum exposure becomes less pronounced.
How the treatment works at Dibélle
Consultation and cooling-off period
All injection treatments begin with a consultation. We look at your smile from different angles, measure gum exposure, assess muscle activity in the lip lifters, and determine the right dose and placement for you.
According to Swedish regulations, a 48-hour cooling-off period applies for injection treatments. This means consultation and treatment take place at two separate visits, at least 48 hours apart. The same treatment type can then be repeated within six months without a new cooling-off period. Read how to prepare for your visit.
Treatment day
The treatment begins with cleansing the skin around the nose and upper lip. Because the dose is so small and the needles so fine, most clients do not need numbing cream for gummy smile treatment, but we always offer it if you want it.
I mark the injection points carefully. Placement is critical for gummy smile treatment. A few millimetres in the wrong direction can result in an asymmetric smile or affect other muscles. This is why precision and experience matter so much here.
Injection
The injection takes less than 5 minutes in total. You feel small pricks, similar to a mosquito bite, but nothing worse than that. Botox is injected superficially into the muscle, not deeply, which makes the treatment especially gentle.
Immediately after the injection there may be slight redness or a small bump that disappears within hours. You can return to your everyday life in Helsingborg the same day, and most clients go straight back to work.
Recovery and aftercare
Gummy smile treatment has among the simplest aftercare of any injection treatment.
The first 4 hours: Avoid massaging or touching the treatment area. Avoid lying down.
The first 24 hours: Avoid intense exercise, alcohol, sauna and tanning beds. Do not sleep face down.
The first 7 days: The result gradually begins to show. The treatment is not fully developed yet, so do not judge the final result at this point.
Day 14: Full result visible.
Aftercare tips
- Do not use a straw with force the first few days (can theoretically spread Botox to other muscles)
- Avoid massaging the area for one week
- Apply SPF 30+ daily if you go outdoors
- Drink water normally, no restriction
- Book a follow-up after 2 weeks if you are a first-time client, we are happy to fine-tune
Results and longevity
The result of gummy smile treatment is subtle but marked. In before-and-after photos you can clearly see that gum exposure is reduced, but the face still looks exactly like your own. This is precisely what makes the treatment so well loved, it corrects without transforming.
In the weeks after treatment, the smile feels somewhat "calmer," as if the muscle is not pulling as hard. Many clients describe it as liberating, especially if they have long tried to adapt their smile to hide the gum.
After 3 to 4 months, the effect gradually begins to fade. Natural muscle activity returns, and the gum is exposed again as before. That is when it is time for a new treatment if you want to maintain the result.
Many clients say the first treatment is the most dramatic, because that is when you see your smile without a gummy smile for the first time. After a few repeat treatments, it becomes the new normal, and you no longer think about it.
Who is gummy smile Botox suitable for?
Gummy smile Botox is a good choice if you:
- Show 2 to 6 mm of gum when smiling broadly
- Have a hyperactive lip-lifting muscle as the primary cause
- Want non-surgical correction of a high lip line
- Are looking for a fast treatment with short recovery
- Want to try before investing in surgical correction
- Are 18 years or older
Gummy smile Botox is not the right choice if you:
- Have over 6 mm gum exposure with a structural cause
- Have vertical maxillary excess (requires jaw surgery for full correction)
- Are pregnant or breastfeeding
- Have a neuromuscular disease (myasthenia gravis, ALS, Lambert-Eaton)
- Have an active infection in the treatment area
- Take aminoglycoside antibiotics (interact with Botox)
Frequently asked questions
Does gummy smile Botox hurt?
No. The needles are extremely fine and the dose is so small that most people barely feel the injection. It feels similar to a mosquito bite. Numbing cream is rarely necessary but is always offered.
Will the treatment affect my smile negatively?
Correctly performed, no. You will still be able to smile naturally. The risk of an asymmetric smile is small with an experienced injector, but it exists. This is why precision is so important, and why you should choose a practitioner with documented experience specifically in gummy smile treatment.
How long does the result last?
3 to 4 months. That is shorter than Botox in the forehead or between the eyebrows, because the muscles around the mouth are more active. Many clients return 3 to 4 times a year for maintenance.
Can I combine this with other treatments?
Yes. Gummy smile treatment is often combined with a lip flip for subtle lip enhancement, lip enhancement with fillers, or general Botox in the forehead. We are happy to plan a holistic approach during the consultation.
What side effects are there?
Very rare when performed correctly. The most common are mild redness or a small bump at the injection site, which disappears within hours. In rare cases, asymmetry can occur if the dose is too high or placement is incorrect. This is why you should choose an experienced practitioner.
Does the treatment affect my teeth or dental care?
No. Gummy smile treatment does not directly affect the teeth or the gums. We treat the muscle, not the tissue in the mouth. You can have any dental treatment without it affecting the Botox result, and vice versa.
Will my colleagues notice I have had something done?
No. This is one of the most subtle Botox treatments. People will notice that your smile looks balanced, but almost no one will be able to say why.
Why choose Dibélle in Helsingborg
Gummy smile treatment requires precision. A few millimetres in the wrong direction, and the result becomes asymmetric or affects other facial expressions. The dose must be adapted exactly to your muscles, your facial width and your desired result. This is not a treatment where "general Botox experience" is enough, you need a practitioner who has performed this particular treatment many times.
At Dibélle on Kullagatan 40 in Helsingborg, all treatments are performed by Abir Mustafa, registered nurse, registered with IVO (Health and Social Care Inspectorate) and the National Board of Health and Welfare. With experience in aesthetic medicine since 2011 and more than 10,000 treatments performed, she has the specific knowledge required for gummy smile treatment.
We work on the principle that every smile is unique. There is no standard dose, no one-size-fits-all. Every treatment is an individual assessment based on your anatomy, muscle activity and personal wishes.
With 4.9 out of 5 based on over 1,100 reviews on Bokadirekt and 4.9 on Google based on 1,225 reviews, we know it is the personal care and the natural results that make the difference.
Are you curious about what gummy smile treatment could do for your smile? Book a complimentary consultation at Dibélle in Helsingborg and we will analyse your smile and create a plan that suits you. Book easily via Bokadirekt, or contact us directly if you have questions. See all Botox treatments and prices for a complete overview.
With care for your smile, Abir Mustafa, Dibélle, Helsingborg
