Gummy smile before and after: the photo hides the only thing that matters

Two people show the same amount of gum when they smile. In a photo, the problem is identical. One of them solves it with a toxin treatment that takes ten minutes. The other won't solve it with toxin at all, not even with ten sessions, because their gum shows for a structural reason, and muscle has nothing to do with it.

A before and after photo doesn't show the cause. And the cause is the whole thing. That's why searching "gummy smile photos" and choosing by the best-looking result is an almost guaranteed way to choose wrong: you're comparing your face with someone whose problem may not be yours.

This article is about how to read those photos and how to find out which group you're in.

What a gummy smile is

It's gum showing above the upper teeth when a person smiles. It isn't a disease, it isn't a defect, and it doesn't require treatment. It's a feature of the smile that bothers some people and goes unnoticed by others, including people with very similar exposure.

What makes someone seek treatment is almost never the millimeter. It's the photo they saw themselves in, the video call, the habit of covering their mouth with a hand. That's worth noting: the discomfort is the clinical finding that opens the conversation, not the ruler.

How many millimeters of gum count as a gummy smile

Dentistry has one convention that exposure above a few millimeters already counts as a gummy smile, and another that large exposure, around seven millimeters or more, counts as a severe case. The problem is that these cutoffs vary from author to author and, on their own, decide nothing.

Two people with exactly the same measurement may need opposite treatments. And someone with little exposure can be very bothered by it, while someone with a lot never thinks about it. The number describes. It doesn't prescribe.

What the assessment needs to determine is something else: why that gum shows.

What causes a gummy smile

In practice, three mechanisms, which often combine in the same smile.

The distinction matters because it changes who treats it. Toxin in someone with vertical maxillary excess delivers a small, temporary, frustrating result. A gum procedure in someone with a hypermobile lip removes tissue without fixing the movement that causes the exposure.

That's why we don't recommend treatment from a photo, and we don't recommend it over WhatsApp. We need to see the smile in action: full smile, restrained smile, speech, rest.

How to get rid of a gummy smile

"Get rid of" is a phrase worth examining. In many cases the realistic goal is to reduce the exposure and balance the smile, not eliminate it. A smile with no gum at all isn't the universal beauty standard the internet sells. Plenty of beautiful people show gum.

That said, the real options:

• Botulinum toxin in the upper lip elevators. It reduces how far the lip rises. It's the treatment of choice when the origin is muscular, and it's the only one on this list that is reversible by definition: if you don't like it, it wears off.
• Gum procedure, when excess tissue covers the tooth. This is dental work, done by a professional qualified for it, and the result is permanent.
• Orthodontics, when tooth position is part of the picture.
• Surgery (lip repositioning or orthognathic surgery) in the more pronounced structural cases. That's a different level of decision, with a post-op period and recovery.

At RUV we treat the muscular side, with toxin, and that's our honest share of the problem. When the assessment shows the cause is structural, we refer you elsewhere, and we say so at the first consultation, not after trying two sessions that were never going to work. Sometimes the best procedure is the one we don't do.

Botox for gummy smile before and after: what the photo shows

If you're going to look at photos (and you will), look for these things:

• Are both smiles the same kind? A full smile in the "before" and a restrained smile in the "after" is the most common manipulation, and the easiest to commit without bad intent: people smile differently when they're happy with the result. Compare how wide the mouth opens and how much of the lower teeth shows.
• Can you see the whole face? A photo cropped at the mouth hides what matters most here: whether the lip got heavy, whether the smile went crooked, whether the expression changed.
• What day is the "after"? Before roughly two weeks, the result is still forming.
• Is there any smile left? A lip that barely rises photographs as a success and behaves like a problem: a short, flattened smile, with that sense that the person is holding something back.

And one warning about a specific case: when there has been previous lip filler, the old product changes how the area behaves and changes the plan. At the clinic we check this with Doppler ultrasound before any treatment. It shows where the material actually is, so we don't have to rely on what the patient remembers having done three years ago.

How long gummy smile Botox takes to work

The effect starts to appear in the first few days and is complete at around two weeks. The real assessment happens on the full result, not halfway there. An early touch-up in this area is the shortest route to overdoing it. The general timeline of how toxin sets in and how long it lasts is covered in the article on toxin before and after, which goes through it day by day.

One thing specific to this area: the upper lip muscles are small and work constantly. You talk, eat, drink. Duration here tends to be shorter than in the forehead or glabella.

Can gummy smile Botox go wrong?

It can, and the way it goes wrong is characteristic: an asymmetric smile, with one side rising more than the other; an elongated, immobile upper lip, giving that "heavy" smile; temporary difficulty pronouncing certain letters or whistling.

None of it is permanent. There's no reversal agent for toxin. What there is, is time, and the effect wears off. In some cases the result can be compensated technically in the meantime by balancing the opposite side. But the lesson comes earlier: in this area the gap between calibrated and overdone is small, and the safe path is to use too little and reassess. Correcting upward is easy. Nobody can correct downward.

Is it worth it?

If the cause is muscular and expectations are realistic, it's one of the procedures with the best ratio of simplicity to impact: a quick treatment, no downtime, and a change the person sees in the mirror every day.

It isn't worth it in two situations. When the cause is structural, because you pay for a small result that will still wear off. And when the discomfort isn't really about the gum but about the whole smile, or the photo, or something a treatment won't fix. That second case comes up more often than you'd think, and naming it is part of the consultation.

The downsides of a gum procedure

For comparison: this isn't what we do here, but it's the alternative that shows up in everyone's research.

• It's permanent. Removed tissue doesn't grow back. That's an advantage when the indication is right and a problem when it isn't.
• It has a recovery period, with healing and a settling phase. What you see at three weeks isn't the final result yet.
• It doesn't fix a muscular component. If the lip rises too far, it will keep rising too far.
• It requires planning by someone who knows periodontics, because it involves the architecture of the gum and the support of the tooth, not just the design of the smile.

What makes up the cost

We don't publish prices, but it's possible to understand what goes into them, and that helps more than a stray number: the cause identified (muscular, gum or structural), the amount of product the case calls for, how many areas are in the plan, the toxin brand used and the maintenance interval. A mild muscular case and a combined case don't cost the same because they aren't the same job. A quote from a photo, without an assessment, is a guess, even when it comes cheap.

When we advise against it

• When the cause is structural. Vertical maxillary excess calls for orthodontics or surgery. Toxin there delivers little and frustrates.
• When the request is "I don't want any gum to show". The goal is to balance the smile, and an immobile upper lip isn't a good result. It's a smile that lost the best thing it had.
• A touch-up before the full result has set in. What gets corrected too early usually turns into excess.
• When there's marked, unassessed facial asymmetry. A crooked smile may predate the procedure, and that needs to be documented before, not after.
• Pregnancy and breastfeeding. An elective procedure waits.
• When the real discomfort isn't the gum. A treatment doesn't fix diffuse dissatisfaction, and promising it will is the start of a bad sequence.

Frequently asked questions

How do you get rid of a gummy smile permanently?

A permanent solution only exists when the cause is anatomical (excess gum tissue or the position of the upper jaw), and the correction is done with a gum procedure, orthodontics or surgery. When the cause is muscular, the treatment is toxin, and it is temporary by nature.

How many millimeters of gum count as a gummy smile?

References vary, and larger exposures are usually classified as severe cases. But the measurement alone doesn't indicate treatment: what determines the approach is the cause and the discomfort, not the number.

Can Botox fix a gummy smile?

When the origin is an overly mobile lip, yes, and well. When the origin is structural, no, and no higher dose turns one case into the other.

Does the smile look strange afterward?

If the dose is calibrated, the smile is still yours, with less gum showing. If it's too high, it looks short and heavy. That's the central risk in this area and the reason to start conservatively.

Who performs this treatment?

A dental surgeon trained in facial harmonization, within the scope of practice defined by the CFO. At RUV, the assessment and treatment are done by Dr. Najla Vicentini Toledo.

How long does it last?

Less than in areas like the forehead, because the upper lip muscles work all day. Maintenance is set case by case, respecting a minimum interval between sessions.