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  • Chapter 24 - Botulinum Toxin in the Treatment of Gummy Smile

  • Edited by Daniel Truong, University of California, Riverside, Dirk Dressler, Hannover Medical School, Mark Hallett, National Institutes of Health (NIH), Christopher Zachary, University of California, Irvine, Mayank Pathak, Truong Neuroscience Institute
  • Book:
    Manual of Botulinum Toxin Therapy
    Published online:
    02 November 2023
    Print publication:
    23 November 2023, pp 207-213

  • Summary

    The gingival smile or gummy smile (GS) occurs when more than 2 to 3 mm of gum is exposed. It may be related not only to the excessive elevation of the upper lip by the involved muscles, but also to alterations in anatomical features like lip length, bone and periodontal and dental structures. The amount of exposed gum can largely differ from patient to patient, with some individuals presenting gum exposure of up to 10 mm. This chapter discusses the different subtypes of gummy smile – anterior, posterior, mixed – using detailed anatomical illustrations of each, including the pertinent musculature. A table lists the specific muscles to target for injection in each subtype.