Gummy Smile Botox in Toronto: What It Can Change, What It Cannot, and What to Ask First
Gummy smile Botox is a small injection of botulinum toxin type A into the muscles that lift the upper lip, so the lip rises a little less when you smile and less gum shows. It is temporary, usually wears off over a few months, and it only suits a gummy smile that comes from an overactive lip. It does not reshape gums, teeth or the jaw.
That is the short version. The longer one matters, because “gummy smile” is a description and not a diagnosis. Some people show gum because the upper lip lifts high, some because the upper jaw sits long, some because the gum tissue itself sits low on the teeth, and many because of a mix. Botox helps with only one of those, and I think a lot of disappointment comes from not knowing which one you have before you book.
This guide is general education for adults in Toronto who are curious about it. At Rejuvenation Med Clinic, our gummy smile correction page describes the treatment, and our broader Botox services in Toronto page lists the other areas we treat. Nothing below is a diagnosis or a promise about your smile. A smile with some gum showing is a normal variation, and leaving it exactly as it is remains a perfectly good choice.
Related Service: Gummy Smile Correction at Rejuvenation Med Clinic
What gummy smile Botox actually is
Botox is a brand name for onabotulinumtoxinA, one of several botulinum toxin type A products used in cosmetic medicine. A very small amount placed in a muscle blocks the nerve signal that tells it to contract, so the muscle moves less for a while. For a gummy smile, the goal is a gentler lift of the upper lip, not a frozen one.
The muscles involved
Several small muscles beside the nose and along the upper lip raise it when you smile. The group most often discussed is the levator labii superioris alaeque nasi, which runs alongside the nostril, with neighbours such as the levator labii superioris and the zygomaticus minor. If those pull harder than average, the lip rides high and gum shows. Our own page puts it simply: Botox is placed in the upper lip’s elevator muscles so there is less lifting when you smile. Exactly which muscles, how much product and where is a decision for the injector who watches you smile in person, and I am deliberately not listing doses or injection points here because they are not something a blog should hand out.
What a gummy smile is, medically
Dentists often call it excessive gingival display. A common rule of thumb in the literature is that a few millimetres of gum showing is considered within a normal, attractive range, and that more than about three to four millimetres is where people start to describe it as gummy. That is a guideline and not a verdict. Plenty of people with more gum showing love their smile, and plenty with less want a change.
What it is not
It is not the same as a lip flip, although the two are often mentioned together and some providers combine them. A lip flip relaxes the muscle ring around the mouth so the upper lip rolls slightly outward, and our Botox lip flip page and the guide on best practices for lip flip procedures explain that treatment. It is also not jaw slimming, which targets the masseter and is covered in our masseter Botox guide.
Why some smiles show more gum than others
Before anyone talks about injections, the cause deserves a closer look. The same photo of a gummy smile can have very different explanations underneath.
A hyperactive upper lip
The lip elevators pull the lip higher than average during a full smile. This is the cause Botox is designed for. A telling sign is that the amount of gum changes a lot between a relaxed expression and a big smile.
A short upper lip
If the lip is short at rest, teeth and some gum may show even without a smile. Relaxing the muscle can still reduce the lift, but the starting point is different and expectations should be modest.
Vertical maxillary excess
When the upper jaw has more vertical length, more gum tends to show. This is a structural trait. Botox does not change bone, so people in this group are usually referred to a dentist, orthodontist or oral and maxillofacial surgeon to discuss options.
Gum tissue that sits low on the teeth
Sometimes the teeth look short because the gum has not fully moved back, a situation dentists call altered passive eruption, or because the gum is thicker. Certain medicines can also cause gum overgrowth. These are gum-level causes and are handled by dental professionals, often with gum contouring.
A mix of causes
Many people have more than one. A good assessment looks at the lip at rest, in a social smile and in a full smile, and then decides whether Botox is likely to be the main answer, a partial answer, or the wrong one.
| What a provider may notice | Likely contributor | Where the answer usually sits |
|---|---|---|
| Lip lifts very high in a full smile, much less in a social smile | Hyperactive lip elevators | Botox is often discussed |
| Teeth look short and gum looks thick | Gum tissue | Dentist or periodontist, often gum contouring |
| Long lower face with gum showing even with a relaxed smile | Upper jaw length | Orthodontic or surgical consultation |
| Short upper lip at rest | Lip length | Botox may help partly, sometimes with other options |
| Gum showing plus a flat, wide smile | Combination | A joint plan, sometimes more than one professional |
What gummy smile Botox can and cannot do
What it may do
Relax the lift of the upper lip so that less gum is visible in a full smile, and soften the high, tight look some people notice in photos. A 2021 meta-analysis and meta-regression on the effect and longevity of botulinum toxin in gummy smile and a systematic review and meta-analysis on non-surgical management of the gingival smile with botulinum toxin A are both listed in the research literature if you like reading studies. I could not open the full text of either while preparing this article, so I am pointing to them as places to start and not quoting numbers from them.
What it will not do
It will not remove gum tissue, change tooth length, correct jaw structure, whiten or straighten teeth, or add fullness to the lips. Our own page says the same thing, that it reduces gum show caused by muscle hyperactivity but does not address structural jaw or gum tissue problems.
The trade-off nobody mentions enough
Because the lip elevators also help shape your smile, relaxing them changes how the smile looks. Done carefully, most people describe a softer, slightly lower upper lip. Done heavily, the smile can look flatter or the upper lip can feel stiff for a while. This is the reason a conservative first treatment with a review visit is a sensible approach.
| Goal | Does Botox address it? | Other routes a provider may discuss |
|---|---|---|
| Less gum shown in a full smile caused by a high-lifting lip | Often, temporarily | Lip repositioning surgery, orthodontics |
| Teeth that look short because of gum position | No | Gum contouring or crown lengthening with a dentist |
| Long upper jaw | No | Orthodontic and jaw surgery consultation |
| Thin upper lip | Not directly | Lip filler, discussed separately |
| Smile that pulls up on one side | Possibly, with assessment | Careful mapping, sometimes asymmetry review |
| Gum overgrowth linked to a medicine | No | Talk to your doctor and dentist |
Is gummy smile Botox approved by Health Canada?
Worth asking, and many pages skip it. The Health Canada product monograph for Botox Cosmetic (AbbVie, revision dated November 2022) lists its cosmetic use as the temporary improvement of upper facial lines, namely the forehead, the lateral canthal lines and the glabellar lines. The upper lip elevators and gummy smile are not mentioned, so using Botox for a gummy smile is an off-label professional use. A newer revision may exist, so check the Drug Product Database for the current one.
What off-label means here
Off-label means using an authorized product in a way that its monograph does not describe. It is common in medicine. It also means the evidence is built more on published studies, clinical training and experience than on the large trials behind the labelled areas. That is not a reason to avoid it, just a reason to ask who is doing it and how often.
Questions that are fair to ask
Ask whether they treat the upper lip regularly, how they decide on the amount, what they do if the lip feels too heavy, and whether they offer a review at about two weeks. A calm, specific answer is a good sign. Candidacy, dosing and technique are decisions for the qualified professional who examines you.
How the appointment usually goes
The assessment
Our page describes a professional assessment of lip movement, gum show, smile dynamics and overall facial balance, which is how a provider decides whether Botox is the right tool. Expect to be asked to smile in different ways, sometimes for photos. You will also be asked about your medical history, medicines, allergies, pregnancy or breastfeeding and past injectables.
The injections
A few small injections are placed in the upper lip elevators beside the nose, customized to your anatomy and muscle strength. Most people describe tiny pinpricks. Our page says Botox treatment needs no surgery or local anesthetic and involves mild discomfort, and our other Botox pages say topical numbing is available on request, so ask if you are needle sensitive.
Right afterwards
The session is short, and there is no formal downtime on our page, so most people go straight back to their day. Small bumps or redness at the injection sites can appear for a short time.
The review visit
The full effect tends to appear around two weeks, so that is the right moment to look at the result in the mirror and in photos and decide whether any adjustment makes sense. Without a review, a provider cannot learn how your muscles respond, and neither can you.
Timeline and how long it lasts
Our gummy smile page says results begin within 3 to 5 days and reach their full effect around two weeks after treatment, and that effects last between 3 and 6 months. Our lip flip page says 3 to 4 months. Those figures are close but not identical, which is typical, since duration depends on dose, your metabolism, how strong the muscles are and how much you use them. The effect is temporary, and muscle activity gradually returns.
| Time after treatment | What many people notice | Worth doing |
|---|---|---|
| Day 0 to 1 | Tiny marks or mild redness at the injection sites | Follow your provider’s aftercare, avoid touching the area |
| Day 3 to 5 | Early softening of the lift in some people | Wait, nothing to adjust yet |
| About 2 weeks | Fuller effect visible | Review visit, photos in a natural smile |
| Around 3 to 4 months | Lip starts lifting the way it used to in some people | Decide whether to repeat |
| Up to about 6 months | Gradual return of muscle activity for others | Book only if you still want it |
Risks, side effects and warning signs
Most side effects are mild and short lived, but this is still an injected drug and it deserves a straight conversation.
Common and usually temporary
Slight redness, swelling, tenderness or bruising near the injection sites. Some people feel their upper lip is a little tight or heavy as the effect settles in.
Smile changes
If toxin affects a neighbouring muscle, the smile can look uneven, the upper lip can feel stiff, or the lip can sit lower than you wanted for a while. It wears off, and a measured first dose lowers the chance. This is the main reason I would choose a provider who treats the area often over one offering the lowest price.
Rare but serious
The Health Canada product monograph for Botox Cosmetic carries a boxed warning about spread of toxin effect away from the injection site, which can cause swallowing, speaking or breathing difficulty. That is uncommon with cosmetic doses, but if it happens it needs emergency care, and your provider should have reviewed your history first.
| What you notice | Usually means | What to do |
|---|---|---|
| Mild redness, small bumps, slight tenderness | Common, short-lived reaction | Keep the area clean, avoid pressing it, mention it at review |
| Smile feels slightly stiff or the lip looks lower | Expected effect or a little too much relaxation | Contact your provider at review, it fades |
| Uneven smile that bothers you | Toxin effect on a neighbouring muscle | Call your provider to discuss options |
| Spreading redness, heat, pus or fever | Possible infection | Get prompt medical care |
| Trouble swallowing, speaking or breathing | Possible serious reaction | Seek emergency care immediately |
Who should wait or talk to a doctor first
The Health Canada monograph says Botox Cosmetic should not be used during pregnancy, advises caution while breastfeeding, and lists contraindications and cautions for people with certain neuromuscular conditions or an infection at the injection site. Our Botox page also asks pregnant or breastfeeding clients to wait. If you take blood thinners, have a nerve or muscle condition, or have had a reaction to a neurotoxin before, say so at the start.
Preparation and aftercare
Before your visit
Our chin and other Botox pages suggest avoiding blood thinners and alcohol for 24 to 48 hours beforehand, though your provider’s own instructions come first, and you should never stop a prescribed medicine without asking the doctor who prescribed it. Come with a clean face, a list of medicines, and photos of smiles you do or do not like so the conversation is concrete.
After your visit
Our Botox pages advise avoiding touching or massaging the treated area and avoiding strenuous facial movement for about 24 hours. Beyond that, normal activity is fine for most people. I would add a small, practical note: do not judge the result on day two. It is not finished.
| Timing | Do | Avoid |
|---|---|---|
| Before | Share medical history and medicines, bring smile photos, ask about candidacy | Alcohol and blood thinners for the window your provider gives |
| First 24 hours | Gentle cleansing, a cool compress if you like | Rubbing, massage or strenuous facial movement |
| First week | Watch for early change and note questions | Judging the final result too early |
| Around 2 weeks | Attend the review, look at photos together | Booking more units without a review |
Gummy smile Botox compared with other options
Botox is one option and often not the only one. Dentists in Toronto commonly offer gum contouring, and some people are also referred for orthodontics or surgery. A fair comparison helps you decide who to see first.
Gum contouring and crown lengthening
These procedures reshape or remove gum tissue so teeth look longer and less gum shows. They are dental procedures, they are more involved than an injection, and they are not quickly reversible. They suit people whose gum tissue is the main cause.
Lip repositioning surgery
A surgical option that limits how far the lip lifts, usually considered when Botox keeps being needed and the person wants something longer lasting. It involves a surgeon, recovery time and the usual surgical risks.
Orthodontic or jaw surgery
For gummy smiles driven by the position of the teeth or the length of the upper jaw. This is a specialist assessment and a much bigger commitment.
Lip filler
Filler adds volume and can change how the lip sits, but it does not relax the muscles that cause gum show. It is sometimes confused with a lip flip. Our lip flip versus lip filler guide and lip fillers page explain the difference, and our dermal filler page covers the areas we treat.
| Option | How it works | Duration | Invasiveness | Suits mainly |
|---|---|---|---|---|
| Botox for gummy smile | Relaxes lip elevators | Temporary, a few months | Injection, no surgery | Gum show from a high-lifting lip |
| Botox lip flip | Relaxes the ring muscle around the mouth | Temporary, a few months | Injection, no surgery | Thin or tucked upper lip with a little gum show |
| Gum contouring | Reshapes gum tissue | Long term | Dental procedure | Gum position or thickness |
| Lip repositioning | Surgical limit on lip lift | Long lasting | Surgery | Lip-driven gummy smile, long term |
| Orthodontics or jaw surgery | Moves teeth or jaw | Permanent in most cases | Specialist treatment | Skeletal or dental cause |
| Lip filler | Adds volume | Temporary | Injection | Lip volume goals, not gum show |
Botox, Dysport and other neuromodulators
Several neuromodulators are used in aesthetic medicine, including Botox and Dysport. Our Dysport page and the guide on Dysport versus Botox explain the differences. Whether one suits you better for the upper lip is an injector’s call, so ask which product they use and why. Our gummy smile page describes Botox specifically.
Cost factors in Toronto
Our Botox page says Botox typically costs between $10 and $20 per unit, and our gummy smile page says the number of units depends on muscle strength and severity and gives an average cost around $397 across providers. Neither is a quote for you. Total cost depends on units, provider experience, how often you repeat treatment and any add-ons. Our guide to Botox costs in Toronto goes through the factors, and our financing page describes payment options. Prices change, so confirm the current figure when you book.
| Cost factor | Why it changes the total |
|---|---|
| Number of units | Stronger lip muscles may need more, a careful first dose may need fewer |
| Provider experience | Small, precise areas reward skill, and fees often reflect it |
| Review or touch-up visit | Some clinics include it, some do not, so ask |
| Frequency of repeat treatment | Results are temporary, so cost is ongoing if you maintain them |
| Combining with other treatments | Lip flip or filler adds to the total |
Who may be a good candidate, and who may not
People most likely to benefit are healthy adults whose gummy smile comes from a hyperactive upper lip and who want a non-surgical, reversible option. People who may be better served elsewhere include those whose gum show comes from bone or gum tissue, those who are pregnant or breastfeeding, and anyone with a condition or medicine that makes neurotoxins unsuitable. It is an adult decision made with a professional, and someone who prefers to keep their smile as it is has made a reasonable choice too.
| Consideration | Often reassuring | Worth discussing first |
|---|---|---|
| Cause of gum show | Lip movement is the main driver | Gum tissue or jaw length may be involved |
| Health history | No relevant contraindications | Neuromuscular conditions, infection, allergy to ingredients |
| Pregnancy or breastfeeding | Not applicable | Wait and talk to your doctor |
| Expectations | Subtle, temporary softening | Wanting a permanent or structural change |
| Smile habits | Comfortable with a slightly lower lip lift | Public speaking, musical or sports demands, mention them |
Questions to ask at a consultation
A consultation at Rejuvenation Med Clinic is a chance to talk through your goals and history, and our booking page and contact page show how to reach us. Whether a consultation is free is something to confirm when you book, since I did not see it stated on the booking page. It does not commit you to treatment, and your plan can change after an individual assessment.
| Question | Why it helps |
|---|---|
| What is causing my gum show? | Confirms whether Botox is the right tool |
| Which muscles will you treat and why? | Shows the provider’s reasoning |
| What will you do if the lip feels too heavy? | Tests how they handle adjustments |
| Do you offer a review at about two weeks? | Gives the result a chance to be refined |
| Who performs the injection, and what is their experience with this area? | Small area, skill matters |
| What are the alternatives, including doing nothing? | Keeps the decision yours |
| What is the cost, and what does it include? | Avoids surprises |
If you are comparing several lower face concerns, you may also find our guides to marionette lines, bunny lines, chin Botox and nasolabial fold filler useful, and our injectable treatment FAQ covers common questions. For wider background, see our article on how Botox is used for medical purposes, and the Canadian Dermatology Association offers general skin and dermatology information.
Please bring your medical history, a list of medicines and any past injectable treatments. If a different option suits you better, or no treatment at all, we would rather say so directly.
This article is general education and not medical advice, a diagnosis or a guarantee of results. See a qualified healthcare professional, including a dentist where gums or teeth are involved, for guidance about your own situation.
Frequently asked questions
What is gummy smile Botox?
Gummy smile Botox is a small injection of botulinum toxin type A into the muscles that lift the upper lip. It relaxes them so the lip rises less and less gum shows when you smile. It is temporary and works only when muscle activity is the cause, not gum tissue or jaw structure.
Does Botox really fix a gummy smile?
It can reduce gum show when a high-lifting upper lip is the cause, though not everyone responds the same way. It does not change gum tissue, teeth or bone. A provider should work out the cause first, since a gummy smile from gums or the jaw may need a dentist.
How long does gummy smile Botox last?
Our gummy smile page says effects last between 3 and 6 months, while our lip flip page says 3 to 4 months. Your own duration depends on dose, metabolism and muscle strength. The effect is temporary, so muscle activity gradually returns and repeat treatment is needed to maintain it.
How long does gummy smile Botox take to work?
Our page says results begin within 3 to 5 days and reach their full effect around two weeks. That is why a review at about two weeks is useful, since the result is fully visible by then and any small adjustment can be discussed.
Is gummy smile Botox safe?
Serious problems are uncommon when it is done by a trained provider, but it is still an injected drug. Common effects are redness, swelling or bruising. Rarely, toxin can spread and affect swallowing or breathing, which needs emergency care. Your provider should review your history first.
Is Botox for gummy smile approved by Health Canada?
The Health Canada monograph for Botox Cosmetic lists upper facial lines such as the forehead, lateral canthus and glabellar lines. It does not mention gummy smile, so this is an off-label professional use. Ask your provider about their experience and approach.
Does gummy smile Botox hurt?
Most people describe tiny pinpricks and brief discomfort. Our gummy smile page says no anesthetic is required, and other Botox pages mention topical numbing on request. Sensitivity varies, so tell your provider if you dislike needles or have felt faint before.
Will my smile look different or frozen?
A careful treatment should leave a natural smile with a slightly lower upper lip lift. Too much relaxation can make the smile look flatter or the lip feel stiff for a while. A measured first dose and a two week review help prevent that.
How much does gummy smile Botox cost in Toronto?
Our Botox page says Botox typically costs $10 to $20 per unit, and our gummy smile page gives an average cost around $397. Your total depends on units, provider experience and add-ons. Prices change, so confirm the current cost when you book.
How many units of Botox are needed for a gummy smile?
That is decided by the injector after assessing your muscle strength and smile. Our page notes it varies with muscle strength and severity. A fixed number from a website is not reliable for your face, so ask your provider how they plan the dose.
Is gummy smile Botox better than gum contouring?
They solve different problems. Botox relaxes the lip muscles temporarily, while gum contouring reshapes gum tissue and is a dental procedure with longer lasting results. Which is better depends on whether lip movement or gum tissue is causing the gum show.
Can Botox fix a gummy smile caused by the jaw or gums?
Generally no. Botox acts on muscle, and it does not change bone, gum tissue or tooth length. If your gum show comes from an upper jaw that sits long or from gum position, a dentist, orthodontist or surgeon is the better first stop.
What is the difference between a lip flip and gummy smile Botox?
A lip flip relaxes the ring muscle around the mouth so the upper lip rolls slightly outward, while gummy smile treatment relaxes the muscles that lift the lip. Some providers combine them. Ask which one matches your goal.
What should I avoid after gummy smile Botox?
Our Botox pages advise avoiding touching or massaging the treated area and avoiding strenuous facial movement for about 24 hours. Before treatment, they suggest avoiding blood thinners and alcohol for 24 to 48 hours. Follow your provider’s instructions and never stop a prescribed medicine without asking your doctor.
Can I have gummy smile Botox while pregnant or breastfeeding?
The Health Canada monograph says Botox Cosmetic should not be used during pregnancy and advises caution while breastfeeding. Our Botox page also asks pregnant or breastfeeding clients to wait. Talk to your doctor and your provider about timing.
Can gummy smile Botox be reversed?
There is no antidote that quickly undoes it, but the effect wears off over a few months as muscle activity returns. If you are unhappy, contact your provider, who can explain what to expect and when it should settle.
Do I need a dentist as well?
Possibly. A dentist can check whether your gums, teeth or bite contribute to the gum show, and that information helps decide whether Botox is likely to help. Many people benefit from both a dental and an injectable opinion.
When should I see a doctor after treatment?
Seek emergency care right away for trouble swallowing, speaking or breathing. Get prompt medical care for spreading redness, heat, pus or fever. Contact your provider if your smile looks uneven, your lip feels very heavy or anything feels wrong.
