Gummy Smile: Etiological Factors and Treatment Modalities

Abstract The excessive exposure of the upper gingiva is termed as gummy smile or excessive gingival display. A typical smile shows 1–2 mm of gingiva, but in cases of excessive display, more than that becomes visible, which can cause self-esteem issues for some individuals. The causes of a gummy smile are multifactorial, with common factors which include short lip with hypermobility, altered passive eruption, vertical maxillary excess (VME), and gingival enlargement. Diagnosing a gummy smile requires a comprehensive evaluation, which may include facial and lip analysis, periodontal assessments, and imaging techniques. Once the underlying cause is identified, treatment options can be tailored. Noninvasive treatments such as botulinum toxin injections or hyaluronic acid fillers may be used for cases involving a hypermobile lip, while more invasive options, such as gingivectomy or orthognathic surgery, are indicated for conditions like altered passive eruption or VME. The success of treatment depends on the specific cause of the gummy smile. Most cases show significant improvement with proper intervention, though some may require more complex procedures. Achieving the best outcomes typically involves collaboration among dental specialists, ensuring comprehensive care and patient satisfaction. Whether through minimally invasive treatments or surgical procedures, addressing a “gummy smile” can enhance both esthetic appearance and overall confidence.