Patients with excessive gingival display may have one of many diagnoses. Being able to properly identify whether the cause of the gummy smile is skeletal (vertical maxillary excess), soft tissue (short upper lip or hypermobile lip) or something else is critical in helping the patient choose treatment. Can we do crown lengthening? Are restorations part of the solution? Can orthodontics improve the esthetics? All of these are possible, and can be highly successful when applied in the proper cases. We will use a combination of simple esthetic analytic approaches to determine the proper treatment protocol.

Learning objectives

• Understanding the role of photography in diagnosis
• Understanding the different presentations of facial, skeletal or dental causes of excessive gingival display
• Differentiate between active and passive altered eruption