Gummy smile

Gummy smile also known as excessive gingival display is a smile that shows an excessive amount of gum under the upper lip. It is a common unaesthetic clinical condition, which can be caused by an abnormal dental eruption (delayed passive eruption), or hyperfunction of the upper lip elevator muscle or by an excessive vertical growth of the bone of maxilla or over-eruption of the maxillary anterior teeth, or a combinations to one of the above described factors together. Several treatment options have been proposed to enhance the smile display and to reduce the gingival exposure. Gummy smile also known as excessive gingival display is a smile that shows an excessive amount of gum under the upper lip. It is a common unaesthetic clinical condition, which can be caused by an abnormal dental eruption (delayed passive eruption), or hyperfunction of the upper lip elevator muscle or by an excessive vertical growth of the bone of maxilla or over-eruption of the maxillary anterior teeth, or a combinations to one of the above described factors together. Several treatment options have been proposed to enhance the smile display and to reduce the gingival exposure. Treatment option include orthodontics, surgery, botulinum toxin A injections, and micro-autologous fat transplantation (MAFT). Botox (BTX-A) has been successful in the treatment of gummy smiles, however the results are not permanent, they last for an average of 6 months. The material is injected into the hyperactive muscles of upper lip, which causes a reduction in the upward movement of lip thus resulting in a smile with a less exposure of gingiva. Botox is usually injected in the three lip elevator muscles that converge on the lateral side of the ala of the nose; the levator labii superioris (LLS), the levator labii superioris alaeque nasi muscle (LLSAN), and the zygomaticus minor (ZMi).