The lower lip covering the incisal edges of the upper canines and premolars is almost a pathognomonic feature of the disorder. Įxcessive gingival display results from an occlusal plane that is lower than expected. It is one of the most common causes of excessive gingival display, and a cephalometric analysis is usually needed to confirm its diagnosis. Vertical maxillary excess is the overgrowth of the maxillary bone in the vertical plane that gives an elongated appearance to the lower half of the face.

Oral radiographs and cephalometric analysis may also be needed the latter indicated for diagnosing VME. The investigations needed to diagnose a gummy smile, and its etiology include frontal and lateral facial analysis, static and dynamic lip analysis, lip line, interlabial distance and display of incisors at rest, and complete periodontal examination.

A gummy smile may result from various disorders, including a short or hypermobile upper lip, altered passive eruption, vertical maxillary excess (VME), dentoalveolar extrusion, and gingival hyperplasia, but VME is one of its most common causes. The critical element in managing a gummy smile is identifying its etiology, which determines the treatment plan and outcomes. In some severe cases, the overexposure of the gingival tissue is evident even in the resting position of the lips. Excessive gingival display, also known as 'gummy smile,' is the overexposure of the maxillary gingiva while smiling.

A gingival display of 1 to 2 mm when smiling is considered normal. Exposing the gingiva when smiling up to some extent provides a youthful look and is cosmetically appealing.

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