A systematic diagnostic scheme for excessive gingival display “gummy smile”

Achieving a harmonious smile has become an integral part of orthodontic treatment. Excessive gingival display or a gummy smile (GS) negatively affects smile esthetics and often prompts patients to seek orthodontic treatment. The manifestation of GS can be due to various etiologic factors that may be present separately or simultaneously in variable degrees. Differentiating the underlying etiologies for each patient with a GS is essential for making an accurate diagnosis and a predictable treatment plan. This article aims to present a comprehensive diagnostic scheme of GS comprising seven sequential steps to identify and quantify the potentially responsible etiologies. A diagrammatic diagnostic chart for a sample case with GS is presented, along with a comprehensive table template of the recommended measurements and their ideal values.