Aesthetic Management of Gummy Smile: From Diagnosis to Treatment

Abstract Objective: The aim of this review is to discuss the causes of a gummy smile, its classification, treatment methods depending on its underlying cause, the muscles involved in the formation of a gummy smile in cases of muscle hyperactivity, and to focus on the use of botulinum toxin in its treatment. Materials and Methods: Available articles published primarily on PubMed, mainly in recent years, were used. These articles focused on "gummy smile" and "the use of botulinum toxin in the treatment of gummy smile." The criteria for selecting appropriate articles emphasized those that discussed the etiology, clinical characteristics, and therapeutic approaches, particularly non-surgical treatment using botulinum toxin. Results: The review indicates that a gummy smile has various etiologies. Depending on its cause, treatment can involve surgery, dental procedures including orthodontics, periodontic treatments, and increasingly popular in recent times, the use of botulinum toxin. The application of botulinum toxin, when combined with an understanding of anatomy and the ability to identify hyperactive muscles contributing to excessive gingival display during smiling, offers a minimally invasive approach. By temporarily blocking nerve impulses, botulinum toxin weakens the muscles, reducing the visibility of gums during a smile. Although botulinum toxin provides promising results, the procedure needs to be repeated, as the satisfactory effect typically lasts for 3-4 months.