Evaluating and Establishing Ideal Smile Esthetics : Beauty is More than Skin Deep
Gingival Display

When the upper lip is concordant with the gingival zeniths of the central incisors at full smile, this is considered no gingival display.^28,38,39, A “gummy smile” or excessive gingival display as well as a low smile line where teeth are not fully displayed can compromise smile esthetics. Gingival display may be categorized into one of five classes. In class 1, the lip is positioned well above the cervical portion of the maxillary teeth at full smile and in class 5 the lip is positioned to provide full coverage of the maxillary teeth during the natural smile. While the ideal amount of gingival display is not uniform among populations, many investigators state that a lower margin of the upper lip that aligns evenly with the gingival margin of the maxillary central incisors is considered optimally esthetic.^28,38,39, However, there are studies that suggest that in some populations, a combination of maxillary incisor visibility and gingival display up to 1mm is judged equally or more attractive as a lip position concordant with the gingival margins.^40,41 The gingival display considered ideal varies based upon subject age, gender, and the societal norms within individual communities.^19,42 Excessive gingival display is less well-tolerated esthetically in men versus women.^19,42 For instance, some studies have shown that patients with up to 3mm of gingival display is acceptable esthetically, particularly for females.^19,42