Esthetic Perception of Gingival Display by Laypeople and Diagnostic Impressions and Etiologic Attribution of Gummy Smile by Dental Professionals: A Cross-Sectional Study.

OBJECTIVE

This study evaluated the diagnostic impressions of gummy smiles and perceived etiologic attribution among general practitioner (GP) dentists and dental specialists and compared the esthetic perception of gingival display between dental professionals and laypeople.

MATERIALS AND

METHODS

Twelve digitally modified smile photographs were generated from a master photograph by altering gingival margin levels and lip position using Adobe Photoshop. A questionnaire was administered to five groups: GP dentists, periodontists, orthodontists, prosthodontists, and laypeople (50 per group; n = 250). Participants rated each image using a 10-cm visual analog scale (VAS). Intergroup comparisons used the Kruskal-Wallis test with Bonferroni-adjusted Mann-Whitney U tests; categorical variables were analyzed using the chi-square and Fisher-Freeman-Halton (FFH) exact tests.

RESULTS

Significant intergroup differences in esthetic perception were observed for most photographs (p  < 0.05). Orthodontists consistently assigned lower esthetic scores than all other groups and were more likely to diagnose gummy smile. Laypeople rated images with mild-to-moderate gingival display more favorably. Orthodontists more frequently attributed gummy smiles to skeletal etiology; periodontists and GPs favored soft tissue-related causes.

CONCLUSIONS

Esthetic perception of gingival display varies significantly among dental specialists and between professionals and laypeople. Differences were also observed in the diagnostic impressions and perceived etiologic attribution of gummy smiles among dental specialties. These findings highlight the subjective nature of gummy smile assessment and emphasize the importance of considering both professional evaluation and patient perception during esthetic treatment planning.

CLINICAL SIGNIFICANCE: The findings of this study demonstrate that the esthetic perception of gingival display, diagnostic impressions of gummy smile, and perceived etiologic attribution may vary between dental professionals and laypeople. Awareness of these differences may facilitate interdisciplinary communication and support a more comprehensive and patient-centered approach to the assessment of gummy smiles.