Excessive gingival display: differences in diagnosis and management by periodontists and dermatologists in Saudi Arabia

Abstract

Background: Excessive gingival display (EGD), commonly known as a \"gummy smile,\" is defined as overexposure of the maxillary gingiva (>3 mm) when smiling. The prevalence of EGD ranges from 10.5% to 29% of the population worldwide. Multiple factors contribute to EGD, including dental, skeletal, and muscular etiologies. Various treatments for EGD include both surgical and nonsurgical approaches. Objectives: This study aimed to identify the similarities and differences in diagnosis and treatment strategies used by periodontists and dermatologists for EGD. Methods: A cross-sectional study was carried out based on the results obtained using a digital survey. A questionnaire focusing on the study objectives was formulated using Google Docs and distributed to specialty practitioners via their institutional email accounts. The first section of the questionnaire collected socio-demographic information from the physician participants. The second section explored their familiarity with EGD, including the different clinical variables, diagnostic measures, and potential treatments. Statistical analysis was carried out using Fisher\'s exact test. Results: Fifty respondents (both male and female) representing various academic levels and institutions in Saudi Arabia participated in this study. Most of the participants from both specialties were familiar with EGD (p = 0.05); however, patient selection varied significantly based on the extent (in mm) of preoperative gingival display (p < 0.001). The participants also differed in their preferred approach to the management of EGD due to different causes. Conclusion: The findings presented in this study revealed the strengths and limitations of the management strategies used by these specialists. Taken together, our findings demonstrated the importance of a shared training program and ongoing collaboration to optimize the treatment of EGD.