**1. Introduction**

A smile has always been an important key in our social life, not to mention if it is an attractive one. The type, degree, tone, at static or a dynamic figure concerns facial beauty as well as the internal mood, or what might be called " the internal smile." The society in the current century is turning towards social media, gadgets, electronics and advertisements mainly based on pictures. Those corporates seeking to recruit applicants for job positions assess the persons photograph in addition to their CV because a photo can tell a lot about an applicant. Hence, there is a growing trend towards enhancement of facial esthetics.

Among the medical professions, many specialties are dealing with smiles; however, the approach to management can vary considerably due to improper diagnosis and lack of knowledge toward the variable treatment options. Specialists such as restorative dentist, prosthodontist, orthodontist, periodontist, maxillofacial surgeon, plastic surgeon, and dermatologist are working around the "smile complex"; however, no clear inter-specialty communication exists to provide the best intervention for patients. This might be a reason for variable management to smile imperfections via different specialties.

In this chapter, the "unattractive smile", is being discussed from different angles and in a totally different manner. The objective is to collect the expertise of variable cosmetic specialties in a single chapter to help practitioners in future decision-making processes in "smile manage‐ ment." Hence, the concepts are presented along with multiple challenging cases with different interventions. Interventions such as restorative veneers in the maxillary anterior teeth can be the answer to all patients' troubles if used in the right cases; while crown lengthening as a sole procedure or in combination with veneers can be the ultimate solution for others [1].

Maxillary surgical procedures such as LeFort 1 may be the only solution in others. Laser therapy for lip irregularities can provide more convenient results in case of fine wrinkles, while Botox and fillers may provide better outcomes for some gummy smiles. The case can be a little

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bit more challenging if the patient is known to have a repaired cleft lip, previous lip trauma, or secondary facial deformity [2].

Other situations where patients visit clinics with a clear demand of what can make them feel happier, such as piercing or cheek dimples can be linked to the patient's own personal satisfaction. On other occasions, clients may be confused, and complain of resenting their profile pictures without clear understanding of their problem needing correction. It is well known, that in the current era of cosmetic revolution and subspecialty care and techniques, continuous evaluation and research regarding the principles of "smile management" are evolving. Therefore, practitioners should keep in mind that proper training in the field, careful case selection, and inter-specialty communication can provide the best results with the least possible complications.
