Correlation of skin color and gingival pigmentation patterns in a group of South Indians in India

Background: Melanin pigmentation of the gingiva occurs in all ethnicities. Excessive pigmentation is an esthetic concern that has increased awareness about depigmentation procedures. The purpose of the present study was to correlate the skin color and gender with the intensity and distribution of gingival melanin pigmentation in a group of South Indians for treatment strategies. Method: Two hundred male and female non smoking healthy subjects aged 18-35 years were included. A clinical examination of gingiva was performed to assess the anatomic distribution of gingival pigmentation. The intensity of gingival pigmentation and the phenotype of gingiva were also assessed. Subsequently, the skin color was visually examined and assessed as fair, wheatish, brown, and dark. Result: Six classes of gingival pigmentation were defined based on the anatomic distribution. Gingival pigmentation was observed as highest in the attached gingiva and interdental papilla (25.4%) and least in the marginal gingiva and interdental papilla (10.2%). The correlation between the skin color and the intensity of pigmentation was statistically significant, with dark skinned subjects having heavy gingival pigmentation. However, no correlation was found between the gender and the phenotype of gingiva with intensity and distribution of pigmentation. Conclusion: South Indians predominantly have pigmentation in the attached gingiva and interdental papilla and their skin color is positively correlated with the intensity of pigmentation. The incidence of pigmentation does not differ between the sexes. We noted that a majority of the subjects had thick gingival phenotype. Anatomic delineation of gingival pigmentation and their contributory factors may help design treatment strategies in depigmentation procedures.