Aesthetic dentistry, DENTISTRY, MEDICINE

gum hyperpigmentation and its management

Are you worried about darker shades of your gums and looking for a solution ? Well, there are ways to get rid of hyperpigmentation; however, before heading to the treatment options I would like to emphasis that you are not the only person with darker gums(gingiva). Like our skin tone, gums are also unique in nature and varies from person to person. Nothing to feel inferior about, it is purely an aesthetic modality until and unless overridden by pathological conditions.

Possible reasons for pigmented gums :

It could be physiological or sometimes pathological too. For some people, as a nature process their gums are hyperpigmented which are often influenced by their gene, race and ethnics. Increased melanin, carotene, iron, bilirubin, oxyhemoglobin are some of the natural cause for hyperpigmentation of gums. Nevertheless, certain pathological changes like hormonal imbalance, heavy-metal poison, medication, smoking and tobacco, other abnormal changes in mucosa of oral cavity could also influence the gum color.

Treatment options :

Various treatment options are available; however, skin colour, extend of pigmentation, upper lip curvature and aesthetic concern are all must be considered before planning for depigmentation procedure.

Chemical method :

Chemicals like ascorbic acid , alcohol are used on the gums to remove pigmentation. It inhibits melanin formation and delaying in repigmentation has also been noticed.

Gingival abrasion :

Here, the superficial layer of the epithelium are denuded to remove pigmentation

pros –

  • Non – invasive method
  • cost effective

cons –

  • increased treatment duration
  •  post treatment pain
  •  need to have dressing at the surgical site for about a week or two
  •  high recurrence rate

Scalpel surgical technique :

In this technique the outer epithelium is excised leaving the inner connective tissue to repair by secondary healing

pros –

  •  simple procedure
  •  most economical
  •  low recurrence rate
  •  requires less time and effort

cons –

  •  pain and post operative discomfort
  •  bleeding during and after the procedure
  •  requires periodontal dressing

Free gingival grafting :

It is nothing but masking the pigmentation with a grafting material, either from your own tissue preferably from the palate or the with synthetic material. However, it requires two surgical sites, post operative pain and discomfort are predominant, moreoever it gives ghost like appearance when compared to the adjacent tissue. These drawbacks are more likely overcome by synthetic material, but those are extremely expensive though.

Electrosurgery :

In this method heat is generated by transmission of high frequency electrical energy to the tissue causing cutting or coagulation of targeted tissue.

pros –

  •  Controlled bleeding
  •  better tissue contouring
  •  less scar on the surgical site

cons –

  •  Pain and discomfort during initial healing time

Laser :

Lasers are advancing modern technology nowadays and it has optimal efficacy in gingival hyperpigmentation.

pros –

  •  Enhanced hemostatic ability
  •  post operatively it has less or very minimal pain, bleed, discomfort , swelling and infection
  •  better wound healing
  •  effective and safe treatment modality
  •  better aesthetics

cons –

  •  Not a cost effective one, as it requires specialized instruments and set up, laser treatments are expensive

Cryosurgery :

It is the most accepted method. In this technique, gums are freeze by the application of cryogens. In this ultra low temperature, gingival epithelium undergo cryonecrosis causing elimination of hyperpigmentation.

pros –

  •  Inexpensive
  •  Long term superior aesthetic
  •  rapid healing
  •  low recurrence rate
  •  No bleed, pain and scar
  •  Does not require anesthesia, suture and dressing

cons –

  •  Post operative swelling might be seen during initial phase of healing

Those are the possible treatment options for gum hyperpigmentation; however, you have to decide whether you need to go for the procedure and it certainly depends on your pathological condition and or your level of confidence on darker gum exposure.

Journal reference :

Alasmari DS, 2018 Sep-Oct;12(5):84-89, An insight into gingival depigmentation techniques: The pros and cons.

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