Melanin pigmentation of the gingiva occur in all races. Melanin, a brown pigment, is the most common cause of endogenous pigmentation of gingiva and is the most predominant pigmentation of mucosa. Gingival hyperpigmentation is seen as a genetic trait in some populations and is more appropriately termed physiologic or racial gingival pigmentation.
Melanin hyperpigmentation usually does not present as a medical problem, but patients may complain their black gums are unaesthetic. This problem is aggravated in patients with a “gummy smile” or excessive gingival display while smiling. The range of darkening effects can be spotted or splotchy (light and dark brown)… all the way to nearly 100% of the gum tissues. Black gums usually refers to the condition where all or most gum tissue is affected, with a complete brown appearance.
The available techniques are:
1. Periodontal surgery: One of the first, and still popular, techniques to be employed was the surgical removal of undesirable pigmentation using scalpels or surgical knives. The procedure essentially involves surgical removal of gingival epithelium along with a layer of the underlying connective tissue and allowing the denuded connective tissue to heal by secondary intention.
2. Gum Bleaching, using proprietary bleaching solutions alter the coloration of the pigmentation directly. Since the cellular structures that create melanin are not removed, there is a likelihood that excess pigmentation can recur. Some patients may have sensitivity issues with the bleaching compounds The new epithelium that forms is devoid of melanin pigmentation. Still invasive procedure, it is a treatment option that is not too appealing for many patients.
3. LASER
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