Assessment of Gingival, Lip and Skin Pigmentation and its Association with Willingness towards Depigmentation among South Indian Female Population: A Cross-sectional Study

Introduction: Facial appearance depends on various factors, including both intraoral and extraoral features. The association between skin pigmentation and gingival pigmentation has been previously established. Severe gingival pigmentation remains an aesthetic concern for individuals, regardless of skin colour. Aim: To explore the relationship between lip, skin and gingival pigmentation and the willingness of South Indian women to undergo depigmentation procedures. Materials and Methods: This cross-sectional study was conducted at the Department of Periodontology, Chettinad Dental College and Research Institute, Chennai, Tamil Nadu, India, from April 2023 to September 2023. A total of 500 South Indian women aged 21-39 years were included. Participants who provided informed consent and had not undergone any antibiotic therapy in the six months prior to participation were included. Individuals were excluded if they had previously undergone any form of aesthetic gum correction, or if they had periodontitis or any gingival pathology affecting gum colour, such as Addison’s disease or malignant neoplasms like Kaposi’s sarcoma. Clinical examinations were conducted to determine lip, skin and gingival colour based on established criteria and validated classifications. Gingival pigmentation and lip pigmentation was classified. Information on area of residence, income, skin type, lip pigmentation, gingival pigmentation type and willingness to undergo depigmentation procedures was also recorded after explaining the available treatment options. Statistical analysis was performed using IBM Statistical Package for the Social Sciences (SPSS) Statistics for Windows, Version 21.0 (IBM Corp., Armonk, NY, 2012). Results: The mean age of the study population was 27.23±4.39 years. Moderate gingival pigmentation was most prevalent among the participants 295 (59%). Regarding skin colour, 323 (64.6%) had brown skin, 143 (28.6%) had fair skin and 1 (0.2%) had dark skin pigmentation. The association between skin colour and gingival pigmentation was statistically significant (p<0.001). Most participants exhibited mild gingival pigmentation (LC2). LC5 and LC6 were not observed in any subjects. The association between lip colour and gingival pigmentation was also statistically significant (p<0.001). Gingival pigmentation showed a very weak positive correlation with willingness to undergo treatment (r=0.017, not significant). Lip pigmentation demonstrated a very weak negative correlation with willingness (r=-0.089, p=0.046), while skin pigmentation showed a very weak positive correlation with willingness (r=0.106, p=0.018). Conclusion: The study results demonstrated a significant association between gingival pigmentation and skin colour, as well as between gingival pigmentation and lip colour.