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Updated: Jul 16, 2025

Oral Health Assessment by Lay Personnel for Older Adults
Published on: February 2, 2020
Gingival Pigmentation Features in Correlation with Tooth and Skin Shades: A Cross-Sectional Study in a Saudi
Purpose:
The present study aimed to observe the anatomical distribution of gingival melanin pigmentation and evaluate its intensity and extent in different age groups and in correlation with skin and tooth shades.
Materials And Methods:
The participants of this study were 391 patients attending the Dental University Hospital. The presence of gingival pigmentation was assessed using De Krom's Oral Pigmentation Chart and its intensity was assessed using the Dummett-Gupta Oral Pigmentation Index. Skin colour and tooth shade were measured using the Fitzpatrick scale and the VITA classical shade guide, respectively. Statistical analyses included descriptive statistics and Pearson's Χ2 test for the association between the study variables.
Results:
The prevalence of gingival pigmentation among the sample size was 74.4%, and pigmentations were present on both arches in 57.6% (n = 224) of the participants. The extent (category 1) was highest when pigmentation was evident in both arches, with category 4 being the least extent. Age and sex did not show a correlation with gingival pigmentation. Gingival pigmentation intensity was mild when pigments were present in one arch (p < 0.00), whereas it was heavy when both arches presented with gingival pigmentation. Medium brown colour and tooth shade A1 were the most common among participants with gingival pigmentation (p < 0.00). The association between gingival pigmentation intensity and extent in relation to skin colour was statistically significant (p < 0.00), as was tooth shade (p < 0.05).
Conclusions:
Gingival pigmentation is highly prevalent in the Saudi population, with different severity and extent levels. The effect of gingival pigmentation on smile and overall facial aesthetics should be considered when providing dental and cosmetic treatments.
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