Changes in Patient-Reported Self-Confidence and Self-Esteem Following Gingival Depigmentation: A Questionnaire-Based Pre-post Study

Background and objective A smile is an essential aspect of facial aesthetics, with the gingiva playing a vital role, as its color and pigmentation significantly impact the overall aesthetic appearance. Gingival pigmentation can shape an individual's view of gingival aesthetics, and when perceived as undesirable, it may affect psychosocial aspects such as self-esteem and self-confidence. This study aimed to assess the self-confidence and self-esteem levels prior to and following the depigmentation procedure, as well as their correlation with the clinical Dummett Oral Pigmentation Index (DOPI). Materials and methods Forty participants with gingival hyperpigmentation were selected from the outpatient department. A gingival depigmentation procedure was performed. An investigator-developed questionnaire with eight paired questions, each asked twice, was used to evaluate self-confidence and self-esteem levels before and one month after surgery and the association with the DOPI. Fisher's exact test and Pearson's chi-square test were utilized for statistical analysis. Results Before depigmentation, 82.5% of participants reported being stared at, while 100% experienced self-consciousness, hesitation about displaying their gums, and reduced confidence; 70% reported offensive remarks and related unhappiness. Following depigmentation, these concerns were reduced to 0%, with significant improvements in self-confidence and self-esteem (p < 0.001). A notable correlation was found between the clinical DOPI score and both smile confidence and levels of self-esteem (χ² = 80, df = 2, p < 0.001). Conclusions Greater emphasis should be placed on aesthetic procedures such as gingival depigmentation, as they considerably affect individuals' self-esteem and self-confidence. Advancements in such aesthetic treatments go beyond merely enhancing outer beauty; they play a decisive role in nurturing inner confidence and empowerment.