A beautiful smile is a balance between the the white component which are the teeth and the pink component, which are the gums. Ideally, the gums are coral pink in color based on the research on the western population. But, the color of the gums may vary depending on the skin complexion and other habits. Indians are said to have pale pink gums. 

The color of the gums owes to the pigments, the epithelial layers, vasculature and keratinization. Generally, in dark skinned individuals, since the melanin content underneath the skin is high, it is this same melanin that accumulates in the oral mucosa and gums. 

Types of gum pigmentation -

1) Based on extent, it may be seen as diffused patches or lace-like strands continuous or dis-continuous or may be a single continuous patch. 

2) Based on color, it may be mild brownish to dark brown, blackish or even dark purplish. 

Causes of gum pigmentation- 

Gum pigmentation (dark gums) result from multiple factors. Most commonly, the cause is physiologic which occurs naturally based on the race and complexion of the individual. The other causes are pathologic, which include- 

1) Endocrine causes- hormone related imbalance like Addison's disease, Albright's disease etc. 

2) Heavy metals- can result in darkening of gum for eg. consumption of lead contaminated water which can leave a black/blue line on the gums margin. 

3) Kaposi's sarcoma- associated with HIV/AIDS. 

4) Drug induced- certain anti-malarial drugs, anti-depressants and anti viral medication on long-term consumption can cause pigmentation. 

5) Smoking- results in pigmentation or melanosis in the upper front region of the gums. This occurs due to the constriction of the micro-vasculature as well as changes in the epithelium. 

Other causes could be Hemochromatosis (due to excessive iron deposition), vascular lesions, discoloration from adjacent silver fillings and habits like tobacco and betel-nut chewing. 

Treatment of dark gums-

Dark gums can be corrected by a procedure called gum depigmentation or gum bleaching. This is a very minor surgical procedure in which the upper epithelial layers of the gums are stripped off using a blade, electrocautery, diamond points or LASER under local anesthesia. As the underlying melanin containing melanocytes get eliminated, the gum upon healing will have a pink colour. A surgical dressing is usually placed at the site. This procedure usually takes 30-60 mins depending on the area to be done. If done using LASER, there is minimal to no pain as well as bleeding with quick recovery. All these procedure are done at the dental office itself. Chances of the pigmentation to reoccur are there after 1.5-2 years especially in smokers. 

Before and after gum depigmentation. Brownish pink gums have been transformed into beautiful coral pink gums.

Gum pigmentation although is not a major complication, it can affect the smile and facial appearance especially for those who have a wide smile with more gum display. A gum bleaching/depigmentation can cause a drastic change in the smile of an individual.