Assessing the role of skin complexion in determining tooth shade, and gingival pigmentation in dental aesthetics.

Abstract

Background & objective: Skin complexion and oral aesthetics significantly influence facial harmony and smile attractiveness. This study aimed to explore the relationship between skin tone, gingival pigmentation, and tooth shade to achieve natural and aesthetically pleasing dental outcomes.

Methods: This cross-sectional observational study was conducted at the Dental Clinic Complex of King Faisal University, Al-Ahsa from September 2024 to January 2025. A total of 261 participants of both genders, with good oral health and healthy central incisors for shade selection, were included. Skin complexion was assessed using the Revlon (Revlon Foundation Makeup Shade Guide, USA), while gingival pigmentation with the Dummett-Gupta Oral Pigmentation Index, and tooth shade using the Vita Easyshade^® V (Bad Säckingen, Germany). Data analysis was performed using SPSS (Version 20.0, SPSS Inc., Chicago), with chi-square, Spearman's correlation, and linear regression tests. A p-value ≤0.05 was considered significant.

Results: Most participants were male (65.5%). Shade A was the most common tooth shade (62.1%), followed by shade B (30.3%). Medium skin tone (51.0%) was predominant, with dark (28.0%) and fair (21.0%) tones following. The majority had no gingival pigmentation (66.7%). A significant association was found between skin complexion and tooth shade (p = 0.018), with a weak positive correlation (ρ = 0.146, p = 0.019). No significant associations were observed with gingival pigmentation or smile satisfaction.

Conclusions: Fair-skinned participants tended to have lighter tooth shades, whereas those with medium and dark skin tones had relatively darker shades. However, gingival pigmentation and smile satisfaction showed no significant correlation with skin complexion.