Relationship of Facial Skin Complexion with Gingiva and Tooth Shade on Smile Attractiveness

Background: A Smile is the most visible record of the dentist care. There are three important factors that play an important role when planning and designing any fixed or removable aesthetic and functional restoration. They include; Facial skin complexion, gingival tissue pigmentation and Tooth shade respectively. Objective: The objective of this study was to determine a relationship of facial skin complexion with the gingiva and tooth shade on smile attractiveness. Methods: This cross-sectional, analytical study was conducted at the Operative Dentistry Department of Altamash Institute of Dental Medicine, Karachi, Pakistan. It included 250 patients from 18-68 years of age of either gender over a period of 1 year from 15th October 2014 to 15th October 2015 respectively. The Facial skin complexion was determined by the Ideal Balance Quick Stick Makeup shade guide manufactured by (Revlon Foundation Makeup Shade Guide, USA) and was divided into three skin tone groups (Fair, Medium and Dark) respectively. The intensity and location of Gingival tissue pigmentation was determined by Dummett-Oral Pigmentation Index (DOPI). Lastly, the shade of middle one-third of labial surface of maxillary teeth was recorded visually with the help of a Vitapan 3D- Master shade Guide (VITA Zahnfabrik, Bad Sackingen, Germany) under a standardized natural day lightening procedure. Results: The data was analyzed by using the SPSS version 20.0 (Statistical Package for Social Sciences for Windows, SPSS Inc. Chicago). Out of 250 participants; 162 were male and 88 were female participants. The most common shade recorded was 2M1 (14.4%) followed by 3M2 (13.6%), 2L1.5 (10.8%) and 2R1.5 (9.6%). Among the males, the most common shade recorded was 3M2 (18.5%) and among the females the most common shade recorded was 2M1 (21.5%). The Value 2 shade was commonly seen in (45.2%), followed by Value 3; (31.2%), Value 1; (13.2%) and Value 4 (10.1%) of patients; However no shade was recorded for Value 5 shade group. The Medium skin complexion was more commonly seen in 60.4% of male participants and a Fair skin complexion was seen in 60.2% of female participants respectively. Conclusion: The prevalence of gingival tissue pigmentation was more found on the attached gingiva and interdental papilla (class II) and more severe in dark-skinned people and lesser in fair-skinned people. People having a fair skin complexion had a lower tooth shade value with the teeth appearing more darker in color whereas, people having a darker skin complexion had a higher tooth shade value with the teeth appearing more lighter in color. The respective male gender had a lower tooth shade value whereas females had a higher tooth shade value. The aging patients had a darker shade of teeth because of a lower tooth shade value respectively.