Interrelationship of Smoking, Lip and Gingival Melanin Pigmentation, and Periodontal Status

BACKGROUND: Cigarette smoking is a significant risk factor for periodontal disease. It also causes pigmentation of oral mucosa. The present study was aimed to assess the effects of smoking on lip and gingival pigmentation and periodontal status and the relationship between pigmentation and periodontal parameters. METHODS: A total of 109 smokers and an equal number of non-smoker controls (mean age: 35.9 years, range: 35-44 years) comprised the study sample. All the participants were assessed for pigmentation on lip and gingiva and overall periodontal status (gingival bleeding, probing depth, and loss of attachment at six points in each tooth). FINDINGS: All the smokers in this study had lip and gingival pigmentation. Two-third of non-smokers had no pigmentation. The mean scores of lip and gingival pigmentation in smokers were seven and four times higher than those of non-smokers, respectively. Pigmentation and periodontal parameters (except gingival bleeding) were found to be positively related with exposure to smoking exposure. Probing depth and loss of attachment were the highest in subjects with pigmented lips and grade three pigmented gingiva. CONCLUSION: Smoking influenced lip and gingival pigmentation and periodontium. All individuals with lip pigmentation presented some form of gingival pigmentation. Probing depth and loss of attachment were more severe in subjects with lip and gingival pigmentation.