Short answer: Gum peeling (depigmentation) is a cosmetic periodontal procedure that aims to give dark brown or blackish areas a lighter pink color by removing the melanin pigment that has accumulated in the surface layer of the gum. It is performed under local anesthesia with a laser or a surgical blade. The surface usually heals within one to two weeks. The result can last a long time, but the pigment may partially return over time, especially in smokers. Before the procedure, the cause of the dark color must be determined through an examination.
The appearance of a smile is not determined by the teeth alone; the color and appearance of the gums that surround the teeth also play an important role. Some people have brownish-black areas on their gums, either in patches or throughout. This usually does not pose a health problem; however, it can be a cosmetic concern, especially for people whose gums show when they smile. One of the procedures used to address this concern is gum peeling, medically known as gingival depigmentation. In this article we look at what the procedure is, why gums can become dark, the methods used, the healing process and how long the result lasts.
What is gum peeling?
Gum peeling is the controlled removal of the melanin-pigmented cells in the top layer of the gum that cause the dark color. After the procedure, a new surface layer containing less pigment forms in its place, so the gum takes on a lighter, more even pink color. It is also popularly known as gum pinkening or gum bleaching.
Gum peeling responds to a cosmetic wish rather than treating a health problem. For this reason, the decision to perform the procedure is made based on the patient's wish together with the dentist's confirmation that the gums are healthy. If there is inflammation, bleeding or pocket formation in the gums, periodontal treatment should be done first.
Why do gums become dark?
Dark color in the gums is mostly caused by excess buildup of a natural pigment called melanin; however, since there can be other causes too, the source of the color should always be evaluated through an examination. The main causes are:
- Physiological (ethnic) pigmentation: As in the skin, melanin production in the gums varies from person to person. Especially in people with darker skin tones, brownish gums are natural and harmless. Gum peeling is most often performed in this group.
- Smoking: Certain substances in tobacco products can increase melanin production and lead to dark patches on the gums of smokers. This is called smoker's melanosis and can decrease over time after quitting smoking.
- Amalgam tattoo: Gray-blue spots formed by metal particles from old silver fillings or that entered the tissue during root canal treatment. Because it is not related to melanin, it is evaluated with different methods, not with peeling.
- Certain medications: Antimalarial drugs, some antibiotics and some hormonal medications can cause pigmentation inside the mouth.
- Systemic conditions: Rarely, hormonal diseases or certain syndromes can show up as widespread pigmentation inside the mouth.
- Pigmented lesions: Although very rare, dark patches that appear inside the mouth and change in shape, color or size can be a sign of a serious disease.
Because of the last two points, dark patches that are especially new, single, irregularly edged, growing or raised should be shown to a dentist for a detailed evaluation, not for peeling. When the dentist considers it necessary, a biopsy or further testing may be requested.
Is gum peeling done with a laser or with the conventional method?
Gum depigmentation can be done with either a laser or a surgical blade (the conventional method); both aim to remove the pigmented surface layer, and the choice of method depends on how widespread the pigmentation is, the thickness of the gum and the dentist's experience.
Laser method
The laser concentrates its energy on the pigmented tissue and vaporizes or removes the surface layer. Types of lasers used include diode, erbium and carbon dioxide lasers. The advantages of the laser include less bleeding during the procedure, no need for stitches and, for some patients, greater comfort during healing. However, the depth of the laser must be well controlled; otherwise, the underlying tissues and bone may be affected.
Conventional (surgical blade) method
In this method, the dentist removes the pigmented surface layer in a thin layer with a surgical blade. It is a predictable and effective method that has been used for many years. There may be slightly more bleeding during the procedure than with a laser; the healing period is similar, taking one to two weeks. In some cases, methods such as surface abrasion with rotary instruments or cryosurgery may also be used.
Whichever method is used, it is important that the procedure is limited to the surface layer of the gum and that the gum margin is preserved. This helps prevent unwanted outcomes such as gum recession.
How is the procedure performed, and what is the healing process like?
Gum peeling is a procedure performed under local anesthesia and usually completed in a single session. Depending on how widespread the pigmentation is, the upper and lower jaws can be treated in the same session or in separate sessions.
- Examination: The health of the gums and the cause and distribution of the pigmentation are evaluated. If necessary, tartar removal and gum treatment are done first.
- Planning: Which areas will be treated and which method will be used are determined.
- Anesthesia: The area is numbed with local anesthesia.
- Removing the pigment: The pigmented surface layer is removed with the chosen method.
- Protection: If necessary, a protective dressing can be applied to the treated area.
In the first days after the procedure, tenderness, a mild burning sensation and a whitish healing layer may be seen on the gums; this is part of normal healing. The surface tissue usually renews itself within one to two weeks, and the final color of the gums becomes clear within a few weeks.
During the healing period, the following is recommended:
- Avoiding hot, spicy, acidic and hard foods in the first days, and choosing lukewarm, soft foods
- Cleaning the treated area gently with a very soft brush, or using a mouthwash as your dentist recommends
- Not smoking; smoking both delays healing and can speed up the return of the pigment
- Using the medications your dentist recommends as instructed and coming to your follow-up appointment
Is gum peeling permanent?
The lighter color achieved with gum peeling can last a long time; however, how long it lasts varies from person to person, and the pigment may partially return over time (repigmentation). This is because some of the melanin-producing cells can remain in the tissue and become active again over time.
The main factors that affect repigmentation are:
- Smoking: In people who continue to smoke, the pigment can return faster and more noticeably.
- Intensity of natural pigmentation: In people with very intense pigmentation to begin with, the likelihood of it returning may be higher.
- The method used and the depth of the procedure.
- Individual factors such as sun exposure and hormonal influences.
If the pigment returns, the procedure can be repeated if necessary. For this reason, it is important for the patient to have realistic expectations about how long the result will last before the procedure. You can find answers to frequently asked questions about gum aesthetics and other periodontal procedures on our frequently asked questions page.
When should you have dark gums examined in Ankara?
If the color of your gums bothers you when you smile, or if you have noticed a new dark patch on your gums that is growing or changing shape, it is advisable to have an evaluation. At our clinic in Park Oran Ofis in Çankaya, we determine the cause of the color in your gums through an examination and, if peeling is a suitable option, share the method, the healing process and its possible limitations with you in advance.
Frequently asked questions
Does gum peeling hurt?
Because the procedure is performed under local anesthesia, pain is usually not felt during it. There may be tenderness and a mild burning sensation for a few days afterward; these complaints are usually kept under control with the measures your dentist recommends.
Does gum peeling damage the gums?
When performed for the right indication and limited to the surface layer only, it is not expected to cause permanent damage to the gums. It is important that the gums are healthy before the procedure and that it is planned by an experienced dentist.
Can gum peeling be done for smokers?
It can, but in smokers healing may be delayed and the pigment may return faster. In smoker's melanosis, quitting smoking can sometimes lighten the color on its own. For this reason, quitting smoking first is recommended.
How many sessions does gum peeling take?
In most cases it is completed in a single session. When the pigmentation is widespread and the upper and lower jaws are treated together, it may be split into two sessions. If the pigment returns over time, the procedure can be repeated.
