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Gum depigmentation, also known as gum bleaching, is a procedure used in cosmetic dentistry to lighten or remove black spots or patches on the gums consisting of melanin. Melanin in skin is very common in inhabitants in many parts of the world due to genetic factors. Melanin pigmentation in skin, oral mucosa, inner ear and other organs is a detoxification mechanism. Some toxic agents bind to melanin and will move out of the tissue with the ageing cells and are expelled to the tissue surfaces. Also in the gums and oral mucosa a visible pigmentation is most often caused by genetic factors, but also by tobacco smoking  or in a few cases by long-term use of certain medications. If smoking stop or change of medication do not solv the problem with a disfigurating melanin pigmentation, a surgical operation may be performed. The procedure itself can involve a laser ablation techniques.
Laser gum depigmentation
Melanocytes are cells which reside in the basal layer of the gingival epithelium. These cells produce melanin, which are pigments that cause light or dark brown spots in gums and oral mucosa. The most common cause is genetic factors or tobacco smoking, Smoker's melanosis. If the melanin pigmentation is found in a person smoking cigarettes, the most effective way to get rid of the pigmentation is to stop smoking. Most of the patients are free from the melanin pigmentation after 3 months.. A dental laser can target and ablate the melanocytes, thus reducing the production of melanin in the gingival tissue. Following laser depigmentation, the gingiva heals by secondary intention. This results in a lighter and more uniform color of the gums. A study found that (Er,Cr:YSGG) laser was effective and there were no signs of re-pigmentation after a 6 month follow up period.
- Lin, YH; Tu, YK; Lu, CT; Chung, WC; Huang, CF; Huang, MS; Lu, HK (2014). "Systematic review of treatment modalities for gingival depigmentation: a random-effects poisson regression analysis". Journal of esthetic and restorative dentistry : official publication of the American Academy of Esthetic Dentistry ... [et al.] 26 (3): 162–78. doi:10.1111/jerd.12087. PMID 24418367.
- Hedin CA: Smoker's Melanosis. An epidemiologic, morphologic and experimental study of oral melanin pigmentation caused by tobacco. Thesis, University of Lund, Sweden 1986.
- Hedin CA, Pindborg JJ, Axéll T: Depigmentation of smoker's melanosis after smoking-stop. J Oral Pathol Med 1993;22:228-230.
- Seker, Basak Kusakci (June 2018). "Treatment of gingival melanin hyperpigmentation with Er,Cr:YSGG laser: Short-term follow-up of patient". Journal of Cosmetic and Laser Therapy: Official Publication of the European Society for Laser Dermatology. 20 (3): 148–151. doi:10.1080/14764172.2017.1288256. ISSN 1476-4180. PMID 28166448.
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