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Smokers Melanosis
Smoker's melanosis presents as a brown to black pigmentation of the oral
tissues.
Can be seen in attached and unattached gingiva, buccal mucosa, and palate.
While there are other types of melanin pigment (considered normal) in
some individuals gingiva, smokers melanosis is not a genetically caused
melanin pigmentation.
Case Report
My sister noticed a brown discoloration on her marginal and papillary
gingiva between #6 and 7 about 3-4 years ago. At the time, she said she
does hold her cigarette here when she smokes.
I noticed at Christmas time that this appeared a bit darker and had the idea that I
should do some research on depigmentation of oral lesions with a diode laser.
Despite discontinuing holding her cigarette in this area, the lesion remained. I
consulted with my friend and colleague, and we agreed this might be fun to
explore!
It made perfect sense to us that this would be an applicable use for the diode laser (soft
tissue laser).
Diode wavelengths are absorbed by pigmented structures, such as hemoglobin and
melanin, and work well in soft tissues. The light energy is transferred to heat, resulting in an
instantaneous tissue reaction of warming, coagulation, and cell vaporization. This
instantaneous reaction is termed ablation and results in minimal tissue bleeding. With the
diode laser, soft tissue procedures can often be performed with slight discomfort requiring
only minimal anesthesia.
~Dimensions of Dental Hygiene, Laser Therapy Basics, Tolle and Sirois, January 2011; 9(1): 50, 52-53.
http://www.dimensionsofdentalhygiene.com/ddhnoright.aspx?id=10224&term=laser%20therapy%20basics
Pre-op Photographs
Set to pulsed for the papilla after noting some slight charring of the tissue.
Allowed tissue to cool.
Post operative instructions included warm salt water and applying Vitamin E
oil.
The tip is placed 0.5 mm into the sulcus. A sweeping, horizontal motion is
used for just a few seconds to reduce oral bacterial levels.
Day 3 Post-Operative
Day 4 Post-Operative
Day 5 Post-Operative
Day 6 Post-Operative
Conclusion
The patient was pleased with this minor cosmetic procedure and consented
to sharing the photographs.
Credits!
Special thanks to Tammy Johns, RDH, BSDH, EP; owner of Absolute Dental
Hygiene where this procedure was performed. She also performed the
procedure! http://www.absolutedentalhygienellc.com/