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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 …