The appearance of dark or black gums is usually caused by intrinsic pigmentation rather than poor hygiene, meaning the discoloration originates within the gum tissue and cannot be removed by brushing or flossing. While often a harmless cosmetic concern, dark gums can occasionally signal a serious underlying health issue. Management focuses on identifying the root cause and, if desired for aesthetic reasons, pursuing professional depigmentation procedures.
Understanding Why Gums Turn Dark
The most common reason for dark gums is the natural presence of melanin, the pigment that determines skin, hair, and eye color. Melanocytes, the cells responsible for melanin production, reside in the basal layer of the gum’s outermost layer (gingival epithelium). In individuals with darker skin tones, these cells naturally produce more pigment, resulting in a healthy, uniform brown or black gum color known as physiological pigmentation.
Nicotine and other chemicals in tobacco smoke can cause smoker’s melanosis. Nicotine stimulates melanocytes to produce excess melanin as a protective response against irritants. This results in dark brown or black patches, typically on the lower gums and the inside of the cheeks, which is reversible if smoking is stopped.
Certain medications can induce oral hyperpigmentation as a side effect. The antibiotic minocycline, often used for acne, is known for causing a bluish-black discoloration. Other drug classes, including antimalarials, antipsychotics, and chemotherapy agents, can also change gum color by increasing melanin production or depositing iron into the tissue.
Although rare, dark gums can manifest systemic diseases, such as Addison’s disease. This endocrine disorder affects the adrenal glands, leading to increased production of a hormone that stimulates melanocytes. The resulting hyperpigmentation appears on the gums, lips, and other mucous membranes, often before affecting the skin. Another cause is the accidental embedding of dental amalgam particles into the gum tissue, creating a benign blue, grey, or black spot known as an amalgam tattoo.
Limits of Home Oral Hygiene
Standard home oral hygiene, including regular brushing and flossing, removes plaque and extrinsic stains from the surface of the teeth and gums. While effective for preventing gingivitis and periodontal disease, these actions have little effect on true gum discoloration because of the pigment’s location.
Melanin pigmentation, whether physiological or induced by smoking, resides deep within the gum’s epithelial layer. The mechanical action of a toothbrush or the chemical action of mouthwash cannot penetrate this tissue layer to remove the intrinsic pigment. Standard home care is designed for plaque-related issues, which is a different concern entirely.
Home care is wholly insufficient for black gums caused by serious infection and may delay necessary professional treatment. While good hygiene is always recommended for overall oral health, it cannot reverse genetic pigmentation or systemic conditions. If the discoloration is caused by the buildup of hardened plaque (calculus), a dentist must perform professional scaling to remove it.
Professional Treatment Options for Gum Depigmentation
When discoloration is purely an aesthetic concern, such as physiological pigmentation or smoker’s melanosis, specialized dental procedures can lighten the gum tissue. These professional treatments focus on removing the pigmented superficial layers of the gingiva. The most common technique is laser depigmentation, which utilizes focused light energy to ablate the melanin-producing cells.
During laser treatment, a dental laser precisely vaporizes the thin, pigmented epithelial layer without damaging the underlying connective tissue. This minimally invasive procedure is typically performed under local anesthetic, offering minimal bleeding and a shorter healing time. The resulting tissue heals into a lighter, pink color, and results can often last for many years.
Alternative methods include surgical excision, or the scalpel technique, which involves physically removing the pigmented tissue. A periodontist uses a surgical blade to de-epithelialize the area, allowing new, non-pigmented tissue to grow. While cost-effective, this method may involve more post-operative discomfort and a longer healing period than laser treatment.
Mechanical abrasion, sometimes called microdermabrasion, uses a high-speed rotary instrument, such as a diamond bur, to selectively remove the pigmented epithelium. This technique is effective but requires careful execution to avoid creating an uneven appearance or damaging deeper tissues. The choice of treatment is based on the extent of the pigmentation, the patient’s overall health, and the clinician’s expertise.
Signs That Require Immediate Dental Attention
While many cases of dark gums are benign, specific accompanying symptoms indicate a need for immediate professional evaluation to rule out serious health risks. Sudden changes in gum color, especially rapidly growing or irregularly shaped black spots, must be examined. This type of lesion could be a sign of malignant melanoma, a rare but potentially aggressive form of oral cancer.
A severe bacterial infection known as Acute Necrotizing Ulcerative Gingivitis (ANUG) causes gum tissue to appear black or greyish due to tissue death. This condition is accompanied by intense pain, spontaneous bleeding, and a foul odor. The gums between the teeth also take on a characteristic “punched-out” or crater-like appearance.
Additional signs of an urgent health issue include dark patches accompanied by systemic symptoms. These may include unexplained fatigue, muscle weakness, weight loss, or changes in blood pressure, which can be associated with Addison’s disease. Any discoloration accompanied by swelling, pus, or a fever requires prompt medical attention to rule out an acute infection or serious systemic condition.