The color of your gums can vary significantly from person to person, ranging from shades of pink to brown. While dark or black gums can be a perfectly normal and healthy characteristic for some individuals, in other instances, such discoloration might indicate an underlying health issue. Understanding the potential reasons behind changes in gum color is important for maintaining oral health and recognizing when professional attention is needed.
Natural Pigmentation
The most common reason for naturally dark or black gums is the presence of melanin, the same pigment that determines skin, hair, and eye color. Gum tissue coloration varies, similar to skin tones. This benign pigmentation is often observed in people with darker skin tones, including those of African, Asian, or Mediterranean descent.
When melanin causes dark gums, the pigmentation is typically symmetrical, affecting both sides of the mouth, and remains stable over time. If your gums have always been a darker shade, it is likely a result of this natural process and usually does not require any treatment. This inherent coloration is simply a normal variation of healthy gum tissue.
Underlying Causes of Darkened Gums
Beyond natural pigmentation, several other factors can lead to the darkening of gum tissue. Some may signal a health concern and warrant further investigation.
Smoking
The chemicals in tobacco stimulate melanocytes to produce more melanin, leading to brown or black patches on the gums, inner cheeks, and sometimes the lower lip. Quitting smoking can often lead to a reduction or even reversal of this discoloration over time.
Medications
Certain medications can cause gum hyperpigmentation as a side effect. Drugs such as minocycline, some antimalarials, or tricyclic antidepressants have been linked to bluish-black or brownish-black gum discoloration. If a change in gum color occurs after starting a new medication, it is advisable to consult a healthcare professional.
Amalgam Tattoos
Amalgam tattoos present as localized blue, gray, or black spots on the gums, typically near where a silver dental filling has been placed or removed. These spots occur when tiny fragments of amalgam become embedded in the gum tissue. While permanent, they are generally harmless and do not pose a health risk, though they can be a cosmetic concern.
Systemic Medical Conditions
Systemic medical conditions can also manifest as darkened gums. Addison’s disease, a rare disorder affecting the adrenal glands, often causes widespread hyperpigmentation, including dark patches on the oral mucous membranes. This oral pigmentation can sometimes be one of the earliest signs of the disease. Peutz-Jeghers syndrome, another rare genetic condition, is characterized by dark spots on mucous membranes, including those in the mouth.
Acute Necrotizing Ulcerative Gingivitis (ANUG)
ANUG, also known as “trench mouth,” is a severe gum infection causing gray or black tissue from dead cells and debris. This painful infection is often accompanied by bleeding gums, foul-smelling breath, and sometimes fever. ANUG results from bacterial overgrowth, often linked to poor oral hygiene, stress, or a weakened immune system.
Physical Trauma
Physical trauma or injury to the gums can also result in discoloration. A bruise may appear dark blue or black. This type of discoloration usually resolves as the injury heals.
Heavy Metal Exposure
Exposure to certain heavy metals, such as lead or bismuth, can lead to a bluish or black line along the gum line. This is a less common cause but indicates systemic exposure.
Oral Cancer
While rare, some forms of oral cancer can present as dark lesions or spots on the gums. Any new or changing dark spot on the gums should be evaluated by a professional to rule out this serious possibility.
When to Consult a Professional
It is advisable to consult a dentist or doctor if gum discoloration appears suddenly or changes rapidly in size, shape, or color. Such changes could signal a new or progressing condition.
Professional evaluation is also recommended if the dark gum coloration is accompanied by other symptoms such as pain, swelling, bleeding, tenderness, or persistent bad breath. These symptoms often point to an inflammatory or infectious process. If the darkening is localized to one specific area rather than widespread, or if you have recently started a new medication, a dental check-up is prudent. If you are concerned about your gums, a professional opinion can provide reassurance or identify potential issues.
Diagnostic and Treatment Approaches
When consulting a professional about darkened gums, they will conduct an oral examination and review your medical history. Diagnostic tests like a biopsy, blood tests, or imaging may be necessary to confirm a diagnosis.
Treatment for darkened gums depends entirely on the underlying cause. If the discoloration is natural melanin pigmentation and poses no health risk, no treatment is medically necessary. However, for cosmetic reasons, gum depigmentation using lasers or surgical techniques can remove excess melanin.
For smoker’s melanosis, smoking cessation is the primary recommendation, as this can lead to fading of the dark patches. If medication is the cause, your doctor may consider adjusting the dosage or switching to an alternative drug. Amalgam tattoos usually do not require treatment unless they are a cosmetic concern.
If a systemic medical condition like Addison’s disease is diagnosed, treatment will focus on managing that underlying condition, which may reduce gum pigmentation. Acute Necrotizing Ulcerative Gingivitis requires professional cleaning, debridement of dead tissue, and often antibiotics. If oral cancer is identified, treatment typically involves surgical removal of the cancerous tissue, and may include radiation or chemotherapy depending on the stage and spread.