Seeing a dark or black spot on a child’s gums can be alarming for any parent. While anxiety about sudden changes in oral health is natural, many causes for this discoloration are benign and temporary. Black gums or dark patches result from various factors, ranging from minor physical trauma to external influences or, rarely, internal systemic conditions. Understanding these potential reasons helps parents know when simple observation is appropriate and when professional evaluation is necessary.
Common Causes Related to Injury and Blood
The most frequent causes of sudden, localized dark discoloration relate to physical trauma and blood pooling beneath the gum tissue. Young children are prone to minor falls and bumps, which can easily bruise the delicate tissues inside the mouth. Hitting the mouth on a toy or furniture can lead to a visible bruise, known as a hematoma, on the gums. This discoloration appears dark because ruptured blood vessels trap deoxygenated blood, which reflects a blue-black color through the tissue.
A specific type of localized trauma is an eruption hematoma, common during the teething process in infants and young children. This presents as a soft, bluish, or dark purple cyst over a spot where a tooth is preparing to emerge. The hematoma forms when fluid and blood accumulate in the tissue surrounding the crown of the erupting tooth, often due to pressure or minor trauma from chewing. The dark appearance is blood mixed into the fluid-filled sac, and it usually resolves when the tooth emerges. Unless the area becomes infected or causes significant pain, an eruption hematoma is considered a normal part of teething.
Pigmentation and External Influences
When discoloration is chronic or widespread, the cause is often related to pigmentation or external staining agents rather than acute injury. The most common cause of dark gums, especially in children with darker skin tones, is physiological or racial pigmentation. This harmless condition occurs due to a higher concentration of melanin, the natural pigment that determines skin and hair color, deposited in the gingival tissue. If a child has always had naturally brown or black gums, it is likely a genetic variation requiring no intervention.
Another benign cause of localized spots is an oral melanotic macule. These are small, solitary, well-demarcated dark brown to black lesions caused by a focal increase in melanin production in the mucous membrane. While they are harmless, a dentist may recommend a biopsy to ensure the spot is not a more serious lesion, especially if it changes size or shape.
External agents, particularly certain medications, can also lead to dark discoloration of the gums or teeth. Liquid iron supplements, often prescribed for iron deficiency, are known to cause extrinsic staining. The iron component can deposit on the surface of teeth and the adjacent gum line, creating a black or dark stain. This staining is purely cosmetic and does not harm the teeth. Parents can minimize it by administering the supplement with a straw or brushing the child’s teeth immediately afterward.
Black oral pigmentation can be a sign of extremely rare systemic diseases, though these are accompanied by other severe symptoms. Addison’s disease, a disorder of the adrenal glands, causes hyperpigmentation of the skin and oral mucosa due to hormonal imbalances. This pigmentation is often diffuse and patchy, affecting the gums, tongue, and buccal mucosa. It occurs alongside serious symptoms like chronic fatigue, weakness, and gastrointestinal issues, which help distinguish this rare diagnosis from common, localized causes.
When to Seek Immediate Professional Advice
While many instances of black gums are harmless, certain signs warrant prompt consultation with a pediatric dentist or pediatrician. Any discoloration that appears suddenly and is accompanied by systemic signs of illness should be evaluated without delay. Concerning symptoms include an unexplained fever, widespread rash, or pronounced lethargy.
Localized signs of an active infection require urgent attention. These include severe swelling of the gum tissue that extends into the face or pus draining from the affected area. Severe, unrelenting pain that cannot be managed with over-the-counter pain relievers suggests an underlying issue beyond simple bruising or benign pigmentation. Additionally, any spontaneous, profuse bleeding from the gums that does not stop with light pressure should be reported to a healthcare provider.
When preparing for the appointment, parents should be ready to provide a detailed history. This information should include when the discoloration was first noticed, whether it is localized or widespread, and if the child experienced any recent trauma or falls. It is also helpful to list any current medications or supplements, as external influences can often explain the color change.