The sudden appearance of brown areas on a child’s gums, known as gingival hyperpigmentation, can cause alarm for parents. While the sight may be unexpected, many causes of brown gums in children are completely harmless. The discoloration is a change in the color of the gum tissue, which normally presents as a uniform pink, and can range from light brown spots to diffuse dark patches. Although some underlying health issues can be involved, the majority of cases are benign and often related to genetics.
Natural Pigmentation and Genetic Factors
The most frequent reason for brown or dark patches on a child’s gums involves a natural physiological process involving melanin. Melanin is the natural pigment that determines the color of a person’s skin, hair, and eyes. It is produced by specialized cells called melanocytes, which are also present in the gum tissue.
In many children, particularly those with naturally darker complexions, this pigment is deposited in the gums, leading to a darker appearance. This is a normal, genetically determined trait, sometimes referred to as racial or ethnic pigmentation. This natural coloring often appears as symmetrical, flat, light-to-dark brown lesions, most commonly affecting the attached gum tissue.
The hyperpigmentation may be present from infancy or develop during early childhood. Since this is simply a cosmetic variation related to genetics, it is not a sign of disease and does not require medical intervention. The intensity of this natural pigmentation can sometimes be influenced by factors like hormones or physical stimuli, but the underlying tendency is inherited.
Localized Causes and External Staining
When the discoloration is not genetic, it may result from a localized event within the mouth or the introduction of external agents. One possible cause is a hematoma, which is essentially a bruise that forms under the gum tissue from trauma. These can occur in young children from minor falls, bumps, or even during the eruption of a new tooth, sometimes appearing as a purplish-brown swelling known as an eruption hematoma. This temporary, localized discoloration resolves as the injury heals or the tooth fully emerges.
External staining can also cause a brown or black appearance on the gums or teeth near the gum line. This often results from exposure to certain substances that can stain the surface, such as specific foods or beverages. Liquid iron preparations are a well-known cause of extrinsic staining on both the teeth and surrounding gum tissue. Unlike true pigmentation, this is typically a superficial stain rather than a color change within the tissue itself, and it may be removed by a professional dental cleaning.
Medication and Underlying Health Conditions
Less commonly, brown gums can be a side effect of systemic medication or an indication of an underlying health condition. Certain medications can induce oral hyperpigmentation by stimulating melanin production or causing the drug or its metabolites to deposit in the tissue. The antibiotic minocycline is a common example, which can cause a blue-grey or brown discoloration, though it is less frequently prescribed to children than adults. Other associated drug classes include some antimalarials and anti-fungal agents.
In rare cases, oral pigmentation can be a manifestation of a systemic disease. Addison’s disease, a disorder where the adrenal glands do not produce enough hormones, causes increased pigmentation on the skin and mucous membranes, including the gums, in a high percentage of patients. Peutz-Jeghers syndrome, a rare genetic disorder, is characterized by dark, freckle-like spots on the lips, mouth lining, and gums, along with an increased risk of intestinal polyps. These systemic conditions are typically accompanied by other symptoms like fatigue or abdominal issues, but the oral pigmentation can sometimes be an early sign.
When to Seek Professional Dental Care
Parents should seek an evaluation from a pediatric dentist or pediatrician if they observe changes in their child’s gums. A professional can help determine if the discoloration is a normal variation or a sign of a complex issue. They will look for characteristics such as symmetry, the history of the pigmentation’s onset, and any correlation with new medications or recent trauma.
A prompt visit is important if the brown spots appear rapidly, change color or size quickly, or are accompanied by other symptoms. Warning signs include pigmentation that is raised, nodular, or ulcerated, which is not typical of benign causes. A visit is also warranted if the child reports pain, has accompanying symptoms like unexplained fatigue or appetite changes, or if the discoloration appears suddenly alongside signs of gum inflammation like swelling or bleeding.