Gum discoloration, especially when dark, can be a surprising observation. While it might cause concern, it is often a harmless variation in an individual’s natural gum color. Healthy gums can range from pale pink to various darker hues, depending on several factors.
Natural Gum Pigmentation
The most frequent reason for darker gum tissue is natural melanin production. Melanin is the pigment that determines the color of skin, hair, and eyes. Individuals with naturally darker complexions, such as those of African, Asian, or Mediterranean ancestry, commonly have more melanin in their gum tissue, leading to shades of brown or black.
This pigmentation is a normal physiological variation and does not indicate any health issues. The color can appear uniformly dark or as patchy areas, affecting one or both sides of the mouth. If your gums have always been a darker shade, it is generally not a cause for concern.
Systemic Factors and External Exposures
Beyond natural pigmentation, several systemic factors and external exposures can lead to darker gums. Certain medications can cause gum discoloration as a side effect. For instance, minocycline, an antibiotic, is known to cause blue-gray or brown pigmentation in oral tissues, including the gums, especially with prolonged use. Antimalarial drugs, antipsychotics, and some cancer therapy medications have also been linked to gum darkening. If discoloration appears after starting a new medication, discussing it with a healthcare provider is advisable.
Smoking is another common external factor contributing to dark gums, a condition known as “smoker’s melanosis.” The nicotine and other chemicals in tobacco stimulate melanocytes to produce more pigment. This leads to brown or black patches on the gums, inner cheeks, and lower lip. This discoloration may diminish or even disappear if a person quits smoking.
Amalgam tattoos, which are benign discolorations, can also cause black or bluish-gray spots on the gums. These occur when tiny particles of silver amalgam from dental fillings become embedded in the gum tissue during procedures like filling placement, removal, or tooth extraction. These flat spots are permanent if not removed.
Systemic diseases can also manifest as gum discoloration. Addison’s disease, a rare endocrine disorder, can cause increased melanin pigmentation in mucous membranes, including the gums. This oral pigmentation can sometimes be one of the first visible signs of the disease, appearing as brown or black patches on the gums, lips, buccal mucosa, and palate.
Oral Health Conditions and Injuries
Specific oral health conditions and physical injuries can also result in black or darkened gums. Acute Necrotizing Ulcerative Gingivitis (ANUG), often called “trench mouth,” is a severe gum infection characterized by painful ulcers, swelling, and dead tissue. This necrosis can cause the affected gum tissue to appear gray or black. ANUG is typically caused by an overgrowth of bacteria, often linked to poor oral hygiene, stress, smoking, or a weakened immune system.
Trauma or injury to the gums can also lead to dark discoloration, similar to a bruise. This occurs when blood vessels beneath the gum surface rupture, causing blood to pool in the tissue, forming a hematoma. Such injuries can result from accidental blows, vigorous brushing, or dental procedures. These bruised areas may appear dark brown, red, purple, or black and are often accompanied by localized pain and swelling.
When to Consult a Dentist
While many instances of dark gums are harmless, certain signs indicate that a dental or medical consultation is appropriate. Seek professional advice if you notice new or rapidly changing discoloration on your gums, or if the dark areas are localized, have irregular shapes, or are accompanied by other symptoms.
It is also advisable to see a dentist if you experience pain, bleeding, swelling, or tenderness in the discolored gum areas. These symptoms, especially when combined with darkening gums, could signal an underlying oral health issue like an infection or advanced gum disease. A dental professional can diagnose the cause of the discoloration and recommend appropriate treatment.