What Causes Black Gums?

by | May 19, 2021 | Gum Disease, Oral Health

Healthy gums can range in color from light pink to dark brown and can vary in shade from person to person. At times, however, you may notice changes in the appearance of your gums, including black spots and a darkened appearance. In many cases, these color changes are nothing serious but can also be a sign of a more serious condition. At Laguna Vista Dental, we understand how scary it can be waking up to black spots on your gums. For that reason, we believe that understanding the causes of black gums can help you decide if you need to seek immediate treatment or are safe to wait until your next dental appointment.

Why are my gums black?

Your gums can develop black spots or dark discoloration for various reasons, including a simple injury. Your gums are soft tissue and an injury to the mouth can cause bruising, much like if you bump your leg on a table. In this case, it is nothing serious and will go away with time. While many causes of black spots or discoloration are harmless, other causes can indicate a more serious underlying condition and require treatment. These are some of the top causes of gum discoloration.


Melanin is the natural substance in your body that gives color to your skin, hair, and eyes. The more melanin your body produces, the darker your skin or hair may be. Those with darker skin are, therefore, more likely to have darker pigment in their gums. If your gums have always been darker pink or even brown in color, there is a good chance it is due to a greater amount of melanin.


Smoking can contribute to discolored gums and black spots. Nicotine in your cigarettes can cause specialized cells in the body, known as melanocytes, to produce increased amounts of melanin. This increased melanin can contribute to darker gums or patches of dark spots on the gums, lips, and inside of the cheeks. Quitting smoking allows the cells to return to normal melanin production and the dark pigmentation to return to normal.


Medications can cause a variety of side effects, including pigment discoloration. This can include changes in the gums. Minocycline, a medicine used to treat acne or certain infections, can cause this pigment change and result in darkened spots on the gums. Other medications that can affect pigmentation include antimalarial and tricyclic antidepressants.

Amalgam tattoo

When you have a cavity filled, your dentist uses amalgam to fill the tooth. In some cases, particles of the amalgam can become lodged in the gums around the area of the filling and stain the gums, creating a dark spot. Unfortunately, amalgam tattoos are not removable, but they are harmless.

Medical conditions

Certain medical conditions can also contribute to changes in the coloration of your gums. In some cases, the changes in coloration improve when the underlying condition is under control. In other cases, the changes in the pigment of the gums are the problem and require immediate medical treatment.

1. Eruption hematoma

You might be familiar with the term hematoma if you have ever developed a bruise. An eruption hematoma is similar to a bruise but occurs when a new tooth comes in. These are very common in children when baby teeth or permanent teeth break through and can make the gums look black or dark purple. These will usually go away on their own in the same way a bruise heals.

2. Melanotic macule

Melanotic macules are similar to freckles and can show up on your skin and even your gums. Some people are born with these, while others develop them later in life. They do not cause any complications and do not require treatment. However, your dentist may choose to biopsy them if they ever change in size, shape, or color.

3. Oral cancer

According to the American Cancer Society, an estimated 54,000 Americans will be diagnosed with oral cancer in 2021. While symptoms of oral cancer can include mouth sores that don’t heal, a sore throat, pain in the mouth, or trouble with chewing or swallowing, it can also cause your gums to darken or appear black. To determine if the changes in your gum pigmentation, along with other symptoms are oral cancer, your dentist or physician will perform a biopsy to look for cancerous cells.

4. Oral melanoacanthoma

Oral melanoacanthoma may sound like something serious, but it is a rare, benign pigmented lesion that suddenly appears on the gums or other areas of the mouth. This brown or black spot is often associated with injuries or friction in the mouth and does not require treatment. However, your dentist may choose to biopsy any spot or lesion to rule out oral cancer.

5. Peutz-Jeghers syndrome

Peutz-Jeghers syndrome is a genetic condition that causes the development of polyps and dark-colored spots on the skin and gums and internally due to mutated cell growth. It also increases a person’s risk for certain types of cancer. While these polyps can be removed, there is no cure for Peutz-Jeghers Syndrome and you will need regular monitoring for cancer development.

6. Acute necrotizing ulcerative gingivitis

Acute necrotizing ulcerative gingivitis is a severe gum disease and infection often referred to as trench mouth. This condition is caused by a buildup of bacteria in the mouth and can cause painful bleeding and discolored gums. It can also cause mouth ulcers and extremely bad breath. Acute necrotizing ulcerative gingivitis is caused by poor oral hygiene, poor nutrition, a weakened immune system, diabetes, and other infections or conditions. The good news is this can be treated with antibiotics, professional teeth cleanings, and the start of a proper oral hygiene routine. When the infection is under control, your gums will return to normal pigmentation.

7. Addison’s disease

Addison’s disease, also known as adrenal insufficiency, is an uncommon condition that affects how your body produces certain hormones. The adrenal glands produce too little cortisol, as well as too little aldosterone in some cases. Symptoms of Addison’s disease include extreme fatigue, weight loss, low blood pressure, as well as hyperpigmentation, or a darkening of your skin. This hyperpigmentation can also affect your gums.


How to get rid of black gums

Treating black gums depends on what is causing the condition. If the black pigmentation comes from an underlying medical condition or infection, treatment focuses on the condition. When treated, the gums will usually return to their original pigmentation. Quitting smoking is often enough to return your gum pigmentation to normal. If the pigment changes to your gums are strictly cosmetic in nature, gum bleaching is an option but can cause damage to the gums and should only be performed by a cosmetic dentist.

It is always a good idea to include gum inspection as a regular part of your oral hygiene routine. It allows you to see changes early and alert your dentist as soon as possible. At Laguna Vista Dental, good oral health is our priority, and we are here to answer all your questions and work with you to create a treatment plan that helps you achieve a beautiful and healthy smile. For more information, contact us online to schedule an appointment or call our office at (916) 684-3105 today.

Krystle Fenton

Krystle Fenton

Krystle Fenton is the owner and lead dentist at Laguna Vista Dental in Elk Grove, CA. Dr. She has earned a Bachelor of Science degree in Biology with a minor in Chemistry from Andrews University. She then went on to Loma Linda University School of Dentistry, where she graduated with honors and is a member of the prestigious Omicron Kappa Upsilon (OKU) National Dental Honor Society. Dr. Fenton is a member of the American Dental Association, California Dental Association, and Sacramento District Dental Society. In her time away from the office, Dr. Fenton enjoys spending time with friends and family, traveling, spending time outdoors and watching movies.

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