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Black Gums: Symptoms, Causes, Prevention and Treatment

May 16, 2023

You might be wondering "Why are my gums black?". Gums, like skin color, come in varying shades. If you have higher levels of melanin, you are more likely to have darker gums. Therefore, black gums are normal for some. However, if your gums are not naturally black, it could mean that your gums are damaged from habits like smoking, you have an underlying health condition, or you are taking certain medications.

4 Common Symptoms of Black Gums

The primary symptom of black gums is varying discoloration including:

  • Light brown
  • Purple
  • Blue/black
  • Red

These discolorations are typically noncancerous but may also be an indication of a more severe condition such as oral malignant melanoma. If you have dark spots on your gums, schedule an evaluation with your dentist or healthcare provider.

7 Reasons why your gums are black

There are seven common reasons that your gums may be turning black, including:

  • Melanotic Macules

    Melanotic macules make up approximately 86% of hyperpigmented gums. This condition is characterized by dark spots on the gums. The spots are typically flat and under 1 cm in diameter. They may be gray, black, blue, or brown. The spots are usually benign and there are no other symptoms. However, since the spots look similar to other conditions that are not benign, your dentist may take a biopsy.

  • Smoker’s Melanosis

    Smoking can sometimes cause an accumulation of melanin in the gums. This is referred to as “smoker’s melanosis”, and approximately 22% of smokers are affected by this condition. The spots are flat and black or brown in color. These spots are also typically benign, but a biopsy may be needed to rule out malignancy.

  • Amalgam Tattoos

    Sometimes, the dental filling material can deposit onto the gums following a dental procedure, resulting in a black or blue-gray spot on the gums. This is known as an amalgam tattoo and appears near the tooth that had the work.

  • Medications

    Certain medications can cause hyperpigmentation on the gums, including:

    • Chlorpromazine
    • Chloroquine
    • Cyclophosphamide
    • Zidovudine
    • Quinine
    • Ketoconazole
    • Minocycline
    • Bleomycin
  • Addison’s Disease

    Addison’s disease is a condition in which the body does not produce enough aldosterone or cortisol hormones due to dysfunction of the adrenal gland. Symptoms include fatigue, abdominal pain, skin darkening in mucous membranes, and dizziness.

  • Peutz-Jeghers Syndrome

    Peutz-Jeghers Syndrome, or PJS, is a rare genetic condition resulting from a genetic mutation. The condition is characterized by growths in the gastrointestinal tract. In addition, freckling ranging from dark blue to dark brown occurs in the mouth, including the gums.

  • Oral Malignant Melanoma

    Oral malignant melanoma is a form of skin cancer developing in the mouth. Approximately 0.2% to 8% of melanomas in the United States are oral. The spots are typically bluish-black to dark brown and in some cases, white or skin-colored lesions may occur, in the early stages, the condition can be asymptomatic, but may change in color, symmetry, and shape. Later, patients may experience open sores as well as bleeding and swelling in the mouth.

Diagnosing Black Gums

In order to diagnose the cause of black gums, your dentist may use the following assessments:

  • Complete dental history
  • Discussion of current symptoms
  • Evaluation of medical history and lifestyle habits
  • Oral exam
  • Examination of lesion/lesions
  • Biopsy

How to prevent Black Gums

If black gums are not natural for you, there are several things that you can do to prevent black spots and maintain healthy gums. These include:

  • Brushing teeth and gums regularly- at least twice daily
  • Flossing- at least once daily
  • Visiting the dentist every 6 months for a dental exam and cleaning
  • Cutting down on sugar
  • Quit smoking

Black Gums Treatment

The cause for your black gums determines the best course of treatment. Addison’s disease or gum infections are typically treated with medications. Changes in gum color due to smoking may be reversed. Ask your dentist or medical provider for help to quit smoking. Gum bleaching may be used to lighten the color of the gums- but should only be done by a professional.

If you are experiencing pain or other problems or if the condition advances into cancer, you need to seek help immediately. Some of the common treatments include:

  • Gingival grafts
  • Chemical methods
  • Surgical abrasion
  • Laser vaporization
  • Electrosurgery
  • Cryosurgery
  • Scalpel gingivectomy

Schedule Your Evaluation with Dr. Afroz Burges

Black gums are normal for those with darker skin tones. Therefore, if your gums are naturally black, you may not have anything to worry about. However, if you have darkening spots forming on your gums, schedule an evaluation with Dr. Afroz Burges in Pearland, TX. She has the experience and expertise to diagnose and treat many dental conditions including darkening gums. She will work with you to ensure that each and every visit is a pleasant one. She will also help you understand your treatment options, as well as the best ways to prevent the same issue in the future.

We are located on Shadow Creek Parkway in Pearland. Our office hours are Monday through Thursday from 8:00 AM to 5:00 PM and Friday from 8:00 AM to 2:00 PM.



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