- Dark spots on the gums can be caused by harmless pigmentation, injuries, or dental materials, but in some cases may indicate a medical condition. Most dark spots are not serious, especially if they are painless and stable in size. However, spots that grow, bleed, or change color should be evaluated by a dentist.
- Eruption hematomas, gum injuries, amalgam tattoos, blue nevus, melanotic macules, and oral melanoacanthoma are some of the causes of dark spots.
- If there are no alarming symptoms, you can ask your dentist during your regular checkup.
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Noticed a black or dark spot on your gums? Most are harmless, but some may require dental evaluation. Learn the common causes and warning signs to watch for.
Eruption Hematoma
Hematomas or bleeding outside the blood vessels can occur in various parts of the body, including the gum tissues. An eruption hematoma can form around young teeth that are erupting and developing their roots.
Eruption hematoma cysts are filled with fluid that may bleed and leave a temporary dark patch. The condition is rare for permanent teeth and is more present with the eruption of primary teeth in infants and children rather than wisdom teeth in adults. Sometimes, the condition requires a surgical procedure to remove the cyst to help the tooth properly erupt.
Gum Injuries
The most common self-inflicted gum injury is toothbrush trauma due to incorrect oral hygiene technique. Sharp-edged food particles can also traumatize the gums, resulting in a cut or bruise that causes pain. This can result in the injured area appearing purple or dark red in color.
An alarming sign is the development of new bruises with no obvious reason. Do not ignore this condition, especially if you also experience gum and nose bleeding. These may be symptoms of thrombocytopenia. This condition prevents blood clotting and requires professional medical attention.
Amalgam tattoos
Amalgam tattoos are permanent discolorations of the gum tissue that usually appear near a tooth with an amalgam restoration. These “tattoos” occur when amalgam particles become lodged under the soft tissue. Generally, they are not visible in an area to cause any cosmetic concerns.
Amalgam is a metal mixture that contains liquid mercury and an alloy of tin, copper, and silver. The dark spots on your gums caused by amalgam do not contribute to health issues.
Occasionally, teeth with amalgam that are extracted may cause amalgam tattoos in the soft tissue.
Blue nevus
Some patches on the gums with dark pigmentation ranging from blue to black are harmless blue nevus. They are not malignant melanoma. A blue nevus resembles a flat or slightly raised mole.
Blue nevi appear in childhood or during puberty, but their cause remains unknown. Most blue nevi are diagnosed by a clinical examination. A biopsy can be performed by a dentist to determine if the patch is benign or malignant, if needed.
Melanotic macule
Melanocytic macules are harmless and often appear in people with more melanin. Such spots can develop later in life. Although not all causes of melanocytic macules are known, occasionally they are associated with symptoms of diseases.
Melanocytic macules are harmless and do not require treatment. However, if they change in size, shape, or color, a biopsy may be needed to determine if the spot is a symptom of oral cancer.
Oral melanoacanthoma
Oral melanoacanthoma is most common in younger people. Oral melanoacanthoma is a rare, benign macular brown-black lesion. It is usually painless and distinguished by sudden appearance and rapid growth.
Smoking
Smoking is a cause of smoker's melanosis, which appears as dark spots on the gums or oral pigmentation of the entire oral cavity. Malodor in smokers is the result of nicotine in tobacco products, which increases the blood supply and reduces the coral pink color of the gums. Smoking is one of the many factors associated with oral cancer.
Medications
Pigmented spots on the gums may be a side effect of some medications. Minocycline, an antibiotic of the tetracycline group, has a rare side effect of causing oral pigmentation. This medication is commonly used to treat bacterial infections. If you suspect that your medicine creates a similar effect, you should discuss the possibility of an alternative medication with your doctor.
Oral cancer
The black color of gum tissue can also be a sign of oral cancer. This condition requires emergency medical treatment. Other common signs of oral cancer include heavy or persistent bleeding, open sores, and swelling in the mouth. The latter contributes to the changes in the voice and constant sore throat. Medical professionals perform oral cancer screenings, biopsies, CT scans, and PET scans to properly diagnose oral cancer.
Treatment options for oral cancer depend on the stage of the disease. Surgical removal may be necessary if the cancer has not spread. Otherwise, eradication of cancer cells requires treatment such as chemotherapy or radiation therapy.
Lifestyle factors such as excessive alcohol and tobacco use are major contributors to oral cancer.
FAQ
What does a black spot on the gums mean?
A black spot on the gums can have several causes, including harmless pigmentation such as melanotic macules, blue nevus, or amalgam tattoos. It may also result from gum injury, eruption hematoma, smoking, certain medications, or, in rare cases, oral cancer. The cause depends on symptoms such as pain, swelling, bleeding, or changes in size or color.
Are dark spots on gums a sign of cancer?
Most dark spots on the gums are not cancerous and are caused by harmless conditions. However, oral cancer can sometimes appear as a black area on the gum tissue. Warning signs include persistent bleeding, swelling, open sores, or changes in voice and throat discomfort. Any spot that changes in size, shape, or color should be evaluated by a dentist.
Can smoking cause black spots on gums?
Yes. Smoking can cause smoker’s melanosis, which appears as dark spots or pigmentation on the gums and oral tissues. Nicotine increases blood supply and reduces the natural pink color of the gums, leading to discoloration.
Can gum disease cause black spots?
In advanced stages of gum disease or periodontitis, the color of the gums may turn dark red and may even appear black. This is due to an excessive amount of calcified black tartar accumulated under the gum tissue, which may result in the black appearance near the gums, but the gums themselves do not have discoloration. Discolored spots related to periodontal disease are the result of poor oral hygiene.
Is a black spot on the gums a reason to visit a dentist?
You can see your dentist at your regular checkup if there are no alarming symptoms. However, if you experience symptoms such as pain, swelling, bleeding, a change in shape or color, contact your doctor as soon as possible.
How to get rid of black spots on your gums?
It is quite difficult to make the gums pink again. Quitting smoking helps restore the natural color to a certain degree. Laser bleaching therapy for soft tissues may also help. Additionally, alternative medications and home remedies, such as herbal teas, can gently remove the discoloration. Unfortunately, not all pigmentation responds to traditional treatments.
References
- Chapman DH, Garsa A (2018). "Cancer of the Lip and Oral Cavity". In Hansen E, Roach III M (eds.). Handbook of Evidence-Based Radiation Oncology. Springer International Publishing. pp. 193–207. doi:10.1007/978-3-319-62642-0_8. ISBN 9783319626413
- Gum disease opens up the body to a host of infections April 6, 2016 Science News "Review and Analysis of the Literature on the Health Effects of Dental Amalgams" (PDF). Life Sciences Research Office. Retrieved 29 July 2009.
Harry Lee, DMD
In my practice, dark spots on the gums are one of those "wait-and-see" symptoms that often turn out to be completely benign—but they still make patients jumpy. I frequently see what we call "amalgam tattoos," which are essentially accidental tattoos caused by tiny silver particles from old fillings getting lodged in the tissue. From my conversations with colleagues, we've noticed that while these look like ominous black marks, they're harmless. However, the real clinical challenge is distinguishing them from a "blue nevus" or, more seriously, oral melanoma.