• Some causes of dark spots on the gums are normal, while others may indicate a serious oral health problem. If you experience pain, swelling, bleeding, changes in shape or color, you should see your dentist as soon as possible.
  • 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.
  • Suspecting dental emergency? Call our emergency dental hotline, 24 hours a day, 7 days a week. We are open now and ready to help you.

Do you have dark spots on your gums? What causes them? Here's everything you need to know.

Eruption Hematoma

Hematomas or bleeding outside the blood vessels can occur in various parts of the body including  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 more present with 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 that appears 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 to 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  nevus appear in childhood or during puberty, but their cause remain 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

Melanotic macules are harmless and often appear in people with more melanin. Such spots can develop later in life. Although not all causes of melanotic macules are known, occasionally they are associated with symptoms of diseases. 

Melanotic 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 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.


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

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 and PET scans to properly diagnosis 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.


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 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, change in shape and 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.