Black or dark gums: why is it?

Having black gums can mean an image and aesthetic problem when it comes to smiling. However, beyond the appearance, that the gingival tissue has a dark color it can be an indication of other complications of oral health.

The normal color of the gums is uniform and pale pink. Since it is in charge of covering, protecting and providing support to the teeth, its care is very important. What is its darkening? What to do about it? Find out!

Causes of black or dark gums

As stated in an article published in Oral Medicine, Oral Pathology and Oral Surgery, there are many factors that can be associated with dark or black pigmented lesions of the oral cavity and perioral tissues.

In general terms, its origin can be physiological or pathological, exogenous or endogenous. In addition, for its diagnosis, the location, distribution, duration, drug use, family history, etc. must be considered. Let's look at the most common causes in detail.


Like any part of the body, the gums can be hit and injured. By falls, accidents, blows, by eating food with sharp points or edges, or by applying too much force when brushing, the gingival tissue can be damaged.

Hematomas on the gingival tissue appear dark red, purple, brown and even black. The presence of bleeding and pain in the area are other symptoms that occur with pigmentation.

They generally reverse on their own and no medical treatment is necessary. In any case, if many bruises appear and there is no apparent cause that has generated them, it will be necessary to consult a health professional, as it may be a blood clotting condition.

Intake of some medications

The use of certain drugs can have darkening of the gums as a side effect. Some women, for example, experience discoloration of the oral mucosa – which turns more blackish or grayish – from the use of birth control pills.

Prolonged use of some medications can lead to the appearance of dark spots on the gums.

Blue nevus

Blue nevus is a round, flat, or slightly raised, black or blue spot. It is a harmless mole that looks like a freckle on the gum. How and why it originates is not known for sure. It appears more often in women, and it usually develops during childhood or adolescence.

The doctor usually makes the diagnosis by simple observation during the oral exam and does not need any treatment. Anyway, If it begins to change in shape, size, or color, a biopsy should be done. In this procedure, part of the tissue is removed to analyze it and rule out or confirm any malignant transformation that indicates cancer.


Amalgam is a material for dental use that is used to make dental fillings, reconstructions or inlays. It is an alloy of silver and mercury, which is almost in disuse today, but was very popular until not long ago.

During its placement there is a risk that material may accidentally move into the gingival tissue. The consequence is the appearance of a black spot on the gum known as a "tattoo."

The diagnosis is generally made with the naked eye during the oral examination, especially if there is a dental element restored with amalgam near the tattoo. Still, an x-ray can also be helpful, as this material has a characteristic radiopaque image.

No treatment is necessary because a tattoo is harmless. To prevent this, the dentist can be asked not to use amalgam in the restorations, or, if this is not possible, to perform an isolation with rubber during the intervention. This separates the teeth from the gums, preventing material from entering neighboring tissues.

It may interest you: Health risk of amalgam fillings

Melanotic macula

Melanotic macules are spots that appear on different parts of the body, including the gums. They look like freckles that are between 1 and 8 millimeters in size, are not accompanied by any other symptoms and are harmless.

The cause of their appearance is unknown, some people are born with them and others develop them in the course of life. In some cases They are associated with conditions such as Peutz-Jeghers syndrome or Addison's disease.

They do not require any treatment. If they change in shape, color, or size, your doctor may suggest doing a biopsy to look for cancer.


This type of black gums is associated with genetic and hereditary causes. Genes, as with eye and skin color, influence the hue of the gums.

People with melanoplakia are those who have more melanin in their gingival tissue. This is not serious, since it is the color of the mucosa of that patient.

Rash cyst

When a tooth is about to erupt, a fluid-filled cyst may appear. Sometimes the content is blood and liquid, which makes the gum appear dark or black.

In some cases, associated with a previous trauma to the eruptive cyst, the lesion fills with blood and this is called an "eruptive hematoma." They also look like an elevation in the gum of a bluish or purple hue.

They are frequent in children in the period of tooth eruption. They can happen in both baby teeth and permanent teeth. Most of the time it resolves on its own, when the tooth on which it was formed manages to erupt.

If the tooth cannot come out on its own, the dentist makes a small cut over the cyst for the tooth to erupt.


Smoking is detrimental to many aspects of health. At the oral level, it not only stains the teeth, but also delays healing, increases inflammation and favors the appearance of oral cancer.

Black gums are common in smokers, as the toxins in cigarettes increase the pigmentation of the mucous membranes and give them a darker hue. The ideal treatment for these patients is to eliminate the harmful habit. If this is not possible, regular check-ups are necessary due to the risk of cancer.

Tobacco use affects the coloration of the gums and, in the long term, increases the risk of oral cancer.

Mouth cancer

The presence of cancer in the mouth can manifest itself with black gums or dark spots on the gum tissue. Sometimes this will be the only symptom. Other times, it can be associated with the presence of open ulcers, bleeding, lumps and swelling of the mouth. It is also possible to experience pain or changes in the tone of voice.

To confirm that a dark spot on the gum is cancer, the dentist must perform a biopsy. Also, other complementary methods are usually necessary, such as CT scans or positron emission tomography scans. These help determine if the cancer has spread or how deep the lesion is.

Treatments depend on the stage of the cancer and its course. In cases where it has not spread, surgical removal is the treatment of choice. On the other hand, when cancer cells have spread to other tissues, it is necessary to supplement with radiotherapy and chemotherapy.

Read also: Lumps on the palate: are they dangerous?

Dental checks for an accurate diagnosis

Black gums, in general, are due to benign causes and do not have serious consequences. However, other times it is a clinical manifestation of a more serious health problem, such as oral cancer.

For the above, It is necessary to consult the dentist in a timely manner in the presence of this symptom. Professional counseling allows you to have an accurate diagnosis and know what behaviors or treatments are necessary.