Why Do I Have Black Gums? Common Causes and the Best Treatment Options

Healthy gums are usually light pink in colour, so noticing dark brown or black areas on your gums can be unsettling. While black gums are often harmless, they can sometimes signal an underlying dental or medical issue that should not be ignored.

In many cases, gum discolouration develops gradually and causes no pain. However, if dark spots on your gums begin to change in size, shape, or colour, or are accompanied by discomfort, bleeding, or swelling, it’s important to seek professional advice.

In this article, we explain the most common causes of black gums, when treatment may be needed, and how dentists determine whether gum discolouration is a cosmetic issue or something that requires further care.

Common Causes of Black Gums

If you notice dark areas on your gums, it’s understandable to feel concerned. In most cases, the cause is harmless, but identifying the reason behind the colour change helps determine whether monitoring or treatment is needed.

Here are the most common black gum causes patients should be aware of:

Smoking (Smoker’s Melanosis)

Smoking is one of the most common causes of dark gum pigmentation. This condition, known as smoker’s melanosis, occurs when nicotine stimulates melanocytes, the cells responsible for producing melanin. As melanin levels increase, the gums gradually take on a darker appearance.

This type of pigmentation does not usually cause pain or disease. Importantly, it is often reversible. After quitting smoking, melanin production slows, and the gums may lighten over time, although the process can take several months or longer.

Bruising or Trauma

Gums can darken temporarily due to bruising caused by:

• Accidental injury to the mouth

• Biting down on hard or sharp foods

• Brushing or flossing too aggressively

Bruised gums may appear dark red, purple, brown, or even black, depending on the stage of healing.

In most cases, the colour fades as the tissue recovers. However, if dark patches appear repeatedly or without an obvious cause, a dental examination is advised, as some blood or circulation-related conditions can also affect gum colour.

Natural Melanin Pigmentation

Some people naturally have darker gums due to higher melanin production. This is a normal genetic variation and does not indicate disease. Natural pigmentation is usually even in colour and remains consistent over time.

If the gum colour has always been dark and there are no other symptoms, treatment is not required. That said, any sudden changes in colour, texture, or shape should still be assessed by a dentist to rule out other causes.

Amalgam Tattoo

An amalgam tattoo occurs when microscopic particles from a silver dental filling become embedded in nearby gum tissue. This creates a flat grey, blue, or black spot, typically near a tooth that has been restored in the past.

Amalgam tattoos are harmless and permanent. They do not spread or develop into disease, and treatment is not necessary unless the diagnosis is uncertain.

Blue Nevus

A blue nevus is a benign pigmented lesion that can appear on the gums or other areas of the mouth. It usually looks like a small blue or black freckle and may be flat or slightly raised. These lesions often develop early in life and remain stable for many years.

Dentists can usually identify a blue nevus during a routine examination. If the lesion changes in size, shape, or colour, further investigation or a biopsy may be recommended as a precaution.

Medication-Related Pigmentation

Certain medications can cause changes in the colour of the gums or teeth. One example is minocycline, an antibiotic commonly prescribed for acne and some infections, which is known to cause oral pigmentation in some patients.

If medication-related pigmentation is suspected, your dentist will review your medical history and medications to confirm the cause and determine whether monitoring or further action is required.

Medical Conditions Associated With Black Gums

Although most cases of black or dark gums are harmless, in rare situations they may be linked to underlying medical conditions. These cases are uncommon, but it’s important to be aware of them, especially if gum discolouration appears suddenly or is accompanied by other symptoms.

Addison’s Disease

Addison’s disease is a hormonal disorder that affects the adrenal glands and disrupts normal hormone production. One of the visible signs can be darkening of the gums, lips, or inner cheeks due to increased melanin production.

Oral changes may occur alongside symptoms such as:

• Persistent fatigue

• Unexplained weight loss

• Muscle weakness

• Low blood pressure

If gum darkening is combined with these symptoms, both medical and dental evaluation are essential.

Acute Necrotising Ulcerative Gingivitis (ANUG)

Acute necrotising ulcerative gingivitis, often referred to as trench mouth, is a severe and painful gum infection. It is more likely to develop in people with poor oral hygiene, high stress levels, weakened immune systems, or nutritional deficiencies.

Common signs include:

• Severe gum pain

• Bleeding gums

• Strong, unpleasant breath

• Fever and general discomfort

• Black or grey gum tissue caused by dead tissue buildup

ANUG requires urgent dental treatment, as the infection can progress rapidly if left untreated.

Peutz-Jeghers Syndrome

Peutz-Jeghers syndrome is a rare genetic condition that can cause dark freckles or spots on the lips, gums, and inside the mouth, as well as on the skin. These pigment changes often appear early in life.

This condition is also associated with an increased risk of certain cancers, which makes early diagnosis and ongoing medical monitoring especially important.

Treatment Options for Black Gums

Treatment depends entirely on the underlying cause.

• Smoking-related pigmentation often improves after quitting smoking

• Infections or systemic conditions require medical or dental treatment

• Medication-related discolouration may be monitored or managed in collaboration with your doctor

• Cosmetic treatments, such as gum bleaching, can lighten gum colour but should only be performed by experienced dental professionals, as improper treatment can damage gum tissue

Not all cases require treatment, but professional assessment ensures nothing serious is overlooked.

Expert Care for Gum Concerns at MGA Dental

At MGA Dental clinics in Brisbane and the Gold Coast, our team is experienced in diagnosing and managing gum colour changes, from harmless pigmentation to conditions requiring treatment. We take a thorough, patient-focused approach to determine the cause of black gums and recommend appropriate care based on your individual needs.

If you’ve noticed dark spots on your gums or changes in gum colour, contact our team at MGA Dental to book a consultation and receive clear, professional guidance for protecting your oral health.