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What causes black gums?

Medically reviewed by Christine Frank, DDS — Written by Claire Sissons — Updated on July 26, 2023

Causes of black gums
Treatment
Prevention
Outlook

Possible causes of black gums include melanin, smoking, certain medications, and more. In some cases, black gums may mean a person has an underlying condition.

The gums are tough tissues that surround and hold the teeth in place. They can range in color from red or pink to brown or black.

Good oral health is essential for overall well-being. Changes in the color of the gums can indicate an underlying health problem, so a person should speak to a doctor to determine the cause.

Causes of black gums

There is a range of conditions that can cause black gums, including:

1. Melanin

female patient at dentist — Gum color can vary from red or pink to brown or black.

The body naturally produces melanin, a substance that gives the skin, hair, and eyes their color. The more melanin a person has in their body, the darker their hair, skin, or eyes will be.

Dark brown or black gums may be due to a person having more melanin in the body. If a person’s gums have always been very dark, there is no cause for concern.

If the gum color changes over a short period, however, or if patches of black appear on the gums, it is probably not caused by melanin and may indicate a medical issue.

2. Smoking

Smoking can cause discolored gums. This is known as smoker’s melanosis.

Specialized cells in the body called melanocytes make melanin. The nicotine in tobacco can cause melanocytes to produce more melanin than usual.

Gums may become more brown or black. The change in color can appear in patches or affect the entire inside of the mouth. The inside of the cheeks and lower lip may also change color.

Research has found a link between quitting smoking and reduced gum discoloration. This suggests that darker patches of color on the gums caused by smoking may be reversible.

3. Medication

Minocycline is used to treat acne and some infections, such as chlamydia. An uncommon side effect of minocycline is pigmentation or discoloration, which can sometimes occur in the mouth.

A person should speak to their doctor about any discolorations caused by medications, as alternative drugs may be available.

4. Amalgam tattoo

An amalgam tattoo can appear anywhere in the mouth but usually appears next to a filling. It looks like a black, grey, or blue patch inside the mouth.

Amalgam is a mix of metals used to make fillings and crowns. If particles of this material get dislodged, it can show up under the skin of the gum.

Treatment is not usually needed for amalgam tattoos, as they do not pose any health risks.

5. Acute necrotizing ulcerative gingivitis

Acute necrotizing ulcerative gingivitis is a gum infection that is also known as trench mouth. It causes fever, painful gums, and bad-smelling breath. An infection can cause black or grey gums if a layer of dead tissue builds up over the gums.

Trench mouth results from the rapid growth of bacteria in the mouth, usually due to gingivitis. Bacteria may build up because of poor oral hygiene, stress, lack of sleep, or an unhealthful diet.

Early symptoms of trench mouth include bleeding gums, bad breath, lots of saliva in the mouth, and feeling ill. Ulcers may form on the gums at the edge of the teeth.

Treatment is straightforward. A dentist will clean the mouth and may prescribe antibiotics.

Rinsing the mouth with medicated mouthwash and keeping teeth and gums clean will help prevent repeat infections.

6. Addison’s disease

man lighting cigarette — Nicotine can cause a higher production of melanin which can lead to discolored gums.

Addison’s disease affects the adrenal glands, which make a variety of hormones. The disorder stops these glands from producing enough hormones.

Early symptoms include:

tiredness
feeling more thirsty than usual
unintended weight loss
lack of appetite
weakened muscles

As Addison’s disease progresses, a person may experience darkened gums and lips. The medical term for this is hyperpigmentation.

As well as affecting the lips and gums, Addison’s disease can cause darker patches of skin in other areas of the body. The most common places where dark patches may develop are on the knees, knuckles, in the lines of the palms, and around scars.

Most cases of Addison’s disease are due to a problem with the immune system. This causes the body to attack and damage the adrenal glands.

Addison’s disease can cause severe complications if left untreated. If hormone levels drop too low, it can cause an adrenal crisis.

Symptoms of an adrenal crisis include severe dehydration, fast and shallow breathing, drowsiness, and pale, clammy skin. An adrenal crisis is a medical emergency.

7. Peutz-Jeghers syndrome

Peutz-Jeghers syndrome is a genetic condition that can increase the risk of developing polyps or cancer.

One of the early symptoms is the appearance of dark blue or dark brown freckles. These can appear in the mouth as well as on the skin of the fingers and toes.

Peutz-Jeghers freckles typically appear in childhood and disappear with age. Another key symptom is bleeding or a blockage in the gut, which usually also occurs in childhood.

A genetic test can show if a person has Peutz-Jeghers syndrome.

Treatment

Treatment for black gums will depend on the underlying cause. Conditions such as gum infections or Addison’s disease will usually need treatment with medication.

It may be possible to reverse changes in gum color that are caused by smoking. A doctor should be able to give advice and support on quitting smoking.

Cosmetic dentists may offer gum bleaching to lighten the color of the gums. However, bleaching can cause damage to gums and should only be done by a registered professional.

Prevention

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Good oral hygiene and reducing sugar intake will help to keep teeth and gums healthy.

People can maintain good oral hygiene by brushing teeth regularly, flossing once a day, and cutting down on sugar.

These actions should be carried out alongside regular visits to the dentist. Maintaining good oral hygiene is the best way to keep teeth and gums healthy.

A person may also wish to brush their gums regularly and gently, using a soft bristle toothbrush.

Oral hygiene products are available for purchase in most pharmacies and online, including toothbrushes, dental floss, and mouthwash.

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Outlook

The causes of black gums can usually be treated. Genetic conditions often show a range of symptoms that can help a doctor or dentist to diagnose a disease.

Paying attention to changes in the color of the gums can help a person find and treat any health problems early.

Dentistry
Endocrinology
Infectious Diseases / Bacteria / Viruses
Smoking / Quit Smoking

How we reviewed this article:

SourcesMedical News Today has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical journals and associations. We only use quality, credible sources to ensure content accuracy and integrity. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.

Addison's disease. (2015, July 15)https://www.nhs.uk/conditions/Addisons-disease/
Kato, T., Takiuchi, H., Sugiyama, S., Makino, M., Noguchi, S., Katayama-Ono, T., … Naito, T. (2016, June 16). Measurement of reduced gingival melanosis after smoking cessation: A novel analysis of gingival pigmentation using clinical oral photographs. International Journal of Environmental Research and Public Health, 13(6), 598https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4924055/
Ni Riordain, R. (2014, June). Amalgam tattoohttps://www.dermnetnz.org/topics/amalgam-tattoo
Nisar, M. S., Iyer, K., Brodell, R. T., Lloyd, J. R., Shin, T. M., & Ahmad, A. (2013, May 31). Minocycline-induced hyperpigmentation: Comparison of 3 Q-switched lasers to reverse its effects. Clinical, Cosmetic and Investigational Dermatology, 6, 159–162https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3674755/
Peutz-Jeghers syndrome. (2017, October)https://www.cancer.net/cancer-types/peutz-jeghers-syndrome/cipeutz-jeghers-syndromeprinter
Ubertalli, J. T. (n.d.). Trench mouthhttps://www.msdmanuals.com/en-gb/home/mouth-and-dental-disorders/periodontal-diseases/trench-mouth

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Medically reviewed by Christine Frank, DDS — Written by Claire Sissons — Updated on July 26, 2023

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7 Causes Of Black Gums - Medical News Today

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Causes of black gums

1. Melanin

2. Smoking

3. Medication

4. Amalgam tattoo

5. Acute necrotizing ulcerative gingivitis

6. Addison’s disease

7. Peutz-Jeghers syndrome

Treatment

Prevention

Outlook

How we reviewed this article:

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