7 Causes of Black Spots on Gums

Medically reviewed by Christine Frank, DDS on November 28, 2017Written by Valencia Higuera on November 28, 2017

 

Gums are usually pink, but sometimes they develop black or dark brown spots. Several things may cause this, and most of them aren’t harmful. Sometimes, however, the black spots can indicate a more serious condition. To be safe, talk to your doctor if you notice any dark spots on your gums, especially if they’re also painful or change in size, shape, or color.

Understanding the most common causes of black spots on your gums may help you decide if you need to seek immediate treatment or wait to bring it up at your next dentist appointment.

1. Bruises

You can injure your gums just like any other part of your body. Falling on your face, eating something with sharp edges, and even brushing or flossing your teeth too hard can bruise your gums. Bruises on the gums are usually dark red or purple, but they can also be dark brown or black. You may also have some minor bleeding and pain in addition to the bruise.

Bruises usually heal on their own without medical treatment. If you start developing more bruises and can’t think of anything that may have caused them, you may have thrombocytopenia, a condition that makes it hard for your blood to clot. Other symptoms include nosebleeds and bleeding gums. Several things can cause thrombocytopenia, so it’s important to work with your doctor to find the right treatment.

2. Eruption hematoma

When a tooth is about to come in, it can create a cyst filled with fluid. Sometimes there’s blood mixed in with the fluid, which can make it look dark purple or black. When an eruption cyst has blood in it, it’s called an eruption hematoma. This usually happens when the eruption cyst is injured by a bump or fall.

Eruption hematomas are very common in children as both their baby teeth and permanent teeth come in. They usually go away on their own after the tooth comes in. If the tooth doesn’t come in on its own, a doctor may surgically open the cyst to allow the tooth through.

3. Amalgam tattoos

If you’ve had a cavity filled, a deposit of amalgam may be left on your gums, creating a dark spot. Amalgam is the particle used for dental fillings. Sometimes these particles become lodged in the area around the filling causing a stain in the soft tissue. Your doctor can usually diagnose an amalgam spot just by looking at it.

Amalgam tattoos aren’t removable, but they’re harmless and don’t require treatment. To prevent them, you can ask your dentist to use a rubber dam the next time you get a filling. This separates your teeth from your gums during dental procedures, preventing particles from getting into surrounding tissue.

4. Blue nevus

A blue nevus is a harmless mole that’s round and either flat or lightly raised. Blue nevi can look either black or blue and usually look like a freckle on your gums.

No one’s sure what causes blue nevi, but they often develop when you’re a child or teenager. They’re also more common in women.

Like amalgam tattoos, your doctor can usually diagnose a blue nevus just by looking at it. They typically don’t need treatment. However, if its shape, color, or size starts to change, your doctor may do a biopsy, which involves removing a piece of the nevus to test it for cancer.

5. Melanotic macule

Melanotic macules are harmless spots that look like freckles. They can show up on different parts of your body, including your gums. Melanotic macules are usually between 1 and 8 millimeters in diameter and don’t cause any other symptoms.

Doctors aren’t sure about the exact causes of melanotic macules, but some people are born with them. Others develop them later in life. They can also be a symptom of other conditions, such as Addison’s disease or Peutz-Jeghers syndrome.

Melanotic macules don’t require treatment. Your doctor may do a biopsy to test the spot for cancer if its shape, color, or size starts to change.

6. Oral melanoacanthoma

Oral melanoacanthoma is a rare condition that causes dark spots to develop in different parts of the mouth, including the gums. These spots are harmless and tend to happen in younger people.

The cause of oral melanoacanthoma is unknown, but it seems to be associated with injuries caused by chewing or friction in the mouth. These spots don’t require treatment.

7. Oral cancer

Cancer inside the mouth can also cause black gums. Other symptoms associated with oral cancer include open sores, unusual bleeding, and swelling in the mouth. You may also have a chronic sore throat or notice a change in your voice.

To determine if a spot is caused by cancer, your doctor will do a biopsy. They may also use different imaging techniques, such as a CT scan or PET scan, to see if the cancer has spread.

If the spot is cancerous, your doctor may surgically remove it if it hasn’t spread. If it has spread, radiation therapy or chemotherapy may help to kill the cancer cells.

Drinking large amounts of alcohol and using tobacco are the biggest risk factors for developing oral cancer. Drink in moderation and avoid tobacco to help prevent oral cancer.

The bottom line

Black spots on your gums are usually harmless, but they can sometimes be a sign of teething problems in children or oral cancer. If you notice a new spot on your gums, make sure to tell your doctor about it. Even if the spot isn’t cancerous, it should be monitored for any changes in shape, size, or color.

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