Dark spots on the gums are most often harmless. They can result from minor bruising, benign moles, or melanotic macules. Still, in some cases they might signal a more serious issue like oral cancer.
Healthy gums are typically pink, but occasionally you may notice black or very dark brown patches. Many of the potential causes aren’t dangerous, yet some could be concerning. If you observe any dark marks on your gums — particularly if they hurt or change in size, shape, or shade — contact your healthcare provider.
Knowing the common reasons for black gum spots can help you decide whether immediate attention is needed or if it’s acceptable to wait until your next dental visit.
1. Bruises
Your gums can be injured just like skin or other tissues. A fall, eating something with sharp edges, or overly aggressive brushing or flossing can all cause gum bruising. Bruises on the gums commonly appear dark red or purple and may also look dark brown or black. Minor bleeding and tenderness often occur along with the discoloration.
Most gum bruises resolve spontaneously without treatment. If you’re developing multiple unexplained bruises, you could have thrombocytopenia, a disorder that impairs blood clotting. Additional signs include frequent nosebleeds or bleeding from the gums. Because thrombocytopenia has various causes, it’s important to work with your physician to identify appropriate treatment.
2. Eruption hematoma
When a tooth is about to erupt it can form a fluid-filled cyst. If that fluid contains blood, the cyst may look dark purple or black — this is called an eruption hematoma. These often occur when the cyst is bruised by a bump or fall.
Eruption hematomas are common in children as both baby and permanent teeth come through. They usually disappear on their own after the tooth erupts. If the tooth fails to emerge, a clinician may need to open the cyst surgically to allow the tooth to erupt.
3. Amalgam tattoos
If you’ve had dental fillings, tiny bits of amalgam can become embedded in the gum tissue and create a dark spot called an amalgam tattoo. Amalgam is the material used in certain fillings, and particles can lodge in surrounding soft tissue during dental work. A provider can usually identify an amalgam stain by its appearance.
Amalgam tattoos are harmless and not removable, so they typically don’t need treatment. To reduce the risk of getting one, you can ask your dentist to use a rubber dam during fillings; this protects the gums from stray particles during the procedure.
4. Blue nevus
A blue nevus is a benign mole that’s round and flat or slightly raised. These nevi can appear blue or black and often resemble a small freckle on the gums.
The exact cause of a blue nevus isn’t known, but they frequently appear during childhood or adolescence and are somewhat more common in women. Your clinician can often recognize a blue nevus by sight, and most do not require treatment. If the lesion changes in shape, color, or size, a biopsy may be performed to rule out malignancy.
5. Melanotic macule
Melanotic macules are benign, freckle-like spots that can form in various body locations, including the gums. They usually measure between 1 and 8 millimeters across and don’t cause other symptoms.
The precise cause of melanotic macules is unclear; some people are born with them while others develop them later. They can also be associated with conditions such as Addison’s disease or Peutz-Jeghers syndrome.
Treatment isn’t necessary for melanotic macules. However, if you notice any alterations in color, size, or shape, your doctor may perform a biopsy to check for cancer.
6. Oral melanoacanthoma
Oral melanoacanthoma is an uncommon condition that produces dark patches in areas of the mouth, including the gums. These lesions are benign and are more frequently seen in younger individuals.
Although the cause is unknown, oral melanoacanthoma seems linked to trauma from chewing or repeated friction within the mouth. These spots generally don’t require medical treatment.
For related concerns about unusual gum lumps, see bump on gums.
7. Oral cancer
Cancer inside the mouth can also present as dark areas on the gums. Other warning signs of oral cancer include open sores, abnormal bleeding, swelling, persistent sore throat, or voice changes.
To confirm whether a lesion is cancerous, your provider will perform a biopsy and may use imaging tests such as CT or PET scans to check for spread.
Treatment depends on stage; if the cancer is localized, surgical removal may be possible. For more advanced disease, radiation therapy or chemotherapy may be used to treat cancer cells.
Heavy alcohol use and tobacco are the primary risk factors for oral cancer. Limiting alcohol intake and avoiding tobacco reduce your risk.
The bottom line
Most black spots on the gums are harmless, although they can sometimes reflect teething issues in children or, rarely, oral cancer. Notify your clinician if you discover a new spot on your gums. Even if it’s benign, it should be observed for any changes in size, shape, or color.
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