Black Gums: Causes, Treatment and Prevention

The color of the gums is usually pink but it can also range from red to light-brown to dark-brown and even black.

Black gums may be normal, caused by smoking, some medical conditions, and a host of other reasons.

Having black gums can be a cause for concern especially if there was a recent change in gum color. This article helps to explain the causes, treatment, and prevention of black gums.

What Could Cause Black Gums?

1. Melanin Pigmentation

Melanin
Melanin is a substance produced by the body and is responsible for the color of the skin, hair, and eyes. The more melanin a person has in their body, the darker the color of the hair, skin, and eyes. A high amount of melanin in the body can also be responsible for black patches on the gums. This cause is normal and is not a reason to worry.

2. Smoking

Smokers are more liable to having black gums and this is because the nicotine in tobacco causes the melanin-producing cells (melanocytes) to produce more melanin than normal. This condition is called smoker’s melanosis. This black discoloration can also affect the lower lip and inner cheek.

3. Side Effect of Medication

medication

An uncommon side effect of minocycline is dark discoloration and pigmentation that can also occur in the mouth. Minocycline is an antibiotic used mostly in the treatment of acne. Other medications that can cause black discoloration are some anti-depressants and anti-malarial medication.

4. Amalgam Tattoo

This is a blue, black or grey discoloration of the soft tissues of the mouth. It is caused when an amalgam tooth filling material enters into the tissues such as the gums or cheeks. Amalgam is a filling material made of metal such as mercury and tin and it is silver colored. If particles of this material are dislodged, it can show up under the gum as a black patch.

5. Acute Necrotizing Ulcerative Gingivitis (ANUG)

Bad breath

ANUG is an infection of the gums that can be caused by poor oral hygiene, malnutrition, stress or a suppressed immune system. It is also known as ‘trench mouth’. This disease causes destruction of the gum tissues leading to build up of the dead or necrotic tissue. This necrotic tissue causes the gums to appear black or grey. Other symptoms are bad breath, fever, and gum pain.

6. Addison’s Disease

Addison’s disease is a disease that affects the adrenal glands that produce steroid hormones. It makes these glands not produce enough hormones. Symptoms include weight loss, muscle weakness, loss of appetite, tiredness, and thirst. As the disease progresses, there may be darkening of the lips and gums called hyperpigmentation.

This hyperpigmentation also affects the knees, knuckles, and palms. If left untreated, it can cause complications and when the hormone levels drop too low, it causes an adrenal crisis which is a medical emergency.

7. Peutz-Jeghers Syndrome

This is a genetic condition of the digestive system that can increase the risk of developing polyps or cancer of the intestine. The early symptoms of this condition are the appearance of dark patches or freckles in the mouth and the skin of fingers and toes. Diagnosis of this condition can be done by genetic testing.

8. Malignant Melanoma

Oral cancer
This is a type of oral cancer that presents as a black spot on the gum. It is developed from the melanocytes and also occurs on the skin.

How Are Black Gums Treated?

• Black gums as a result of melanin pigmentation require no treatment. If you are concerned about cosmetic solutions, many options are available. They include bleaching of the gums, removing the darkened gum tissue with a scalpel, cryosurgery, and free gingival grafting. Free gingival grafting involves taking healthy tissue from the roof of the mouth and placing it on the dark area of the gum.

Quit smoking
• Smoking cessation programmes and other measures to help quit smoking can reverse black gums caused by smoking cigarettes and the use of tobacco products.
• A review with your managing physician on medications that cause black gums as a side effect is very essential so that alternate drugs can be made available.
• Amalgam tattoo requires no treatment as there is no health risk involved. Cosmetic solutions can also be made available.

Mouthwash
• Professional cleaning in the dental clinic, also known as scaling and polishing, use of antibacterial mouthwash like chlorhexidine, and antibiotic therapy will help to treat black gums caused by ANUG. The underlying condition like stress or malnutrition should also be addressed.
• Medical conditions such as Addison’s disease and Peutz- Jeghers syndrome needs to be managed by a physician.
• If the cause of the black gums is a suspected case of malignant melanoma, the tissue needs to be biopsied and sent to the laboratory to confirm the diagnosis and aid proper treatment planning.

How Do I Prevent My Gums From Getting Black?

The following methods are important in preventing black gums.

Tooth brushing
a) Proper oral hygiene practices like brushing twice daily and rinsing with an antibiotic mouthwash twice daily can help to prevent gingivitis.
b) Discuss with your dentist about using tooth-colored fillings like composite instead of amalgam.
c) Visit your dentist regularly, at least twice a year and whenever you notice any change in the color of your gums.

Balanced diet
d) Ensure that you eat a well-balanced diet rich in fruits and vegetables to prevent malnutrition.
e) Make sure you rest and also engage in stress-relieving behaviors like yoga.
f) Programs that are aimed at helping smokers to quit smoking will go a long way in preventing smoker’s melanosis.

In Summary

Black gums can be caused by a variety of reasons which may range from mild to severe. Ensure you visit your dentist once you notice any black discoloration on your gums so that it can be addressed appropriately.

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Onyeka Mgbemere, BDS

Dr. Onyeka Mgbemere is a graduate of Dentistry and a licensed dentist who is passionate about the promotion of oral health education and prevention of oral diseases. She is currently undergoing her residency program in Oral medicine after spending years working at a Naval hospital. Her hobbies are watching movies and reading.