How to Deal with “Black Gums” from Smoking [Plus, 9 Other Causes]

While most people tend to have pink gums, that’s not always the case. It helps to pay attention to your natural gum color. That way, if something changes, you can figure out the cause and decide whether or not you should speak to a doctor.

In most cases, gum discoloration is harmless and treatments exist to restore gums to their original color. However, if you’re a smoker, you should be aware of what causes your gums to darken and your treatment options.

Not all causes of black gums change gum color overall but rather leave black spots around the gums.

How to Spot Discoloration of The Gums

Melanin, specifically melanocytes, gives your gums their color. The amount of melanin varies from person to person, so gum color also tends to vary from person to person — healthy gums come in a large swathe of colors! As a result, darker gums can simply point to genetics and aren’t anything to worry about.

You should be concerned, however, if you notice a change in your natural gum color.

Spotting discoloration can be as simple as noticing any distinct changes in your gum color during your routine oral hygiene. You can also share any concerns with your dentist during your next appointment. They’ll be able to more thoroughly evaluate your gums.

10 Causes of Black Gums

Many influences can cause gums to turn darker or even black. Medication, certain medical conditions, and smoking are the most common causes.

Most instances of darkened gums are simply cosmetic. However, in some cases, they can be a symptom of something more troubling. Knowing what causes black gums is crucial for maintaining not just your oral health, but your overall health.

1. Smoker’s Melanosis

One of the main causes of dark/black gums is smoking. Tobacco can cause the cells responsible for making melanin, melanocytes, to increase melanin production.

As a result, gums may turn dark brown or black. This discoloration can occur in either patches or the entire inside of the mouth as a whole.

2. Acute Necrotizing Ulcerative Gingivitis

Also known as “trench mouth” from its roots in World War I, acute necrotizing ulcerative gingivitis is a severe gum infection that is usually the result of poor oral hygiene, stress, lack of sleep, or an unhealthy diet.

It may also be caused by HIV infection or triggered by smoking.

This is a severe form of gum disease (periodontal disease) that requires treatment from a dentist.

Symptoms may include foul breath, painful/bleeding gums, a surplus of saliva, and fever. Some patients also experience ulcers on the gums near the teeth. Gum discoloration is a result of dead tissue build up.

3. Addison’s Disease

Addison’s disease causes is a disorder that affects the adrenal glands, causing them to produce insufficient hormones. This autoimmune disease occurs when the immune system mistakes healthy cells for foreign invaders and attacks them like it would a virus or pathogenic bacteria.

Symptoms range from tiredness, thirst, lack of appetite, weight loss, muscle weakness, and darkened lips and gums (hyperpigmentation).

4. Amalgam Tattoos

These blue, black, or gray patches inside the mouth occur as a result of recent fillings or crowns. Amalgam is a mixture of various metals used to make both.

It sometimes stains the inside of the mouth when the amalgam comes into contact with the tissue. While for some people, these spots are harmless, there is some evidence that they are related to chronic inflammation.

Because of toxicity concerns surrounding amalgam fillings or crowns, if you’re worried about amalgam, ask your dentist about other options.

5. Medication Side-Effects

Some medications like minocycline (used in acne treatments) have side effects which include discoloration of the gums. Other medications that may be at fault include antimalarials, cancer drugs, antibiotics, antipsychotics, and tricyclic antidepressants.

Simply changing the medication can help restore color — just be sure to talk to your prescribing physician before changing or stopping any medications.

6. Peutz-Jeghers Syndrome

This genetic condition causes noncancerous growths called hamartomatous polyps in the gastrointestinal tract that greatly increase the risk for certain cancers.

Children tend to develop dark spots over their bodies, including in and around their mouths. A genetic test can be used to identify Peutz-Jeghers.

7. Trauma

Gums can also be bruised due to trauma or injury. Impacts, cuts, or even brushing too hard can damage the gums.

One specific (rare) condition known as oral melanoacanthoma may be caused by injuries in the mouth.

Gum bruises from injury tend to clear up on their own over time and aren’t much cause for concern, but if you experience unexpected pain, it’s probably time to talk to your dentist.

8. Eruption Hematoma

Most common in Caucasian children, eruption hematomas (cysts) may happen when adult teeth come in. These dark patches may or may not require surgical treatment.

9. Melanotic Macule or Blue Nevus

Both of these features show up as discoloration of the gums. Melanotic macules appear as freckles, while a blue nevus may be slightly raised (more like a mole).

Generally considered to be harmless, your dentist may want to investigate this kind of spot if it begins to change in size or color.

10. Oral Cancer

Though it’s usually not the culprit, some cases of dark gums are a sign of oral cancer. Your dentist will be the first to pick up on this and other possible symptoms, which is just one more reason to never skip an appointment!

How to Lighten Dark Gums Caused By Smoking

Whether or not gum discoloration can be repaired depends on the condition that causes it. Some treatments can restore natural color to the gums, others may only manage the condition.

However, with dark gums caused by smoking, the easiest way to restore natural color to the gums is to quit smoking. But sometimes that isn’t enough on its own.

Cosmetic dentists can sometimes help restore gum color by brightening the gums through laser de-pigmentation treatment, bleaching, and surgery.

Laser De-Pigmentation

With laser treatment, your cosmetic dentist would treat the area with a local anesthetic to help you remain comfortable during the 20-45-minute process.

The laser vaporizes a thin layer of gum tissue, leaving room for the creation of new tissues. These tissues usually grow back as pink, rather than brown or black. The results of laser treatment can last up to 20 years.

Gum Bleaching

Using a bleaching solution along with laser de-pigmentation, your cosmetic dentist will lighten up your gums. Just like a standard de-pigmentation treatment, you may experience minor discomfort that over-the-counter medicines can relieve.

Keep in mind that gum bleaching requires a professional dentist and should not be tried alone.

Surgery

This process is more invasive. Your dentist will apply an anesthetic before the procedure, then they will surgically remove the damaged gums. By removing the outer layer of gum epithelium, the gum tissue below usually regrows into pinker and healthier looking than the darker gums.

This is called muco-osseous gum surgery.

Whatever treatment you choose, quitting smoking beforehand is the best way to ensure that you achieve the lasting, healthy-looking gums you desire.

What You Should Expect After Laser De-Pigmentation

As an outpatient procedure, you can expect minimum side-effects from laser de-pigmentation. Usually, there is some mild discomfort from the process, but that can be managed with over-the-counter pain medication as well. And you can also expect to eat, drink, and talk normally right after the de-pigmentation procedure.

For the best results, you should not smoke for at least 7 days after your procedure. And quitting altogether will help you maintain a healthy, beautiful smile with healthy-looking gums after your treatment.

Preventing Black Gums

While you can’t control your production of melanin, darkening of the gums can be prevented in many cases with good dental hygiene. This includes brushing with a soft-bristled toothbrush, flossing, and keeping up with teeth cleanings.

Above all, avoid smoking and all forms of tobacco, as these not only may change the color of the gums but leave you at a higher risk for oral cancer, severe gum disease, and more.

When to Talk to Your Dentist About Black Gums

It’s natural to feel some concern or worry if you notice gum discoloration. While some people have naturally darker gums and others have freckles, gum discoloration could hint at a more serious health concern. Scheduling a trip to your local dentist can be an easy way to put your mind at ease.

During your evaluation, your dentist will examine your gums and ask you a series of health questions. If there’s a cause for concern, more tests may be ran or treatment provided to help repair your gums.

However, if you are a smoker, then it’s most likely that your dark gums are a side-effect of that habit. Quitting smoking and treating the darkened gums with cosmetic dentistry are your best bet to rapidly restore your oral health.

Read Next: Are Cigars Better Than Cigarettes For My Teeth?

7 References

1. Malek, R., Gharibi, A., Khlil, N., & Kissa, J. (2017). Necrotizing ulcerative gingivitis. Contemporary clinical dentistry, 8(3), 496. Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5644015/
2. Underner, M., Maes, I., Urban, T., & Meurice, J. C. (2009). Effects of smoking on periodontal disease. Revue des maladies respiratoires, 26(10), 1057-1073. Abstract: https://www.ncbi.nlm.nih.gov/pubmed/20032842
3. Buchner, A., & Hansen, L. S. (1980). Amalgam pigmentation (amalgam tattoo) of the oral mucosa: a clinicopathologic study of 268 cases. Oral Surgery, Oral Medicine, Oral Pathology, 49(2), 139-147. Abstract: https://www.ncbi.nlm.nih.gov/pubmed/6928285
4. Lampe, A. K., Hampton, P. J., Woodford-Richens, K., Tomlinson, I., Lawrence, C. M., & Douglas, F. S. (2003). Laugier-Hunziker syndrome: an important differential diagnosis for Peutz-Jeghers syndrome. Journal of medical genetics, 40(6), e77-e77. Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1735508/pdf/v040p00e77.pdf
5. Gupta, A. A., Nainani, P., Upadhyay, B., & Kavle, P. (2012). Oral melanoacanthoma: A rare case of diffuse oral pigmentation. Journal of oral and maxillofacial pathology: JOMFP, 16(3), 441. Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3519227/
6. Nagaveni, N. B., Umashankara, K. V., Radhika, N. B., & Satisha, T. M. (2011). Eruption cyst: A literature review and four case reports. Indian Journal of Dental Research, 22(1), 148. Abstract: https://www.ncbi.nlm.nih.gov/pubmed/21525694
7. Monteiro, L. S., Costa, J. A., da Câmara, M. I., Albuquerque, R., Martins, M., Pacheco, J. J., … & Figueira, F. (2015). Aesthetic depigmentation of gingival smoker’s melanosis using carbon dioxide lasers. Case reports in dentistry, 2015. Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4410537/

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