A dark spot on gums may look concerning. Fortunately, in the vast majority of cases these spots are benign and easily explainable. Let's consider some of the more common conditions that might cause gum discoloration and what can be done about them.
An amalgam "tattoo" occurs when a silver filling is being placed and some of the metal filling material inadvertently becomes lodged in the gum tissue or cheek. It usually looks like a small, irregularly shaped dark blue discoloration. They may look strange when you brush your teeth, but these dots are perfectly harmless and require no treatment.
Trauma, such as accidentally biting your tongue or cheek or being hit in the mouth while playing sports, can leave a bruise, appearing as a dark spot on the gum or cheek. You would most likely be aware of this happening and can easily relate the bruise to a specific injury. This type of injury will usually heal by itself in a week or two and requires little treatment beyond palliative care, such as rinsing with warm salt water.
For any lesion that is more severe or doesn't seem to be healing, you should see your dentist. You should also always wear amouth guard to protect your teeth while playing contact sports.
Minor oral injuries, such as a cut from sharp food, can sometimes result in a pyogenic granuloma, a bright red or purple swollen bump. This overgrowth of tissue can also appear in the mouth during pregnancy, notes the British Association of Dermatologists. If they are bothersome, granulomas can be easily removed, and they are not malignant or dangerous.
Dark Gum Spots & Teething
Occasionally, a swollen spot known as an eruption hematoma can form over a child's erupting tooth. When this small, fluid-filled cyst contains blood it appears dark blue or purple. The word "hematoma" refers to an area filled with blood, just like any bruise you might get from bumping your knee or elbow. This is a harmless lesion that requires no treatment and will disappear as the tooth grows into the mouth.
In rarer cases a dark spot on gum tissue can point to a disease or growth. A nevus, for example, is a congenital tumor-like malformation of the skin or mucous membrane that can develop in the mouth. It may appear as a dark blue pigmented mole and is typically harmless and requires no treatment.
The circulatory disease thrombocytopenia, characterized by a deficiency in the number of platelets in the blood, can also be marked by oral spots called thrombocytopenic purpura. Other oral symptoms include spontaneous bleeding gums and the appearance of small red dots called petechiae on the roof of the mouth and the cheeks. This condition requires referral to a doctor for accurate diagnosis and treatment.
What to Do About Dark Spots?
Many soft-tissue-related dark spots in the mouth are harmless, and there is no need to remove or disturb them unless they become painful. It's no secret that your mouth is a reflection of the health of your whole body, so it never hurts to see your dentist if you notice any perplexing oral changes. They will likely already perform a regular oral cancer screening and other checks of your soft tissues at your regular dental cleanings.
If your dentist is uncertain about the cause of a dark spot on gums, they may have you return in a week to see if there are any changes. If there are persistent symptoms or problematic changes in the size, shape, or color of a spot, your dentist may refer you to a doctor or oral surgeon for appropriate followup.