Brown or dark patches along the gums are, in most people, simply melanin, the same pigment that gives skin and hair their colour. Healthy gums range from pale pink to deep brown, and darker gums are not a sign of poor health. Some people still prefer a lighter, more even gum colour when they smile, and gum depigmentation is a cosmetic treatment that can do that. Before any of it, though, a dentist needs to confirm that the colour really is harmless pigment.
Most dark gums are normal
The amount of melanin in the gums is largely inherited, so pigmentation is often visible in several members of a family and is more common in people with darker skin. It usually appears as an even band or patches on both sides of the mouth and has been present for as long as the person remembers.
A few other things can darken the gums. Smoking can increase pigmentation, particularly at the front of the mouth. Some medicines can change gum colour, and a small grey or blue-black mark near an old silver filling is often a fleck of filling material in the tissue. Colour alone does not tell you whether gums are healthy; bleeding, swelling and recession are better signs to watch. Our article on gum disease treatment describes those signs.
When a dark spot needs checking first
Pigment that has always been there and looks even on both sides is rarely a concern. A dark spot that is new, growing, changing shape or colour, raised, or sitting on its own deserves a proper look. Any patch or sore in the mouth that has not healed or has changed within three weeks should be checked by a dentist or GP. Very occasionally a pigmented area needs a biopsy to rule out something more serious, and cosmetic treatment should wait until the cause is clear.
How depigmentation lightens the gums
Melanin sits in the thin outer layer of the gum. Depigmentation removes that layer so the gum heals with a lighter surface. The main techniques are:
- Scalpel removal, where the pigmented layer is carefully shaved off. This has long been the standard method.
- Laser removal, where a dental laser removes the layer and seals small blood vessels as it goes, so there is usually little bleeding.
- Other methods such as electrosurgery or freezing the tissue, chosen less often.
A systematic review by Gul M and colleagues (Journal of Indian Society of Periodontology, 2019) looked at 25 clinical studies comparing other methods, most often laser, with scalpel stripping. In their pooled analysis of laser against scalpel, the two gave similar lightening and no significant difference in colour returning, while laser treatment was associated with less pain after the procedure. The authors also noted more return of pigment after laser treatment at the six-month check, and called for better quality trials before firm conclusions are drawn.
Treatment is done under local anaesthetic. The gum is usually tender for some days while a new surface forms, and the lighter colour shows as it heals. Some people need more than one session, depending on how dark and widespread the pigment is.
The colour can come back
Depigmentation is not always permanent. Pigment can gradually return in some people over months or years, and how often this happens varies between techniques and between studies. Smoking is linked with more pigmentation, so stopping smoking helps both the result and the health of the gums.
Because the treatment is cosmetic, there is no medical need to have it. Leaving naturally dark gums as they are is a perfectly healthy choice.
Colour and shape are separate questions
Depigmentation changes the colour of the gums but not their shape or height. If a high smile line shows a lot of gum, or the gum line is uneven, procedures such as gingivectomy and gum reshaping deal with the contour, and the two are sometimes planned together. For the teeth themselves, our comparison of bonding versus veneers explains the main cosmetic options.
Gums that are receding need a different approach, explained in our article on receding gums.
Common questions
Are dark gums unhealthy?
Not usually. Even, long-standing pigment is normal. New or changing spots should be checked.
Does depigmentation hurt?
The area is numbed during treatment. Tenderness while the gum heals is common, and in studies laser treatment has tended to cause less discomfort afterwards than scalpel removal.
Will smoking affect the result?
Smoking is associated with gum pigmentation, so continuing to smoke may make it more likely that colour returns.
If you are concerned about dark areas on your gums, our general dentists in Melrose Park can check them and talk through whether any treatment is worth considering. After your assessment you will usually receive a written treatment plan, often by email. Current offers are on our current deals page.
