Short answer: Gum discoloration (bruising) is when part of the gum turns purple, blue-gray or dark red. The most common causes are bleeding after an injury, a harmless amalgam tattoo caused by particles from amalgam fillings, advanced gum inflammation and tooth-related infections. Patches with no known cause that last longer than two weeks, grow or are raised should always be evaluated by a dentist.
The color of your gums gives important clues about your oral health. In most people, healthy gums are light pink; a purple, bluish or dark red change in this color naturally causes concern. Purple or bruised gums can have many different causes, from the temporary mark of a minor injury to a harmless stain left by an old filling, and from gum inflammation to a tooth-related infection. Because it can, though rarely, be a sign of more serious conditions, identifying the cause correctly is important. In this article we explain the possible causes of gum discoloration, when it should be taken seriously and the treatment approaches.
What is gum discoloration?
Gum discoloration is when the normal pink color of the gum, in one area or throughout, gives way to purple, blue-gray or dark reddish-purple tones. It may appear as a small spot in a single place, or it may affect the area around a tooth or a large part of the gums.
The features of the color change give an idea of the possible cause. That is why, during the examination, the dentist looks for answers to the following questions:
- How long has the color change been there; did it start suddenly or has it been present for a long time?
- Is the area flat, raised or swollen?
- Is it accompanied by pain, bleeding, discharge or tenderness?
- Is there an amalgam filling, crown, extraction or root canal treatment nearby?
- Is the patch growing or changing shape over time?
- Do you bruise or bleed easily elsewhere on your body?
It is also worth remembering that natural gum color varies from person to person. Especially in people with darker skin tones, brown or dark pigmentation of the gums is usually completely normal and should not be confused with bruising.
What causes gum discoloration?
The most common causes of gum discoloration are bleeding after an injury, an amalgam tattoo formed when particles from amalgam fillings settle in the tissue, advanced gum inflammation and tooth-related infections; less often, medications, changes in blood vessel structure and bleeding disorders can also play a role.
- Trauma: A small bleed under the gum can occur after biting something hard, hard contact with a toothbrush, a fall or a blow. Like bruises elsewhere on the body, it changes color and fades within a few days.
- Amalgam tattoo: When amalgam fillings are placed or removed, or when a nearby tooth is extracted, small metal particles can become embedded in the gum tissue. It usually appears as a flat, blue-gray spot that does not hurt and does not change over time. It is considered harmless.
- Gum inflammation and disease: Long-standing inflammation can slow blood circulation in the gum and cause the tissue to take on a dark reddish-purple color. Swelling, bleeding when brushing and bad breath often accompany it.
- Tooth-related infection: An infection that develops at the root tip of a tooth whose nerve has died can show itself as purplish swelling in the gum, tenderness and sometimes a draining bump. The tooth itself may also darken.
- Smoking: Smoking can cause increased brown, dark pigmentation of the gums.
- Medications: Some antibiotics, antimalarial drugs and certain other drug groups can cause color changes in the tissues of the mouth.
- Vascular formations: Small clusters of blood vessels or dilated vessels can appear as bluish-purple bumps.
- Bleeding tendency and systemic conditions: Diseases that affect blood clotting, some blood disorders, blood-thinning medications and severe vitamin deficiencies can cause bruising and bleeding of the gums.
When does gum discoloration matter?
Gum discoloration should always be evaluated by a dentist when it appears without an obvious cause, lasts longer than two weeks, grows, becomes raised or bleeds, or is accompanied by symptoms such as pain, swelling and fever.
The following situations require a closer look:
- Dark patches with no known cause that grow over time or change color and shape
- Color changes that are raised, have irregular edges or have a sore on them
- Easy bruising elsewhere on the body, nosebleeds or prolonged bleeding in addition to gum discoloration
- Widespread gum swelling, fatigue and unexplained fever
- A draining bump or increasingly painful swelling around a tooth
The vast majority of pigmented lesions in the mouth are benign. However, very rarely, serious lesions such as melanoma can also appear in the mouth as dark patches. For this reason, for patches whose cause cannot be clearly identified and that are changing, the dentist may recommend taking a small tissue sample (biopsy) for a definitive diagnosis. When symptoms suggest a bleeding tendency, a referral to the relevant physician is made.
How is gum discoloration treated?
Treatment of gum discoloration depends entirely on the underlying cause; some conditions go away on their own without any treatment, while others may require gum treatment, root canal treatment or minor cosmetic procedures.
- Discoloration from trauma: It usually goes away on its own within a few days to a few weeks. During this time, it is enough to avoid irritating the area and to use a soft brush. If it does not go away, it is evaluated again.
- Amalgam tattoo: It does not require treatment from a health standpoint. If it is in a visible area and bothers you cosmetically, removal with surgery or a laser can be considered. When the diagnosis is uncertain, a biopsy may be performed.
- Gum inflammation: With tartar removal, cleaning of deposits below the gum line if needed and improved daily care, the gum usually regains its healthy color.
- Tooth-related infection: The tooth that is the source of the infection receives root canal treatment, abscess drainage or, if necessary, extraction. The dentist decides whether antibiotics are needed.
- Medication-related discoloration: It is evaluated together with the doctor who prescribed the medication; the medication should not be stopped on your own.
- Physiological pigmentation: It does not require treatment. If the person is bothered by it cosmetically, gum lightening procedures can be considered.
The treatment plan is created after the cause has been correctly identified through an examination and any necessary tests. You can find other frequently asked questions about color changes in the mouth on our frequently asked questions page.
How can gum discoloration be prevented?
Although it is not possible to prevent every type of gum discoloration, regular and gentle oral care, early treatment of gum disease, protection from injury and staying away from smoking significantly reduce the risk.
- Brush with a soft-bristled brush without pressing hard on the gums.
- Clean between your teeth every day with floss or an interdental brush.
- If you play contact sports, wear a custom mouthguard.
- Avoid using hard objects such as toothpicks in a way that pokes into the gums.
- Stay away from cigarettes and tobacco products.
- If you notice a color change in a tooth that has taken a blow, have it checked.
- Make sure the soft tissues of your mouth are also examined at regular dental checkups.
What should you do when you notice a color change in your gums?
When you notice new discoloration on your gums that does not go away in two weeks or is growing, the safest course is to have it evaluated through an examination rather than guessing at the cause. If swelling, pain or fever accompanies it, you should not postpone your appointment. At our polyclinic in Oran, Çankaya, the location and features of the color change and the nearby teeth are examined; X-rays are taken if needed, and when further evaluation is required, a referral to the appropriate specialist is made.
Frequently asked questions
Does a purple spot on the gum go away on its own?
Discoloration caused by an injury usually goes away on its own within a few days to a few weeks. Spots such as amalgam tattoos, however, are permanent but harmless. Spots that last longer than two weeks or grow need to be evaluated by a dentist.
Is an amalgam tattoo dangerous?
An amalgam tattoo is a spot made up of small filling particles embedded in the tissue and is considered harmless. It does not require treatment but can be removed for cosmetic reasons. When the diagnosis is uncertain, the dentist may recommend a biopsy.
Can gum discoloration be a sign of a blood disorder?
Although rare, diseases that affect blood clotting and some blood disorders can cause bruising and bleeding of the gums. If easy bruising elsewhere on the body, frequent nosebleeds or fatigue are also present, you should see the relevant physician.
Can gum inflammation make the gums turn purple?
Long-standing gum inflammation can cause a dark reddish-purple color change due to slowed blood circulation in the tissue. Once the inflammation subsides with tartar removal and regular care, the gums usually return to their healthy color.
