Black Spots Between Teeth and Gums: Causes, Cancer Risk, and Treatment

What Causes Black Spots Between Teeth and Gums?

Black spots between teeth and gums, also called pigmented lesions, can develop due to various reasons. Some potential causes include:

Dental Plaque

When plaque, a sticky film of bacteria, builds up on teeth, it can harden into tartar and cause inflammation and discoloration of the gums. The bacteria in plaque produce pigments that can cause black spots between teeth and gums.

Smoking

Chemicals in tobacco smoke can stain teeth and irritated gums. This discoloration often appears as black spots along the gumline.

Medications

Certain medications like antimalarial drugs, chemotherapy drugs and some antibiotics can cause black pigmentation in the mouth. The discoloration is usually harmless.

Amalgam Tattoos

Tiny fragments of metal from amalgam fillings can embed in the gums and cause grey or black stains. Amalgam tattoos are permanent but harmless.

Pigmented Oral Lesions

In some cases, benign growths like nevi and melanotic macules can appear as black spots on the gums. Oral melanotic macules are common in people with darker skin tones.

Oral Melanoma

While rare, dark black lesions between teeth and gums can sometimes indicate oral melanoma, a serious form of cancer. Other symptoms like swelling, numbness and loose teeth may accompany oral melanoma.

When to See a Dentist

occasional small black spot along the gumline is usually harmless. But multiple or growing black spots, or spots accompanied by pain, blisters or swelling, require an exam by a dentist or oral medicine specialist. Early diagnosis of any underlying condition is key.

See a dentist promptly if you notice:

• Dark spots that are larger than 2 mm
• Spots that have an irregular border
• Pigmentation that extends beneath the gumline
• Lesions with variable coloring like black, brown and tan
• Spots that bleed easily when brushed or flossed
• Pain or tenderness around a pigmented lesion
• Numbness or tingling in the mouth
• Loose teeth near the affected area
• Spots that rapidly increase in size
• Dark lesions on the palate, tongue or inner cheeks

During the exam, your dentist will check for signs of gum disease, oral cancer and other dental issues. Most causes of black spots between teeth and gums are benign. But a prompt diagnosis is vital for ruling out melanoma and monitoring any lesion for changes over time.

Professional Treatment for Black Spots Between Teeth and Gums

If you have black spots between your teeth and gums, your dentist has several tools to remove or lighten the pigmentation:

Scaling and Root Planing

This deep cleaning procedure removes plaque and calculus from teeth and diseased gum tissue. Scaling and root planing can treat mild discoloration caused by plaque buildup.

Laser Therapy

Advanced dental lasers can selectively target and remove dark pigment between teeth and gums without harming healthy tissue. The procedure is painless with minimal recovery time.

Cryosurgery

Freezing the affected tissue with liquid nitrogen causes the lesion to blister and slough off. The blackened tissue is gradually replaced with healthy new gum tissue.

Surgical Excision

Oral surgeons may surgically remove lesions using a scalpel. This allows testing of the tissue to rule out cancer.

Chemical Peels

Light chemical peels applied to the gumline can remove superficial pigmentation by exfoliating the top layer of gum tissue.

Medications

Topical prescription creams like hydroquinone or triamcinolone may lighten pigmented lesions between teeth and gums.

Home Remedies for Black Spots Between Teeth and Gums

Certain home treatments may help lighten or remove small dark lesions on the gums:

Oil Pulling

Swish oil like coconut, sesame or sunflower around the mouth for 10-20 minutes then spit it out. Some claim oil pulling therapy can remove plaque and whiten teeth.

Saltwater Rinse

Gargling with warm salt water may help reduce gum inflammation and clear away bacteria.

Baking Soda and Lemon Juice

Mix a paste of baking soda and fresh lemon juice and gently rub it on stained areas. Rinse thoroughly when done.

Turmeric Paste

A paste of turmeric powder, mustard oil, salt and lemon juice may help brighten discolored gums.

Diluted Hydrogen Peroxide

Applying hydrogen peroxide with a cotton swab can bleach pigmented lesions, but may irritate sensitive gums.

When to See an Oral Medicine Specialist

For multiple persistent black spots between teeth and gums, or any suspicious looking lesions, an oral medicine dentist can provide specialized care:

• Oral pathology evaluation - Testing cells from lesions to identify any disease.
• Biopsy - Removing a small tissue sample to test for cancer cells.
• Oral surgery - Safe removal of benign or cancerous growths.
• Oral medicine therapy - Prescription bleaching gels to lighten stubborn pigmentation.
• Oral cancer screening - Thorough exams to detect any signs of melanoma or other cancers.
• Follow up care - Ongoing monitoring of precancerous or cancerous lesions.

Oral medicine dentists have advanced training in diagnosis and treatment of mouth diseases beyond general dental care.

When are Black Spots Between Teeth and Gums Serious?

In the vast majority of cases, black lesions between teeth and gums are harmless. But any mouth sore that does not heal within two weeks needs an evaluation. Rarely, dark spots may indicate:

Oral Melanoma

Aggressive melanomas inside the mouth often start as small dark lesions. Catching them early is critical for survival.

Kaposi's Sarcoma

These malignant lesions are linked to HIV/AIDS and cause purplish or brownish spots on the gums.

Metastatic Cancer

Cancers like melanoma and breast cancer can spread to the mouth and appear as dark patches.

Any growing, bleeding or painful lesion warrants a prompt oral cancer screening. Though most pigmented lesions are benign, it is important to monitor any spots for changes over time.

Preventing Black Spots Between Teeth and Gums

Practicing good oral hygiene and avoiding irritants can help prevent black lesions between teeth and gums:

• Brush teeth twice daily with a soft bristle brush.
• Floss daily to remove plaque from between teeth.
• Get professional cleanings every 6 months.
• Avoid tobacco and excess alcohol.
• Eat a healthy diet low in sugars and refined carbs.
• Drink water after consuming staining foods and drinks.
• Rinse mouth after using medication that cause staining.
• Wear a mouthguard to prevent amalgam tattoos during dental work.

Catching and treating gum disease early on can also prevent blackened lesions caused by plaque buildup. See your dentist if you notice swelling, redness or tenderness in your gums.

When to Seek Emergency Care

In rare cases, black spots between teeth and gums may indicate a dental emergency. Seek emergency care if you experience:

• Sudden swelling of the face, mouth, gums or neck
• Numbness in the mouth or face
• Difficulty breathing or swallowing
• Severe mouth pain
• Bleeding not stopped with pressure
• Rapidly spreading dark lesions

These can be signs of a serious dental infection, allergic reaction or aggressive cancer needing hospital treatment.

Outlook for Black Spots Between Teeth and Gums

Benign pigmented lesions usually respond well to treatment and do not recur if the source of irritation is addressed. Any concerning spots should be monitored at regular dental visits.

With early detection, even malignant black lesions often have good outcomes. Oral melanoma is the most concerning, but is still highly treatable in early stages.

Practicing oral hygiene, avoiding irritants and getting regular dental care helps limit black spots between teeth and gums and preserve your oral health.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.