Purple Gums: What They Mean and How to Treat Them

Healthy gums are typically pink and firm, manifesting natural melanin pigmentation influenced by genetics and ethnicity. However, purple gums can be a warning sign of an underlying issue. This discoloration may indicate poor blood circulation, gum disease, vitamin deficiencies, or even systemic health problems. Therefore, identifying the cause and seeking timely intervention is crucial to maintaining healthy gums and preventing further complications.

Why do purple gums happen?

Gum discolouration occurs when there is an alteration in blood flow, irritation, or infection in the tissues. Purple gums are often a sign of inflammation, reduced circulation, or underlying medical conditions. Various factors, including lifestyle choices and systemic diseases, contribute to this change. Recognizing these causes early can help prevent serious oral health issues and ensure that your smile stays healthy.

Causes of purple gums

Gum disease (gingivitis & periodontitis)

One of the primary reasons for purple gums is gum disease, which results from plaque and bacteria accumulating along the gum line. Gingivitis, in the early stage, causes redness, swelling, and bleeding. If left untreated, it can progress to periodontitis, an advanced condition leading to gum recession, deep pockets, and even tooth loss.

Common symptoms of gum disease include:

• Bleeding gums during brushing or flossing
• Gum swelling or tenderness
• Persistent bad breath
• Receding gums and loose teeth

Poor circulation and blood flow issues

Restricted blood circulation can lead to dark or purple gums. Poor circulation may result from cardiovascular diseases, diabetes, or smoking. Reduced oxygen and nutrient supply to the gums weakens the tissues, leading to discoloration and increased susceptibility to infections. Those with circulatory issues should monitor their gum health closely.

Melanin pigmentation

Natural melanin pigmentation can cause gums to appear darker, even in healthy individuals. This is particularly common among people with darker skin tones. Studies show that oral melanin pigmentation is nearly 100% prevalent in individuals of African descent and between 30%-98% in Asian populations. 

Bruises

Gums, like any other soft tissue, can bruise due to trauma. Common causes of gum bruising include:

• Falling or experiencing a facial injury
• Eating sharp-edged foods
• Brushing or flossing too aggressively

Bruises typically appear dark red, purple, or even black. Minor bruises heal naturally, but recurring bruises without an identifiable cause may indicate an underlying disorder such as thrombocytopenia, which affects blood clotting. Additional symptoms may include nosebleeds and persistent gum bleeding. Seeking medical attention is essential for proper diagnosis and treatment.

Eruption hematoma

An eruption hematoma occurs when a developing tooth forms a cyst filled with blood and fluid, making the surrounding gum tissue appear dark purple or black. These cysts are common in children as their baby teeth or permanent teeth emerge. In most cases, eruption hematomas resolve once the tooth fully erupts. However, if the tooth remains trapped, a dentist may need to surgically open the cyst to facilitate proper eruption.

Vitamin deficiencies

Deficiencies in key vitamins, particularly vitamin C and iron, can negatively impact gum health. Vitamin C plays a crucial role in collagen production, and its deficiency can cause weakened gum tissues, leading to purple gums. Iron deficiency anemia reduces oxygen supply to the tissues, also contributing to discolouration.

Common symptoms of vitamin deficiencies include:

• Pale or purple gums
• Increased gum sensitivity
• Easy bruising and slow-healing wounds

Smoking and tobacco use

Nicotine and harmful chemicals in tobacco restrict blood circulation in the gums, leading to discolouration. A condition called smoker’s melanosis affects approximately 22% of smokers, causing the gums to turn dark brown or purple. The severity is dose-dependent, meaning the more someone smokes, the darker the gums become. 

Oral infections

Bacterial, viral, or fungal infections can result in gum swelling, redness, and color changes. Common oral infections include:

• Oral thrush: A fungal infection caused by Candida, characterised by white patches and red or purple gums
• Abscesses: Painful, swollen pockets of bacterial infection in the gums
• Herpes simplex virus: Can lead to ulcerations and color changes in the gums

Hormonal changes

Hormonal fluctuations during pregnancy, menopause, or conditions like polycystic ovary syndrome (PCOS) can increase gum sensitivity and lead to discoloration. Increased blood flow to the gums due to hormonal shifts may cause them to appear darker or swollen. Pregnant individuals should pay extra attention to their oral hygiene to prevent complications like pregnancy gingivitis.

Certain medications

Some medications can alter gum colour and cause overgrowth. The common culprits include:

• Blood pressure medications
• Anticonvulsants
• Chemotherapy drugs, such as cyclophosphamide, busulfan, bleomycin, etc.

Discussing alternative treatments with a healthcare provider may be beneficial if medication-induced gum discoloration occurs.

Consequences of Untreated Purple Gums

Progression to severe gum disease

If purple gums are left untreated, gingivitis can progress to periodontitis, which may lead to tooth loss and jawbone deterioration. Advanced gum disease requires extensive treatment, including deep cleanings, medications, and in some cases, surgery.

Chronic bad breath (halitosis)

Gum disease and infections harbour bacteria that produce foul-smelling gases, leading to persistent bad breath. This can be socially distressing and difficult to mask with mouthwash or breath fresheners.

Increased risk of heart disease

Studies show a strong link between gum disease and cardiovascular issues. Bacteria from infected gums can enter the bloodstream, contributing to inflammation in the arteries, increasing the risk of heart disease, strokes, and other systemic conditions.

Pain, discomfort, and sensitivity

Purple gums often indicate inflammation, which can cause pain and sensitivity when eating, drinking, or brushing. Over time, this discomfort may discourage proper oral hygiene, worsening the condition further.

Treatments for purple gums

Addressing purple gums requires a combination of professional care, improved oral hygiene, and lifestyle adjustments. Effective treatments like those listed below help restore gum health, reduce discolouration, and prevent further complications.

Home and professional care

• Professional dental cleanings

Deep cleaning procedures, such as scaling and root planing, remove plaque and tartar buildup beneath the gum line. This process reduces inflammation, promotes healing, and restores the natural colour of the gums with time.

• Antibacterial mouthwashes and rinses

Dentists may recommend chlorhexidine mouthwash or other antibacterial rinses to help control bacterial growth and prevent gum infections. These rinses also help reduce swelling and improve the appearance of purple gums.

• Improved oral hygiene routine

Maintaining a consistent oral care routine is essential for preventing and treating purple gums:

• Brush twice daily using a soft-bristle toothbrush to avoid irritation.
• Floss daily to remove plaque and bacteria from between teeth, reducing the risk of gum disease.
• Use water flossers or interdental brushes to clean hard-to-reach areas and minimize gum irritation.

• Lifestyle changes

Adopting healthier habits can significantly improve gum health and reduce discolouration:

• Quit smoking to restore blood circulation and prevent further gum damage.
• Maintain a nutrient-rich diet with vitamin C and iron to strengthen gum tissues and promote healing.

Medications and surgical treatments

• Antibiotic treatment for purple gums

Antibiotics play a crucial role in treating bacterial infections that contribute to purple gums. By eliminating harmful bacteria, they help reduce inflammation, promote healing, and prevent mild infections from progressing to severe periodontal disease.

Commonly prescribed antibiotics for oral infections include amoxicillin, a broad-spectrum option, and metronidazole, often combined together to target anaerobic bacteria. Depending on the severity, antibiotics may be taken orally or applied directly to the gums under the guidance of your dentist.

• Surgical options for purple gums

For individuals seeking to lighten dark or discolored gums, several surgical procedures can help restore a healthy gum appearance, such as:

• Laser vaporisation: This gentle procedure uses carbon dioxide and soft tissue diode lasers to remove darkened gum tissue while preserving healthy tissue. It is also painless and ensures a quick recovery.
• Cryosurgery: Involves applying extreme cold to affected gum tissues to remove damaged cells and improve gum color. It is effective for treating oral lesions contributing to discolouration.
• Electrosurgery: Uses electrical currents to eliminate discolored gum tissue. However, it may lead to undesired tissue reduction, making it less suitable for minor discolouration cases.

By combining professional treatments, proper oral care, and healthy lifestyle changes, individuals can successfully manage purple gums and maintain optimal oral health.

How to prevent purple gums

While some cases of purple gums can be prevented with good oral hygiene and healthy habits, not all types are avoidable. Natural pigmentation due to skin tone, as well as gum discoloration caused by certain medications, cannot be prevented. However, when purple gums result from poor hygiene, gum disease, smoking, or nutritional deficiencies, taking the right precautions can significantly reduce the risk.

Maintain a strong oral hygiene routine

• Brush with fluoride toothpaste to prevent plaque buildup.
• Use a water flosser to remove debris and bacteria from hard-to-reach areas.

Use the right dental products

• Electric toothbrush: An electric toothbrush provides effective plaque removal and promotes healthier gums.
• Antibacterial mouthwash: Antibacterial or fluoride mouthwashes strengthen gums and prevent infections.
• Dental floss alternative: Water flossers and interdental brushes are gentler on sensitive gums.

Eat a gum-healthy diet

• Vitamin C-rich foods (citrus fruits, bell peppers) support gum tissue health.
• Iron-rich foods (spinach, lean meats) prevent anemia-related gum problems.

Stay hydrated

Drinking plenty of water helps flush out bacteria and prevents dry mouth, reducing the risk of gum infections.

Visit the Dentist regularly

• Schedule dental checkups every six months to detect gum problems early.
• Professional cleanings remove tartar buildup that cannot be eliminated with at-home care.

Purple gums can be an indicator of serious oral health issues, including gum disease, poor circulation, and vitamin deficiencies. Left untreated, they can lead to tooth loss, chronic bad breath, and even systemic health complications like heart disease.

Fortunately, professional dental care, proper oral hygiene, and lifestyle changes can restore gum health and prevent further problems. Regular dental visits, quitting smoking, using antibacterial mouthwashes, and maintaining a balanced diet are key steps in preventing and treating gum discoloration. Taking proactive measures today ensures healthier gums and a brighter smile for the future!