In many cases it is possible to spot a dark black or brown spot on the oral mucosa that raises questions about its origin and nature, as well as causing concern to the patient.

Regarding the origin of such spots, there can be a wide range of causes. Their evaluation requires taking a history of the patient with scrutiny, a thorough clinical examination accompanied by a biopsy and a histopathology examination, except in cases where the clinical signs and medical history almost certainly indicate the innocent nature of the lesion.

The detailed description of the pigmented lesions goes beyond the scope of this brief summary. In general, the exact color, location, distribution, duration, changes in size, color or peripheral boundaries, drug use, and family history are all important elements that will contribute towards an accurate diagnosis.

Spots of this type can often be considered normal, in the context of racial pigmentation while other common causes include smokers’ melanosis and discolorations attributed to common dental materials such as amalgam and silver cones. Among other causes, a relatively large class of drugs taken on a long term basis may be related to the development of brown spots in the mouth as well as neoplasms in the form of nevi and less often melanoma. Finally, there are systemic pathological conditions and syndromes as well as vascular lesions that the Oral Medicine specialist must keep in mind when investigating discolored spots in the mouth.

Frequently asked questions

I have recently spotted a brown spot on my palate that I think has grown in size. What should I do?

The change in size is an element that necessitates surgical removal of the lesion and an appropriate histopathology examination in order to accurately identify its nature.

I have observed that around one of my teeth, which has an amalgam filling, there is a black spot which for many years has been present without any changes. Should I worry?

This is probably an amalgam tattoo, one of the most common causes of black spots around the teeth with such fillings. The condition is benign. However, such a diagnosis requires clinical examination and regular checks by an Oral Medicine specialist in order for it to be considered safe.


Oral Pigmented Spot
Oral Pigmented Spot