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Amalgam Tattoo

Definition

Amalgam tattoo is a common pigmented lesion of the oral mucosa.

Etiology

The tattoo is caused by implantation of amalgam particles in the oral mucosa.

Main Clinical Features

•Gray, black, or bluish macular or papular lesion that is usually solitary, although patients may also present with multiple lesions

•The lesion may be visible radiographically as a radio-opacity, provided that the amalgam particles are large enough

Diagnosis

The diagnosis is usually based on clinical criteria.

Differential Diagnosis

•Other types of tattoos

•Pigmented nevi

•Malignant melanoma

•Racial pigmentation

•Hematoma

•Addison disease

Treatment

No treatment is necessary, unless aesthetics are a concern. In this case, tissue resurfacing surgery may be done.

References

Forsell M, Larsson B, Ljungqvist A, et al. Mercury content in amalgam tattoos of human oral mucosa and its relation to local tissue reactions. Eur J Oral Sci 1998;106:582–587.

Stewart CM, Watson RE, Experimental oral foreign body reactions. Commonly employed dental materials. Oral Surg Oral Med Oral Pathol 1990;69:713–719.