A number of conditions may cause discoloration of the gingival.
Features to consider:
(1) focal, linear or diffuse
(2) temporary or persistent
Causes of linear blue/black/gray discoloration (relative to the gingival margin, punctate dots under magnification):
(1) lead line (Burton line): due to formation of lead sulfide
(2) bismuth
(3) mercury
(4) tattoo
Causes of diffuse discoloration:
(1) quinacrine (blue or purple)
(2) other drugs
(3) diet
(4) hemochromatosis
(5) racial (dark-skinned)
(6) Addison's disease
Other:
(1) chromogenic bacteria (periodontal)
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Specialty: Otolaryngology
ICD-10: ,