The oral mucosa, gingiva and tongue may become discolored from a number of causes.
Mechanism of discoloration:
(1) direct surface contact (staining)
(2) deposition of pigment into soft tissue
Physiologic or Racial: A darkly pigmented person may have patches of pigment in the oral mucosa.
|
Drugs : |
Feature |
|
alpha-methyldopa |
black tongue |
|
amiodarone |
slate to blue |
|
amodiaquine |
black from melanin deposition |
|
bismuth (Pepto-Bismol, other) |
blue line about 1 mm from the gingival margin, black tongue |
|
busulfan |
black from melanin deposition |
|
chlorhexidine gluconate oral rinse |
black from melanin deposition |
|
chloroquine |
black from melanin deposition |
|
cisplatin |
black from melanin deposition |
|
clofazimine |
red |
|
hydroxyquinoline |
black from melanin deposition |
|
minocycline |
blue or blue-black |
|
oral contraceptives |
black from melanin deposition |
|
phenothiazines |
slate-gray |
|
quinidine |
black from melanin deposition |
|
quinoline |
black from melanin deposition |
|
zidovudine (AZT) |
black |
|
zinc |
gray or black |
|
Metals : |
Feature |
|
arsenic |
dark gray |
|
copper salts |
blue to green |
|
gold |
gray, black or blue |
|
lead |
blue line about 1 mm from the gingival margin |
|
mercury |
blue-black |
|
silver |
slate gray to bluish |
|
thallium |
blue gingival line, green-black tongue |
|
tellurium |
black |
|
vanadium |
green |
|
Oral Agents |
Feature |
|
betel nut (Areca nut) chewing |
dark red (see above) |
|
food, soft drink or candy colors |
any, depending on food coloring |
|
tobacco |
black from melanin deposition |
|
wine |
dark red color |
|
Disease-related |
Feature |
|
Addison's disease (adrenal cortical insufficiency) |
light brown to black from melanin deposition |
|
Peutz-Jeghers syndrome |
black spots from melanin deposits |
|
hemochromatosis |
black from melanin deposition |
|
malignant melanoma |
black |
Specialty: Otolaryngology
