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Dark Spots in Mouth: Causes, Treatment, and When to Seek Medical Attention

What causes dark spots in the mouth. How to identify different types of oral discoloration. When should you be concerned about black dots inside your cheek. What treatments are available for various mouth pigmentation issues.

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Common Causes of Dark Spots in the Mouth

Discovering a dark spot or discoloration inside your mouth can be unsettling, but it’s often harmless. Several benign conditions can lead to pigmentation changes in the oral cavity. Understanding these causes can help alleviate concerns and determine when medical attention is necessary.

Oral Nevi: Moles Inside the Mouth

Oral nevi, commonly known as moles, can appear as small brown, bluish-gray, or almost black dots inside the mouth. These slightly raised spots typically form on the roof of the mouth or inner lip but can also develop on the cheeks. Oral nevi are generally asymptomatic and don’t require treatment. However, a biopsy may be recommended to rule out melanoma, even though there are no reported cases of oral nevi becoming cancerous.

Blood Blisters: Temporary Discoloration

Blood blisters in the mouth can range from purple to dark red and often result from pinched skin. These fluid-filled sacs are usually large enough to feel with your tongue and may be painful when touched or when consuming spicy foods. Most blood blisters resolve on their own without treatment, but persistent or recurring blisters warrant a doctor’s visit.

Melanotic Macules: Harmless Hyperpigmentation

Oral melanotic macules are flat areas of hyperpigmentation with well-defined borders, averaging about a quarter of an inch in diameter. These noncancerous spots may require a biopsy to distinguish them from melanoma, but they generally don’t pose health risks.

Dental-Related Causes of Oral Discoloration

Sometimes, dental procedures or habits can lead to dark spots in the mouth. Understanding these causes can help differentiate between cosmetic issues and potential health concerns.

Amalgam Tattoos: Leakage from Dental Fillings

Amalgam tattoos result from leakage of dental filling material containing mercury, tin, zinc, silver, and copper. These dark blue, gray, or black spots often appear near fillings and are permanent unless removed surgically. They don’t cause symptoms or require treatment but may be confused with more serious conditions.

Smoker’s Melanosis: Stains from Tobacco Use

Approximately 22 percent of smokers develop blotchy stains inside their cheeks and gums, known as smoker’s melanosis. While these stains don’t cause symptoms or necessitate treatment, a biopsy may be recommended to rule out other conditions. Laser treatment or electrosurgery can remove the discoloration if desired.

Rare but Serious Causes of Oral Dark Spots

While most dark spots in the mouth are benign, some rare conditions can cause similar symptoms. It’s crucial to be aware of these possibilities to ensure timely medical intervention when necessary.

Oral Melanoma: A Rare Form of Cancer

In extremely rare cases, a dark spot inside the cheek may indicate oral melanoma, a type of skin cancer affecting pigmented cells. Early-stage oral melanoma often presents as a dark brown to blue-black spot with minimal symptoms. As it progresses, pain, ulcers, and bleeding may occur. Oral melanoma is twice as common in men and is typically diagnosed around age 56. Treatment options include surgery, immunotherapy, radiation, and drug therapy.

Peutz-Jeghers Syndrome: A Genetic Condition

Peutz-Jeghers syndrome causes noncancerous growths in the intestines and stomach, often accompanied by dark spots on the lips, inside the mouth, and around the eyes, nose, and anus in children. These spots usually fade with age. While there’s no cure for this genetic condition, surgery can remove digestive tract polyps to manage complications.

Addison’s Disease: Hormonal Imbalance

Addison’s disease, or adrenal insufficiency, can cause hyperpigmented blotches inside the mouth. This hormonal disorder also leads to symptoms such as extreme fatigue, weight loss, salt cravings, low blood sugar, and skin hyperpigmentation. Hormone replacement medication is typically used to manage Addison’s disease.

When to Seek Medical Attention for Oral Dark Spots

While many oral dark spots are harmless, certain signs warrant professional evaluation. Knowing when to consult a healthcare provider can ensure timely diagnosis and treatment of potentially serious conditions.

  • Persistent or growing dark spots
  • Changes in color, size, or texture of existing spots
  • Accompanying symptoms like pain, bleeding, or ulceration
  • Multiple new spots appearing in a short time
  • Personal or family history of skin cancer
  • Spots that interfere with eating, speaking, or other oral functions

If you notice any of these signs, it’s advisable to consult a dentist or doctor for a thorough examination and potential biopsy if necessary.

Diagnostic Procedures for Oral Dark Spots

Accurate diagnosis of oral dark spots is crucial for appropriate treatment and peace of mind. Healthcare providers may employ various methods to determine the cause of oral discoloration.

Visual Examination and Medical History

The first step in diagnosing oral dark spots typically involves a thorough visual examination of the mouth and a review of the patient’s medical history. The healthcare provider will assess the spot’s size, color, texture, and location, as well as inquire about any associated symptoms or risk factors.

Biopsy: Confirming or Ruling Out Serious Conditions

In many cases, a biopsy may be recommended to definitively diagnose the cause of oral dark spots. This procedure involves removing a small sample of the affected tissue for microscopic examination. Biopsies are particularly important for ruling out oral melanoma and other potentially serious conditions.

Imaging Studies: Looking Deeper

In some cases, imaging studies such as X-rays, CT scans, or MRIs may be ordered to evaluate the extent of the condition, especially if there’s suspicion of underlying structural abnormalities or spread of a cancerous lesion.

Treatment Options for Oral Dark Spots

The treatment approach for oral dark spots depends on their underlying cause. While many benign conditions require no intervention, others may benefit from various treatment modalities.

Observation and Monitoring

For benign conditions like oral nevi or melanotic macules, regular monitoring by a healthcare professional may be the recommended course of action. This approach ensures that any changes in the spot’s appearance or behavior are detected early.

Surgical Removal

In cases where the dark spot is causing discomfort, interfering with oral function, or there’s a suspicion of malignancy, surgical removal may be necessary. This can be done through traditional excision, laser surgery, or cryosurgery, depending on the specific case.

Laser Therapy

Laser treatments can be effective for removing certain types of oral dark spots, such as amalgam tattoos or smoker’s melanosis. This approach offers precision and minimal invasiveness, often with quicker healing times compared to traditional surgery.

Medical Management

For systemic conditions like Addison’s disease that cause oral hyperpigmentation, treatment focuses on managing the underlying disorder. This often involves hormone replacement therapy or other medications to address the root cause of the discoloration.

Prevention and Oral Health Maintenance

While not all oral dark spots are preventable, maintaining good oral hygiene and making lifestyle changes can reduce the risk of developing certain types of discoloration and promote overall oral health.

Regular Dental Check-ups

Routine dental examinations allow for early detection of oral abnormalities, including dark spots. Dentists can monitor existing spots and identify new ones before they become problematic.

Smoking Cessation

Quitting smoking not only reduces the risk of developing smoker’s melanosis but also improves overall oral and general health. Smoking cessation can lead to a gradual fading of existing tobacco-related stains in the mouth.

Proper Oral Hygiene

Maintaining good oral hygiene practices, including regular brushing, flossing, and use of antimicrobial mouthwashes, can help prevent certain oral conditions that may lead to discoloration.

Sun Protection

While less common, sun exposure can contribute to oral pigmentation, particularly on the lips. Using lip balm with SPF and avoiding excessive sun exposure can help prevent sun-related oral discoloration.

Living with Oral Dark Spots: Psychological and Social Considerations

The presence of visible oral dark spots can have psychological and social impacts on individuals. Understanding these effects and learning coping strategies can improve quality of life for those affected.

Emotional Impact

Some individuals may experience anxiety, self-consciousness, or reduced self-esteem due to visible oral dark spots. Acknowledging these feelings and seeking support from healthcare providers, friends, or support groups can be beneficial.

Communication Strategies

For those concerned about others noticing their oral dark spots, developing comfortable ways to explain the condition can ease social interactions. Having a brief, factual explanation ready can help alleviate awkwardness and educate others.

Cosmetic Options

In cases where dark spots are visible and causing distress, discussing cosmetic options with a dentist or oral surgeon may be helpful. While not all spots can be safely removed, understanding available options can empower individuals to make informed decisions about their oral appearance.

Understanding the various causes of dark spots in the mouth, from benign conditions like oral nevi to rare but serious issues like oral melanoma, is crucial for maintaining oral health and peace of mind. While many oral dark spots are harmless and require no treatment, it’s important to monitor any changes and seek professional evaluation when necessary. Regular dental check-ups, good oral hygiene practices, and lifestyle modifications can help prevent certain types of oral discoloration and promote overall oral health. By staying informed and proactive, individuals can effectively manage oral dark spots and maintain a healthy, confident smile.

Causes and What Needs to Be Treated

Finding a black spot or dot on the inside of your cheek can be alarming, but it’s not necessarily a sign of something serious.

A variety of harmless conditions can cause discoloration in your mouth, such as moles, hyperpigmentation, and leakage from your dental fillings.

In extremely rare cases, a black spot may be a sign of a type of cancer called oral melanoma. Oral melanoma accounts for about 1.6 percent of cancers of the head or neck, and less than 1 percent of all melanomas, according to The Oral Cancer Foundation.

Keep reading to find out what may be causing a black spot on the inside your cheek and when you should see your doctor.

The following conditions may cause a black dot, a small, circular mark, to form on the inside of your cheek.

Oral nevi

Oral nevi are small brown, bluish gray, or almost black dots that can appear inside your mouth. Nevi is a medical term for moles (nevus is singular).

Oral nevi are usually slightly raised. They’re more common on the roof of the mouth or inner lip, but they can also form on the cheeks. They usually don’t cause any symptoms.

No treatment is usually necessary for an oral nevus, and there are no reports of an oral nevus becoming cancerous. However, your doctor or dentist may still recommend getting a biopsy to make sure it’s indeed a nevus and not melanoma.

Blood blister

Blood blisters are sacs of fluid that fill with blood. They can range in color from purple to dark red. They commonly form when the skin in your mouth gets pinched.

Blood blisters are often big enough that you can feel them with your tongue. They most often form on the soft parts of your mouth, like your cheek or inner lips. They’re typically painful when touched, or if you eat spicy food.

The majority of blood blisters don’t last long and don’t need treatment if you leave them alone. But if the blood blister lasts for more than 2 weeks or becomes a reoccurring problem, it’s a good idea to visit your doctor.

Melanotic macules

Oral melanotic macules are areas of hyperpigmentation that average about a quarter of an inch in diameter. They can be as small as 0.04 of an inch. These spots are typically flat and have a well-defined border.

Oral melanotic macules are noncancerous, but your doctor may recommend a biopsy to rule out melanoma.

The following are potential causes of dark spots on the inside of your cheek. Spots can vary in size but they are larger than a dot.

Leakage from a dental filling

Amalgam is a material made of mercury, tin, zinc, silver, and copper. It’s been used for more than 150 years for dental fillings.

Amalgam tattoos are leakages from these dental fillings. They’re relatively common and usually appear dark blue, gray, or black. They’re most often located next to a filling.

Amalgam tattoos don’t cause any symptoms and don’t need treatment. They’re permanent unless removed with laser surgery.

Smoker’s melanosis

Smoking can leave blotchy stains called smoker’s melanosis inside your cheeks and gums. About 22 percent of people who smoke have this staining.

These stains don’t cause symptoms and don’t need treatment. However, your doctor will likely recommend a biopsy to rule out other conditions. The stains can be removed with laser treatment or electrosurgery.

Oral cancer

Melanoma is a type of skin cancer that affects pigmented cells called melanocytes.

Melanoma is most common on parts of your skin frequently exposed to sunlight, but it can also form in your mouth and nose. In extremely rare cases, a dark spot inside your cheek may be a sign of oral melanoma.

In its early stages, oral melanoma often has minimal symptoms. It usually manifests as a dark brown to blue-black spot. It can also be unpigmented or white. In its late stages, the spot may be accompanied by pain, ulcers, and bleeding.

The average age of diagnosis of oral melanoma is 56. Oral cancer is twice as common in men as women.

Treatment for oral melanoma may include:

  • surgery
  • immunotherapy
  • radiation
  • drug therapy

Peutz-Jeghers syndrome

Peutz-Jeghers syndrome is a condition that causes noncancerous growths called polyps in the intestines and stomach.

Children who develop this condition also commonly develop dark spots on their lips, inside their mouth, near their eyes and nose, and around their anus. The spots usually fade with age.

People with Peutz-Jeghers syndrome also often develop complications such as pain, bleeding, or bowel obstruction.

There’s no current cure for Peutz-Jeghers syndrome, but surgery can remove the polyps in the digestive tract.

Addison’s disease

Addison’s disease, or adrenal insufficiency, is a deficiency of the hormones produced by your adrenal glands. One of the symptoms of Addison’s disease is hyperpigmented blotches of skin inside your mouth.

Other symptoms include:

  • extreme fatigue
  • weight loss
  • salt cravings
  • low blood sugar
  • hyperpigmentation

You can take medication to replace the hormones your adrenal glands can’t produce by themselves.

Even though the chances of developing oral melanoma is very low, it’s good practice to see your doctor whenever you notice an abnormally colored spot or dot in your mouth.

It’s especially important to get the spot checked if you’re older than 55 years. Older adults have a higher risk for developing oral cancer.

Your doctor may use the following tests to help confirm a diagnosis of the dark spot inside your cheek:

  • Physical inspection. Your doctor may be able to identify the spot during a physical examination simply based on its appearance.
  • Biopsy. During a biopsy, your doctor will cut away a small piece of the spot and send it to a lab for analysis.
  • Blood test. Your doctor may administer a blood test measuring your potassium, cortisol, and ACTH hormone levels if they suspect Addison’s disease.

Finding a dark spot or dot in your mouth is unlikely to be a sign of cancer. However, it’s still a good idea to show it to your doctor or dentist. If it does turn out to be cancerous, getting an early diagnosis and treatment can improve your outlook.

Pictures, causes, treatment, and when to seek help

Black spots inside the cheek can have several causes, such as blisters or hyperpigmentation. In rare cases, they may indicate something more serious, such as mouth cancer.

Many harmless conditions can cause a black spot to develop inside the cheek. Often, there will be no other symptoms, and it will improve without treatment.

Rarely, however, a black spot inside the cheek may be a symptom of oral melanoma. This is a rare type of cancer.

The American Cancer Society estimate that just over 54,000 people will develop mouth or throat cancer in 2021. Melanoma usually accounts for 0.5% of all oral cancers.

This article will examine some potential causes of a black spot inside the cheek. It will also look at some treatment options and when a person should contact their doctor.

Blisters are raised bubbles on the skin with fluid inside. They can occur anywhere on the body, including in the mouth.

Blood blisters contain blood and appear dark red or purple. They may develop in the mouth due to accidentally biting the cheek or as a result of an allergic reaction.

Learn more about blood blisters in the mouth here.

Treatment

Blood blisters are not typically harmful, and they will often heal without treatment.

Sometimes, however, they may cause pain or discomfort. In these cases, a person can use over-the-counter (OTC) pain relief medication.

Amalgam tattoos occur when metal fillings leak, causing dark marks to appear inside the mouth.

These marks can appear when a dentist places or removes a filling and tiny metal fragments fall between the teeth.

They most commonly appear on the gum or cheek, near the amalgam filling. However, they can appear anywhere in the mouth.

Treatment

Amalgam tattoos do not cause any symptoms or require any form of treatment.

Smoking can cause smoker’s melanosis. This is a condition wherein brown or black pigmentation develops inside the mouth and throat.

Treatment

This condition is not harmful, and it does not require treatment.

However, the tobacco smoke that causes these spots is harmful to various areas of the body. For example, smoking can cause gum disease, tooth loss, and mouth cancer, as well as several other conditions.

Melanoma is a cancer of the pigment-making cells, or melanocytes, that typically affects the skin. However, these cancers can also occur on mucosal membranes, such as in the mouth.

Oral melanoma usually appears as a raised area that has a black, brown, or dark blue appearance. These marks can be asymmetric with an irregular border.

There may also be swelling, if inflammation is present.

One 2020 article notes that oral melanoma is not related to sun exposure. Healthcare professionals are unsure about what the risk factors may be, but they may include:

  • dental irritation
  • cigarette smoking
  • alcohol consumption

Treatment

The main treatment option for oral melanoma is surgery. A healthcare professional may also recommend radiation therapy.

Addison’s disease is an endocrine disorder that occurs when the adrenal glands, which are the glands on the top of the kidneys, do not make enough of certain hormones. These include cortisol and aldosterone.

The National Institute of Diabetes and Digestive and Kidney Diseases note that Addison’s disease can cause the development of darker areas on the skin and inside the mouth.

Other symptoms can include:

  • chronic fatigue
  • muscle weakness
  • abdominal pain
  • weight loss
  • appetite loss

Treatment

Treatment for Addison’s disease will include hormone replacement medications. People can take a corticosteroid, such as hydrocortisone, to replace missing cortisol. They will take an oral tablet two or three times per day.

To replace aldosterone, a person can take fludrocortisone to help balance the amount of fluid and sodium in the body.

Peutz-Jeghers syndrome is a rare genetic condition that causes dark freckles to appear around the face and inside the mouth. It may also cause mushroom-shaped tissue growths called polyps to develop throughout the gastrointestinal tract.

Peutz-Jeghers syndrome can also cause other symptoms, including:

  • nausea
  • vomiting
  • stomach pain
  • rectal bleeding
  • digestive issues

Treatment

There is currently no cure for Peutz-Jeghers syndrome. However, treatments may involve surgically removing any polyps that are causing gastrointestinal problems.

A doctor or dentist will perform a physical examination of the black spots to determine the cause. Also, they will likely ask the person whether or not the spots are painful or have any accompanying symptoms.

A doctor may also check a person’s medical history for any signs of genetic conditions, such as Peutz-Jeghers syndrome, that could be the cause. They might also review the person’s dental records for the presence of metal fillings.

Depending on their assessment, a doctor may also order additional tests to make a firm diagnosis. For example, they might require a blood test or skin sample for further analysis.

Many causes of black spots inside the cheek, such as amalgam tattoos, are harmless.

Although no medical treatment is necessary for some causes of a black spot in the cheek, a person should contact a doctor about any sore or spot that lasts for longer than 3 weeks.

If the black areas develop sores or ulcers, these could be symptoms of mouth cancer. Early detection of mouth cancer is crucial for successful treatment.

There are many possible causes of black spots inside the cheek. For most people, these spots will cause no additional symptoms and will not require treatment.

Some people may require OTC treatments for causes that cause pain, such as blood blisters. Other causes, such as mouth cancer, will require medical treatment.

Although black spots inside the mouth may be harmless, it is worth contacting a doctor about persistent cases. They can help determine whether the spot is harmless or requires further care.

Spots in the mouth: what are the causes

Spots in the mouth: what are the causes | Moscow
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