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Smoker's melanosis is seen with the naked eye as a brown to black pigmentation of the oral tissue i.e. the gums, [1] cheeks or palate [2] as well as in larynx. [3] [4] It is most often seen in the lower labial gingiva of tobacco users. Most easily it is found in Caucasians, due to their lack of a genetically caused melanin pigmentation. [5] [6]
Amalgam tattoo is a grey, blue or black area of discoloration on the mucous membranes of the mouth, typically on the gums of the lower jaw. It is a healthcare caused lesion, due to entry of dental amalgam into the soft tissues. It is common, painless, and benign, but it can be mistaken for melanoma
These macules often vary in shades of brown, size and are confluent, Although any oral site can be affected, in almost all cases pigmented macules appear on the buccal mucosae, lips and around the mouth. Pigmented macules on the face are less common. The extent of oral involvement and degree of pigmentation varies between each individual case.
Mouth care: increase oral intake, practice good oral hygiene, use sugar free gum (to increase saliva flow), regular use of mouth rinses, pilocarpine medication, reduce alcohol intake and smoking cessation. Saliva substitutes are also available as a spray, gel, gum or in the form of a medicated sweet; Dry skin: creams, moisturising soaps
A similar, but more pronounced palatal keratosis occurs with reverse smoking. This is where the lit end of the cigar or cigarette is held in the mouth, another form of smoking associated with high levels of heat in the mouth. [6] This form of the condition is sometimes termed "reverse smoker's keratosis", [9] and is a premalignant lesion.
Adults should have a total of 32 teeth (16 teeth in each arch). By the age of 2 + 1 ⁄ 2, children have a total of 20 deciduous teeth (10 in each arch). Abnormal findings are missing, loose, broken and misaligned teeth. Diseases of the teeth include baby-bottle tooth decay, epulis, meth mouth and Hutchinson's teeth.
Leukoplakia located on the floor of the mouth, the posterior and lateral tongue, and the retromolar areas (the region behind the wisdom teeth) have higher risk, whereas white patches in areas such as the top surface of the tongue and the hard palate do not have significant risk. [3]
The clinical manifestation of mild dental fluorosis is mostly characterised a snow flaking appearance that lack a clear border, opaque, white spots, narrow white lines following the perikymata or patches as the opacities may coalesce with an intact, hard and smooth enamel surface on most of the teeth. [7]