Q: One month after having dental implant surgery, I noticed brown spots inside my mouth. Is this normal and is it something to worry about?
A:
– Agnes in Cooper CityYou have heard the expression: “A red herring.” In this case, let’s call it a “Brown herring.” Both imply a rare occurrence.A recent article in the Journal of the American Dental Association reported a 63 year old white woman in Spain presented with brown spots scattered about the inside of her cheeks, hard palate and in the posterior upper jaw one month after implant surgery. Biopsies were taken to rule out any oral cancer lesions such as melanoma. The test results showed a very rare, nonthreatening, benign condition called oral melanocanthoma (OMA). Only 60 cases of OMA have been reported in the literature since 1979. Surgery could have been causal or incidental to the appearance of these lesions. What is important is for the dentist to recognize the lesions and properly test them to rule out any more serious pigmented lesions unrelated to the implants. OMA’s are completely harmless and have never been proven to be related to implants. More common causes of pigmented spots inside the mouth are lupus, Addison Disease, certain medications such as antimalarial agents, antibiotics, antiviral and antifungal agents and iron deficient conditions. However, hands down, the most common cause of dark spots in the mouth are amalgam tattoos; old silver fillings that rub against the inside of the cheeks and gums, leaching metal deposits beneath the tissues.