Black Spots on Oral Mucosa: Causes and Concerns

Black spots on the oral mucosa?

Hello, today I suddenly noticed a small black spot, about 1 millimeter in size, on the oral mucosa in the sublingual area, which is not painful.
Could this be due to a trauma or is there another possibility? Additionally, if there is long-term occasional bleeding from the gums due to chronic cavities, what could be the cause? Does this increase the risk of oral cancer or other diseases? Thank you.

min, 20~29 year old female. Ask Date: 2005/02/14

Dr. Zeng Guanghui reply Dentistry

There is a sudden appearance of a black spot about 1 millimeter in size on the sublingual alveolar mucosa.
Generally, this is more likely to be caused by trauma to the oral mucosa, which can occur from sharp edges of teeth, ill-fitting dentures, or accidentally biting the mucosa, leading to a small hematoma.
Additionally, long-term dental caries can result in hard tissue loss in teeth, which may cause excessive growth of the surrounding gum tissue.
This hyperplastic gum tissue is often composed of granulation tissue and has a tendency to bleed.
It is recommended to consult a dentist for diagnosis and treatment of the hyperplastic gum tissue and the areas of dental loss to restore the proper function of the oral soft and hard tissues.

Reply Date: 2005/02/14

More Info

When you notice a black spot or a small bump on the oral mucosa, particularly in the sublingual area (under the tongue), it can understandably cause concern. The appearance of such spots can arise from various causes, and understanding these can help alleviate anxiety and guide appropriate action.

Firstly, a black spot in the oral cavity can be due to several benign conditions. One common cause is a melanotic macule, which is a flat, brown or black spot that can occur on the oral mucosa due to an increase in melanin production. These are usually harmless and do not require treatment unless they change in size, shape, or color. Another possibility is a traumatic fibroma, which can occur from repeated irritation or trauma, such as biting the cheek or tongue. This can sometimes appear as a dark spot if there is localized bleeding or bruising.

If the black spot is raised and firm, it could also be a papilloma, which is a benign growth caused by the human papillomavirus (HPV). These are typically painless and may require removal if they cause discomfort or concern.

Regarding your question about long-standing dental issues, such as cavities leading to gum bleeding, this can be indicative of periodontal disease. Chronic inflammation and infection of the gums can lead to gum recession and bleeding, which may also contribute to changes in the appearance of the oral mucosa. While periodontal disease itself is not directly linked to an increased risk of oral cancer, the presence of chronic inflammation in the mouth can be a risk factor for various oral health issues, including potentially increasing the risk of malignancies over time.

It's important to monitor any changes in the oral cavity. If the black spot persists, changes in appearance, or if you experience any additional symptoms such as pain, swelling, or difficulty swallowing, it is advisable to consult a healthcare professional, preferably an oral surgeon or a dentist. They may recommend a biopsy to rule out any serious conditions, including oral cancer, especially if there are concerning features associated with the lesion.

In summary, while a black spot on the oral mucosa can often be benign, it is crucial to remain vigilant and seek professional evaluation if there are any changes or concerns. Regular dental check-ups are essential for maintaining oral health and catching any potential issues early. If you have a history of dental problems, addressing these with your dentist can help mitigate risks and improve overall oral health.

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