Amalgam Tattoo (Focal Argyrosis)
What are Amalgam Tattoos?

An Amalgam Tattoo (also called a focal argyrosis) is the
most common pigmentation of the oral cavity.  It is an area
of permanent bluish-gray pigmentation resulting from
amalgam (silver) filling particles falling into small, open
wounds created during dental treatment or by trauma
shortly after a dental treatment, when small, fresh
particles still cling to the mucosa.
Photos of Amalgam Tattoos
What are the Signs & Symptoms of an Amalgam Tattoo?

The amalgam tattoo presents as a soft, painless, non-
ulcerated, blue / gray / black
macule (a small, flat,
distinct, coloured area of skin that is ≤ 10 mm in diameter
and does not include a change in skin texture or
thickness) with no surrounding reddening.

They are more common in the lower jaw than the upper,
typically in the
bicuspid-molar region.  The tattoo is found
more frequently in women than in men, perhaps because
women more frequently seek dental care.  It is also seen
more frequently with advancing patient age, presumably
because of increased exposure to dental procedures over

There are no symptoms of an
amalgam tattoo.  In most
cases, you won't even know you have one.

How are they treated?

Reassurance.  No treatment is necessary but a biopsy
can be performed to rule out
melanoma or another
pigmented lesions.

Tattoos visible on the X-ray are usually not biopsied and
those occurring on the visible part of the lips can be
removed for cosmetic reasons.

There is
no malignant potential for this lesion.

Do they come back?

An amalgam tattoo is permanent unless it is removed
surgically.  As
amalgam tattoos do not cause harm, the
prognosis is excellent.

Useful websites:

Doctor Spiller

University of Arkansas, College of Health Sciences

Bond's Book of Oral Diseases (4th Edition)  / The
Maxillofacial Center for Diagnostics & Research
Last Updated 18th August 2010