|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 amalgam
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
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
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.
University of Arkansas, College of Health Sciences
Bond's Book of Oral Diseases (4th Edition) / The Maxillofacial Center for Diagnostics & Research
Refuat Hapeh Vehashinayim 2004. Amalgam Tattoo (Amalgam Pigmentation) of the Oral Mucosa - Clinical
Manifestations, Diagnosis & Treatment
Dermatol Online J 2008. Amalgam Tattoo
NEJM 2011. Images in Clinical Medicine. Amalgam Tattoo
Austral J Basic & Appl Sci 2012. Prevalence of Oral Pigmented Lesions - A Prospective Study
Q J Med 2012. Clinical Picture. Pigmented Lesions in the Oral Mucosa - The Ugly But Good
J Oral Med Oral Surg 2019. Short Case Report. Extensive amalgam tattoo (amalgam pigmentation) on the palatal
|Last Updated 27th December 2019