Prevalence of Oral Pigmented Lesions in Dental Outpatient Attending Piramerd Dental Health Center in Sulaimani

Tavga Ahmad  Hussain; Balkees Taha  Garib

doi:10.56056/amj.2025.324

Authors

Tavga Ahmad Hussain B.D. S, H.D.D, KHCMS Candidate of Oral and Caxillofacial Medicine. Ministry of Health, Sulaimani, Iraq
Balkees Taha Garib Ph.D. Professor of Oral Pathology, College of Dentistry, University of Sulaimani, Iraq

DOI:

https://doi.org/10.56056/amj.2025.324

Keywords:

Amalgam tattoo, Melanin, Pigmentation, Racial, Smoker’s melanosis

Abstract

Background and objectives: Pigmentation of the oral mucosal is commonly encountered and constitutes a variety of clinical presentation that can be physiological, systemic disease, post inflammatory, drugs, smoker melanosis, hemoglobin and iron association, melanoacanthoma, melanotic macule, Malignant Melanoma, amalgam tattoo and idiopathic. This mucosal discoloration may arise from either endogenous pigments or exogenous materials and they are classified as melanocytic and non-melanocytic pigments in origin. The objective of this study was to determine the prevalence of various types of oral mucosal pigmentation among a sample of dental patients.

Methods: This cross-sectional study was carried out at the Piramerd Dental Health Center on December 2022 to May 2023, involving a cohort of 500 dental patients. Medical and dental histories were taken from all the participants were undergoing through a thorough intra oral examination to determine number, distribution, shape, location and color of pigmented lesions.

Results: Oral mucosal pigmentation presents 28.2% a sample of dental patient in Sulaimani city. Racial pigmentation (77.3%) and smoker's melanosis (17.3%) were identified as the predominant factors contributing to oral pigmentations. Most of the patients (97.8%) had diffused or multifocal pigmentation, while a focal pattern was identified in only three patients (% 2.1). The frequently affected areas included gingiva (80.1%) buccal mucosa (64.5%) and labial mucosa (34%) The area demonstrating the lowest incidence was the lower lip (2.1%) and palate (1.4%).

Conclusion: Oral mucosal pigmentation is a common occurrence, with racial and smoker's pigmentation being the most frequently encountered discolorations, primarily affecting the gingiva and buccal mucosa.

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References

Firoozi P, Noormohammadi R, Rafieyan S. Effect of environmental tobacco smoke on oral pigmentation: A systematic review. J Oral Health Oral Epidemiol. 2020;9(1):1–6.

Rotbeh A, Kazeminia M, Kalantari M, Rajati F. Global prevalence of oral pigmentation and its related factors: a systematic review and meta-analysis. J Stomatol Oral Maxillofac Surg. 2022;123(5): e411–24.

Gondak RO, da Silva-Jorge R, Jorge J, Lopes MA, Vargas PA, Silva-Jorge da R. Med Oral Patol Oral Cir Bucal. 2012;17(6):919–43.

Hassona Y, Sawair F, Al-karadsheh O, Scully C. Prevalence and clinical features of pigmented oral lesions. Int J Dermatol. 2016;55(9):1005–13.

Tarakji B, Umair A, Prasad D, Alsakran M. Diagnosis of oral pigmentations and malignant transformations. Singapore Dent J. 2014;35: 39–46.

Tavares TS, Meirelles DP, de Aguiar MCF, Caldeira PC. Pigmented lesions of the oral mucosa: A cross-sectional study of 458 histopathological specimens. Oral Dis. 2018;24(8):1484–91.

Eisen D. Disorders of pigmentation in the oral cavity. Clin Dermatol. 2000;18(5):579–87.

Rosebush MS, Briody AN, Cordell KG. Black and Brown: Non-neoplastic Pigmentation of the Oral Mucosa. Head Neck Pathol. 2019;13(1):47–55.

Albuquerque DM, Cunha JL, Roza AL, Arboleda LP, Santos-Silva AR, Lopes MA, et al. Oral pigmented lesions: a retrospective analysis from Brazil. Med Oral Patol Oral Cir Bucal. 2021;26(3): e284–91.

Suma GN, Prakash SMR, Rao D, Goel S. Blue rubber bleb nevus syndrome: Prominent oral findings. Indian J Dermatol Venereol Leprol. 2010 Mar 1;76(2):168–71.

Lee HY, Na SY, Son YM, Kang HK, Baek JO, Lee JR, et al. A malignant melanoma associated with a blue nevus of the lip. Ann Dermatol. 2010;22(1):119–24.

Alawi F. Pigmented lesions of the oral cavity: an update. Dent Clin North Am. 2013;57(4):699–710.

Kamble K, Guddad S, Nayak A, Suragimath A, Sanade A. Prevalence of Oral Mucosal Lesions in Western Maharashtra: A Prospective Study. J Indian Acad Oral Med Radiol.2017;29(4):282–7.

Collins JR, Brache M, Ogando G, Veras K, Rivera H. Prevalence of oral mucosal lesions in an adult population from eight communities in Santo Domingo, Dominican Republic. Acta Odontol Latinoam. 2021;34(3):249–56.

Mumcu G, Cimilli H, Sur H, Hayran O, Atalay T. Prevalence and distribution of oral lesions: a cross-sectional study in Turkey. Oral Dis. 2005;11(2):81–7.

Shaheen RS, Alsaif FM, Alghofaily GA, Alhumaid NS, Almusallam RZ, Alharthi R a. The Prevalence and Extent of Physiological and Pathological Gingival Pigmentation in Patients Visiting Riyadh Elm University Clinics. Pak J Med Health Sci.2021 Oct 30;15(10):3039–43.

Dantas TS, do Nascimento IV, Verde ME, Alves AP, Sousa FB, Mota MR. Multifocal oral melanoacanthoma associated with addison’s disease and hyperthyroidism: A case report. Arch Endocrinol Metab. 2017 Aug 1;61(4):403–7.

Joska L, Venclikova Z, Poddana M, Benada O. The mechanism of gingiva metallic pigmentations formation. Clin Oral Investig. 2009 Mar 1;13(1):1–7.

Luiz J, Parizi S, Nai GA, Alborghetti G. Amalgam tattoo: a cause of sinusitis: J Appl Oral Sci. 2010 Jan-Feb;18(1):100-4.

Amérigo-Góngora M, Machuca-Portillo G, Torres-Lagares D, Lesclous P, Amérigo-Navarro J, González-Cámpora R. Clinicopathological and immunohistochemical analysis of oral melanocytic nevi and review of the literature. J Stomatol Oral Maxillofac Surg. 2017;118(3):151–5.

Shumway BS, Rawal YB, Allen CM, Kalmar JR, Magro CM. Oral Atypical Cellular Blue Nevus: An Infiltrative Melanocytic Proliferation. Head Neck Pathol. 2013;7(2):171–7.

Dhanuthai K, Theungtin N, Theungtin N, Thep-Akrapong P, Kintarak S, Klanrit P, et al. Pigmented Oral Lesions: A Multicenter Study. Eur J Dent. 2022 May 1;16(2):315–9.

Ünsal E, Paksoy C, Soykan E, Halil Elhan A. Oral melanin pigmentation related to smoking in a Turkish population Community. Dent Oral Epidemiol. 2001;29(4):272–9.