Do you see a black discoloration inside your mouth? If you got a filling recently, it probably stems from that and is known as an amalgam tattoo.

This tattoo isn’t pretty at all, in fact, it is a side effect of the fillings.

It will leave black or grey spots without any other symptoms.

However, that could be a symptom of an underlying dental and skin condition.

This article discusses the causes behind the appearance of such black spots and whether they are harmless or not.

Keep reading below to know more!

causes of amalgam tattoo

Amalgam Tattoo Symptoms and Causes

Essentially this is a discoloration.

The spots, blue, gray or black in color can appear on the gums, inside of the cheeks or even lips.

The tattoo will be the size of 0.5 inches hence, it is not noticeable.

Though these spots are not raised like bumps on the tongue.

You can see it clearly and may consider it something dangerous.

Truth be told, it is actually harmless.

If the tattoo originates from a filling, then it is nothing to worry about.

When you get decay that turns into a cavity then getting a tooth filling becomes absolutely necessary.

Amalgam refers to silver fillings that fill the cavities.

New filings are usually of resin and porcelain.

However, amalgam, an alloy, contains metals such as tin, copper, mercury and silver.

When you go to your dentist they will remove decay or replace an old filling.

Using a handpiece, they will drill your tooth.

Drilling can result in amalgam particles flying across all places including inside the mouth.

During this procedure, the amalgam particles can lodge in the soft tissue of the mouth or the oral mucosa.

These particles form lesions that heal and are then trapped inside the tissue.

Since these are metal particles, they start leaking silver into the tissue they are trapped inside.

Hence, the silver leaves a metallic discoloration or tattoo onto your gums, lips or cheeks depending on where the particles fly away.

Filling polishing, removal and placing is the procedure where it can happen or in an apicoectomy.

In an apicoectomy, your dentist removes the tip of the root, then cleaned it and places a filling in the root of the tooth.

It is usually present in the gum near filling but because of the flying particles, you can get it on roof of your mouth.

diagnosis through dental x ray


Is it Something to Worry About?

The good news is, this discoloration is harmless.

However, it contains mercury.

In fact, the amalgam particles may contain 50 percent mercury.

However, these lesions are small, they do not pose a threat of mercury poisoning.

So, these are not toxic.

They are lest a cosmetic concern, however, a stubborn one.

The tattoos will remain in place if you do not seek treatment.

Though, there is another concern to worry about.

What if this discoloration is not an amalgam tattoo? 

There are other diseases that the tattoo could point towards too.

Some of these can be highly dangerous such as mucosal melanomas.

This is rare cancer that can happen in people who have been taking tobacco in the form of smoking or chewing tobacco for years.

Hence, you will have to immediately treat it and not let it be like a harmless tattoo.

There are also other conditions that this tattoo could be possibly signaling.

More on that below!

Thus, in order to be wary of a serious problem, you will need to visit your dentist for a diagnosis.

Your dental history may be enough for a diagnosis.

They can give the discoloration a look and knowing you just got fillings can confirm its presence.

It is easier to find it if it is present adjacent to the filling.

For further assurance, your dentist can perform an X-ray.

However, a dental radiograph is not the best way to diagnose it.

This is because the particles need to be big enough to come in an X-ray.

Thus, it can hardly detect a quarter of tattoos.

If your dentist fears the condition is worse hinting at cancer, they will recommend you to get a biopsy.

That can diagnose any serious problems hidden underneath the appearance of that tattoo.

What can they be?

black spots inside mouth above teeth


Is it Really an Amalgam Tattoo?


This is a birthmark appearing inside your mouth because of an excess of blood vessels.

While it is red in color, it can get darker looking like a tattoo.

Oral Pigmentation 

A pigment resembling a tattoo can form inside the mouth.

The diseases that cause it include, Acromegaly, Addison’s disease, Nelson’s syndrome and Albright Syndrome.

Asphalt Tattoos 

Did you ever fall down on the road getting a road rash?

Odds are that asphalt pieces or metal pieces from the road can end up in your mouth.

Hence, causing pigmentation in your mouth.

However, they rarely reach the mucosal membrane of the mouth.

Graphite Tattoos

The pencil you use at school is made of graphite and lead.

If a piece of that pencil gets stuck inside your gums then it will discolor later.

signs and symptoms of amalgam tatoo and black spots in mouth

Mucosal melanoma

This is a very rare cancer of the internal membranes.

Usually, people who have been using some form of tobacco can get in later in life.

The appearance may resemble an amalgam tattoo, however, the lesion can also swell and will pain.

If you wear dentures, you may notice that they no longer fit you.

This will most probably appear in the inner sinus cavity and the mouth.

When you go to your dentist, let them know if you are a long time smoker because melanoma can be fatal and needs invasive, prompt treatment.

Lead bullets

A wound from lead shots and bullets near the mouth area can leave a color inside.

Moreover, fire ammunition and metal particles can also leave rubbings resembling tattoos in your mouth.

Pigmentation Due to Medicines 

Taking a different variety of drugs and medications can also leave a mark on your mouth.

These dark spots form because of melanin accumulation darkening tissues.

Smokers are at a higher risk for this.

treating amalgam tattoo

Treatment for Amalgam Tattoo

Since, this condition is not harmful, the only reason behind treating it could be cosmetic.

They are also not as noticeable if they occur inside your cheeks and the roof of the mouth.

Though an amalgam tattoo on tongue, lips and corner of your mouth will be noticeable.

If it does not concern you then you can leave it as is because it is neither harmful nor causes any symptoms.

That said, you can always opt for treatment to remove it and restore your appearance.

The options you have to do so include:

  • Laser

Laser treatments can destroy tattoos, eliminating them from your skin.

The same lasers can also work to remove them from your mouth.

A diode laser destroys the tattoo particles by stimulating the skin cells.

Henceforth, the skin cells remove the trapped particles that are causing the stain.

The body’s lymphatic system clears the particles naturally.

Otherwise, you can also extract them through the skin.

After you are done with the treatment, you will need to use a soft toothbrush.

This results in new cell growth.

Hence, after the procedure, for a few weeks, use a very soft toothbrush gently while the new cells grow.

This is a popular growing treatment for tattoo removal however, it is not the most common treatment.

That is…

  • Surgery

Surgical excision can completely remove the tissues that have discoloration.

With the use of a scalpel or knife, your doctor removes the tissue that is tattooed.

They can also choose to transplant your mucosal tissue or use a graft to repair the tissues.

Hence, through this excision, you can remove the patch of discolored tissues surgically.

fillings inside teeth

Why Do You Need a Filling?

Since amalgam tattoos result from tooth fillings, should you skip them altogether?

Not at all!

You need tooth fillings because of cavities.

When the tooth decay worsens forming holes in your teeth, there is no other way to save it than getting fillings.

It isn’t given that you will get a tattoo if you need fillings.

In fact, nowadays fillings are made more from resin and porcelain and less from silver or metal.

Hence, there is a slim chance to get the tattoo in case your doctor goes for an amalgam filling instead.

However, you can always try to not get any cavities.

Reduce your daily sugar intake and be mindful of your eating habits.

Do not eat more carbohydrates, acidic, starchy and sugary foods that can contribute to decay.

Rather brush and floss regularly to prevent the accumulation of food particles and bacteria.

However, wait at least 30 minutes after eating something acidic and sugary.

Besides that, use an interdental brush and mouthwash occasionally.


You do not need to worry about an amalgam tattoo.

However, whenever you see black, blue or gray spots inside your mouth, it is best to get them checked.

If it is a tattoo then treating it for cosmetic purposes is no problem but it could also be a more serious problem that needs immediate treatment.

Hence, get checked immediately to avoid any bigger concerns.