What is the Black Spot on the Inside of my Cheek?

During your regular brushing and flossing routine, you may be alarmed if you find a black spot on the inside of your cheek. Black spots or dark spots on the inside of your cheek can be caused by a variety of different things, most of which are mild and easily treatable. However, some causes of black spots are more serious, like oral cancer. For this reason, it is important to schedule an appointment with your dentist to determine the cause of your black spot. Some possible causes of a black spot inside the cheek include: 

 

Blood Blister

A blood blister is a sac of fluid and blood that forms when the skin gets pinched. They can appear reddish or purplish in color and are usually big enough to be felt with the tongue. In addition to forming on the cheeks, blood blisters can also form inside the lips. In most cases, a blood blister will resolve on their own, however if they last longer than two weeks you will need to visit your dentist. 

 

Melanotic Macules

A melanotic macule is a small area, usually around a quarter of an inch in diameter, of hyperpigmentation. Melanotic macules are flat, benign, and have a defined border. However, your dentist may perform a biopsy to rule out oral cancer or refer you to your doctor for further testing. 

 

Leaky Dental Filling

For several years, amalgam fillings were commonly used in dentistry to restore decayed teeth. Dental amalgam is composed of multiple metals including copper, tin, mercury, zinc, and silver. Unfortunately, when these fillings get old they can leak and cause the surrounding tissues to stain a dark blue, gray, or black color. These stains are permanent and are known as amalgam tattoos. If your dentist suspects a leaky filling is the cause of your dark spots, the filling will either need to be repaired or replaced to prevent other complications. 

 

Smoker’s Melanosis

Around 22% of smokers can develop a condition called smoker’s melanosis, which is characterized by blotchy dark stains on the gums and insides of the cheeks. The stains themselves are harmless and don’t require treatment, but a biopsy may be performed to rule out oral cancer. Stains caused by smoker’s melanosis are permanent. 

 

Oral Cancer

In extremely rare cases the cause of a black spot on the inside of the cheek can be oral cancer, specifically oral melanoma. Oral melanoma can appear white and unpigmented, dark brown, or a blue black color. In the later stages, it may also be accompanied by additional symptoms such as pain, ulcers, and bleeding. Due to the seriousness of oral cancer, you will need to schedule an appointment with your dentist to rule out oral cancer as the cause of your dark spot. They may perform a biopsy or refer you to your doctor for further testing. 

 

 

Certain Medical Conditions

In some cases, dark spots in the mouth can be caused by certain medical conditions such as Peutz-Jeghers syndrome or Addison’s disease. In these cases, a visit to your primary care physician will be needed to confirm the diagnosis and to get the right treatment.