Closing an Unattractive Gap between Your Two Front Teeth

Smoker's melanosis is an oral condition that primarily affects people who smoke or chew tobacco. It changes the appearance of your gums and other oral tissues. Here are five things you need to know about smoker's melanosis.

What are the symptoms?

If you have smoker's melanosis, you'll see dark brown or black patches on your oral tissues. The gums, insides of the cheeks, floor of the mouth, roof of the mouth, and tongue can be affected. These patches are flat and irregularly shaped. The patches can sometimes be arranged in a map-like configuration.

If you're a smoker and notice changes in the appearance of any of your oral tissues, you need to see your dentist immediately.

How does smoking cause smoker's melanosis?

Cigarette smoke stimulates your melanocytes, the cells that make the melanin that give your oral tissues their color. It's not known if the chemicals or the heat of the smoke are responsible for this stimulation. When these cells are stimulated, they produce more melanin than is normal for you, and this leads to excessive melanin deposits and the formation of darker brown or black patches.

Is it serious?

Smoker's melanosis is a benign condition. It's not cancerous or pre-cancerous and is a cosmetic issue. Since the patches are made of excess melanin, they're essentially the same thing as the freckles on your skin.

The concern with smoker's melanosis is that it looks very similar to other conditions that are dangerous, such as oral malignant melanoma. Your dentist may want to take a biopsy of your patches to confirm that they're not cancerous. If the biopsy shows that the cells are not cancerous, your dentist will proceed with treatment for smoker's melanosis.

How is it treated?

Your dentist will recommend quitting smoking, as the patches may go away by themselves if you do so. If the patches persist after you quit, many treatments are available to restore the appearance of your gums. Patches on other oral tissues, like the insides of your cheeks, will be left alone as they don't pose an aesthetic problem.

Laser gum depigmentation can be used to remove your patches. This treatment is both quick and painless. During the procedure, your dentist will aim a laser beam at your patches. The heat from the laser will destroy the melanocytes in the area. When your gums heal, they will be their original, lighter color.

Gingival grafting can also be used in some cases. During this procedure, the darkened patches of your gum tissue will be surgically removed and replaced with tissue from the roof of your mouth. Of course, this is only possible if the roof of your mouth isn't also affected by smoker's melanosis.

How common is smoker's melanosis?

The prevalence of smoker's melanosis within the United States isn't known, but studies have been done in other countries. A Swedish study found that 21.5% of people who smoked tobacco had smoker's melanosis, compared to only 3% of non-smokers. A Turkish study reported that 27.5% of smokers had smoker's melanosis compared to 8.6% of non-smokers. Based on these studies, it's likely that the condition is common among American smokers, too.

Smoker's melanosis tends to affect females more often than males, possibly due to the effect of estrogen. It's more common among older people than younger people, which suggests that long-term smokers have a higher risk of developing smoker's melanosis.

If you are a smoker and notice dark patches inside your mouth, see your dentist right away. You may have smoker's melanosis, a cosmetic dental problem, but it could also be something more serious, so don't delay seeking treatment.