Black appearing material is seen in the fibroadipose tissues beneath the normal squamous mucosa.

Higher power shows the material is irregularly distributed between fibroconnective tissue and does not elicit any inflammatory response.

An amalgam tatoo is recognized as a gray or blue spot on the oral mucosa, lips, tongue or palate, developing as a result of silver amalgam fillings within the mucosal soft tissues. They are usually only a few millimeters at most and sometimes are noticed on dental X-rays. The amalgam tatoo is generally permanent, unless specifically excised.

No treatment is required.

Completely benign.