cultural gingival tattoo, oral pigmented lesion, intentional oral tattoo, ritualistic tattooing


Background: Cultural gingival tattooing is the practice of placing pigmented material into the maxillary anterior gingiva as a means of aesthetic enhancement, medicinal therapy, or assimilation in some African and Middle Eastern nations.

Case Description: This is a report of a 47-year-old female from Senegal who presented with cultural gingival tattooing for cosmetic purposes. The patient’s maxillary facial gingiva displayed a gradient of blue-grey-black pigment that extended from the right maxillary second molar to the left maxillary second molar.

Clinical Relevance: There are many systemic and local causes of pigmentation in the oral cavity, many of which require laboratory testing or biopsy for definitive diagnosis and resultant appropriate therapy. In contrast, cultural gingival tattooing is a clinically recognizable entity in the context of an appropriate patient history. While this entity is clinically diagnostic, it can pose a hurdle in routine oral cancer screening as it has the potential to obscure other pathoses.