Amalgam Tattoo

By | October 27, 2021

An amalgam tattoo is created when the dental filler amalgam is deposited in the gums. This creates the typical black-dark discoloration, especially on the gumline.

What is an amalgam tattoo?

According to ACRONYMMONSTER.COM, a deposit of the dental filler amalgam in the gums can lead to discoloration of the gums.

The amalgam tattoo is now a phenomenon in the oral cavity, because the filling material amalgam was used in many patients. Black metal pigments, so-called amalgam particles, build up over time around the gums near a filling. The periodontium and gums in the immediate vicinity of the filling material are therefore affected.

In addition, the finding can sometimes also be seen as an unsightly, dark gum line near metal crowns. If the amalgam tattoo occurs on the inside of the cheek, many patients are concerned because they consider the phenomenon to be another, more serious disease.

But even in this case it is only a matter of tiny metal particles in the mucous membrane of the cheeks. The original name of an amalgam tattoo comes from these trapped particles in the lining of the cheek. While drilling out old amalgam fillings, these were thrown against the cheek mucosa and actively pressed into it, i.e. tattooed.

If the amalgam tattoos can be seen on the alveolar ridge, this can indicate excess amalgam or overpressed fillings that were not removed and rinsed away carefully enough after the amalgam filling was made.


The dental material amalgam is considered problematic because of its high mercury content. Measurements of electrolysis in the oral cavity and blood analyzes for mercury come to the conclusion that over time the mercury, which is initially firmly anchored in the amalgam as an alloy, is dissolved out and swallowed with the saliva.

According to the current state of knowledge, the toxic heavy metal mercury is neither metabolized nor rendered harmless by the liver cells. So there is no detoxification of the released mercury in the organism. This is why many patients have their amalgam fillings removed. The fillings should only be removed in large pieces and with the help of plenty of water spray.

The German Society for Dentistry now regards any form of amalgam tattoo as a malpractice. The main causes of amalgam tattoos are considered to be iatrogenic, that is, caused by the action of the dentist. The problem of amalgam tattoos was not known as such for a long time, only when such phenomena became more frequent, a more detailed investigation of the causes was carried out.

The range of instruments and the working methods of dentists have continued to be optimized, so that patients today hardly have to reckon with the phenomenon of an amalgam tattoo after the removal of old amalgam seals. The unsightly discolored gums particularly affect patients who had their old amalgam fillings removed in the 1980s and 1990s.

Symptoms, ailments & signs

The amalgam alloy has no place outside of a tooth filling, so any form of amalgam tattoo represents a potential health risk for the patient. Because the mercury that is dissolved out enters the bloodstream through contact with the mucous membrane, it is deposited as a heavy metal in the liver and fatty tissue.

Removal is then no longer possible. The signs and symptoms of latent mercury intoxication can be very diverse and as such are not directly associated with amalgam over a long period of time.

The most important key symptom of an amalgam tattoo for the patient and the dentist are metal particles trapped in the oral mucosa, these trapped amalgam particles then lead to the pigment-like black discoloration of the cheek mucosa or the gums near the amalgam fillings.

Amalgam tattoos are particularly disturbing from a cosmetic point of view, and most dentists consider the disease value to be low. Nevertheless, the consequences of years of creeping mercury poisoning should not be underestimated. Especially against the background that every patient reacts differently to the mercury.

Diagnosis & course

The diagnosis is made in the dental practice on the basis of the visual findings. It is worthwhile for the patient to have a second dental opinion, because even today there are dentists who are unfortunately not aware of the phenomenon of amalgam tattoos. Amalgam tattoos are always chronic in the oral cavity of the person affected, unless therapeutic remedial action is taken in good time.

In terms of differential diagnosis, an amalgam tattoo must be distinguished from other putrefactive processes of the oral mucosa and from malignant melanoma of the oral mucosa. In its early stages, this black skin cancer of the oral mucosa can look astonishingly like an amalgam tattoo. For a differential diagnosis, the affected oral mucosa can also be examined histologically. In the fine tissue, a so-called foreign body granuloma appears as a local defense reaction of the mucous membrane against the amalgam inclusion.


In and of itself, having an amalgam tattoo in the oral cavity is not a cause for concern. The unsightly discoloration of the oral mucosa is actually caused by an amalgam entry into the oral mucosa. However, the amalgam tattoo usually does not need treatment. However, the doctor could decide differently if there is a real allergy to heavy metals or especially amalgam components.

In addition to the highly toxic mercury, the amalgam also contains metallic components such as tin, copper, silver, palladium and zinc. An allergy can potentially be triggered to any of the metals it contains. However, the amalgam allergy is very rare. It would be noticeable immediately after placing an amalgam seal.

The associated symptoms usually go away after a while. However, further amalgam seals should be avoided. The amalgam tattoo is itself a therapy-related complication that can arise when an amalgam seal is placed. However, the consequences of amalgam tattoos are considered harmless by medicine. Nevertheless, the dark discoloration of the oral mucous membrane near the seal can become inflamed by various circumstances.

In this case, it should be checked whether local treatment of the inflamed area is necessary because of this complication. According to current medical understanding, the amalgam tattoo itself cannot be understood as a medical complication that requires treatment. Whether an alternative practitioner would recommend the removal of the amalgam varies.

When should you go to the doctor?

In the case of amalgam tattoos on the gums, those affected should definitely go to the dentist . The grayish discoloration on the gums indicates that there is too much wear and tear from old amalgam seals. Therefore, a visit to the dentist should clarify whether and how the fillings need to be removed. It is probably advisable to replace the old amalgam seals with plastic seals or ceramic inlays.

The likelihood of long-term consequences from amalgam wear increases with the number of amalgam seals. Environmentalists say more than nine seals with recognizable amalgam tattoos are dangerous. The dentist should determine to what extent there are already other reasons for a necessary dental rehabilitation. These can include, for example, a weak immune system or small electric shocks in the mouth.

A visit to the doctor for amalgam tattoos is also advisable, because diseases such as Alzheimer’s and Parkinson’s can occur as a long-term consequence of years of wear and tear from amalgam or mercury particles. The abrasion is not harmful from the point of view of conventional medicine, but it can be different in individual cases. The dentist or a trained environmental doctor can determine whether there are signs of chronic poisoning, intolerance or allergy to dental materials.

The problem is that most orthodox doctors follow the paradigm that amalgam tattoos are harmless. A purely symptom-based medicine will unfortunately hardly conduct research into the causes. Therefore, the choice of doctor should be made with care.

Treatment & Therapy

Since the exact cause of the amalgam tattoo is known, the patient can be offered a causal therapy, with the help of which the amalgam inclusions in the mucous membrane can be completely and permanently removed. However, several therapy sessions may be required for this. For amalgam tattoo removal, a patient should only see a dentist who is familiar with the electrolytic removal process and has experience in the field.

Every time the amalgam is removed, there is an additional risk of the release of mercury. For the therapy of choice, the dentist works with the so-called loop electrode of an electrotome. The tattooed area is brushed with the electrode with a medium current. Once the individual granules are exposed, they adhere to the loop and can be carefully removed from the oral cavity.

Outlook & forecast

As a rule, amalgam tattoos discolour the gums so that they look black. This can significantly reduce the health of the person affected, so that amalgam poisoning can still occur. In most cases, the discoloration is not directly visible, so that there are no particular complications or complaints. If the person concerned does not take amalgam at regular intervals, no further complaints will arise. Diagnosis of this disease can be made directly by a dentist.

Amalgam tattoo treatment can be done by removing it. In most cases, the affected person has to have several sessions, as the treatment is associated with pain in some cases . However, there are no further symptoms and the symptoms disappear after the treatment.

Whether there is any consequential damage to the body itself depends on the amount of amalgam absorbed. Sometimes it comes to headaches or fatigue . With small amounts, however, there are no life-threatening symptoms. The affected person may have to have their dental fillings renewed and forego the amalgam.


The best prevention against amalgam tattoos is to absolutely avoid the dental material amalgam. This is possible today in almost all cases of fillings for the treatment of caries . If old amalgam seals are to be removed, the dentist must not only use the necessary instruments but also exercise the necessary filigree care so that the amalgam tattoos cannot even result in typical iatrogenic damage.


An amalgam tattoo is not a serious condition. Possible symptoms of intoxication have not yet been proven. If a treatment is carried out, optical aspects are usually relevant. If the discoloration is visible when you laugh or speak, it makes people feel uncomfortable around other people.

The risk of a personality change arises. Since follow-up care refers to scheduled check-ups in the event of an illness, it does not play a role in the case of an amalgam tattoo. Patients consult their dentist as soon as they see the blue-gray or blue-black spots.

Together with the person concerned, he or she decides on therapy. Several treatment appointments are often required. Removal using a twisting probe with an electrotome has become established. After a successful treatment, the therapy is over. However, there is no immunity to the amalgam tattoo. The patient can suffer from the spots again at any time. Only an independent precaution prevents recurrence. Those affected should avoid the material amalgam, which triggers the discoloration.

Longer follow-up care is conceivable in rare cases. If the patient has developed an allergy to heavy metals, old amalgam seals must be removed. These productions are no longer used in today’s tooth corrections. Follow-up care then aims to document the state of recovery.

You can do that yourself

Once the amalgam tattoo diagnosis has been confirmed and it has been established that the discoloration in the mouth is not a malignant mucosal melanoma, the patient can breathe a sigh of relief.

There are various discussions about whether the amalgam particles stored in the oral mucosa represent a burden for the body. But even if there are no complaints, the dark area can be cosmetically annoying and should be removed. Depending on the size of the amalgam tattoo, however, this procedure can be quite time-consuming, because transplants are then required to cover the defect.

If the patient with an amalgam tattoo suffers from diffuse symptoms such as headache or chronic fatigue, amalgam poisoning can be considered. This is especially true if the patient is known to have an allergic reaction to certain metals and amalgam components. Even then, removal of the tattoo should be attempted.

Following this, draining and detoxifying measures are helpful. For this purpose, the patient should place himself in the hands of a naturopathic doctor or alternative practitioner who will prescribe appropriate homeopathic remedies . But saunas, steam baths and sweat-inducing sport also detoxify the organism. Even various foods have a detoxifying effect, such as asparagus or fruit that is rich in water. During the detox process, the patient should allow themselves plenty of rest and avoid alcohol and nicotine.

Amalgam tattoo