Oral Melanotic Macule MEDizzy Melanocytic Lesions A Guide to Clinical Differential Diagnosis of Oral Mucosal Lesions Continuing Education Course dentalcare.com WHAT CAUSES A BLACK SPOT ON GUMS? Fairywill What Caused These Multiple Hyperpigmented Macules of the Mouth? 56M with an asymptomatic, darkly pigmented lesion on the attached gingiva of the maxilla, an irregularly shaped macule with varied pigmentation, including shades of black, brown, and gray. Brendan Gallagher, DDS