Macular Pigmented Oral Mucosal Lesions: An Amalgam Tattoo Case Report Dentistry Today An oral melanotic macule is a harmless dark spot found on the lip, most often the lower lip, or inside the mouth, either on the gums, inside the cheek, or on the roof of the mouth. An oral melanotic COM August 2004 Diagnosis UW School of Dentistry Differential Diagnosis of Pigmented Lesions in the Oral Mucosa: A Clinical Based Overview and Narrative Review