The Case of a Foreign Body Tattoo

This 12-year-old boy was undergoing an initial evaluation at the orthodontics department when a grey-colored spot was noted above his left lateral incisor. Since there were no amalgams on his teeth, or had ever been, the orthodontist was curious about what it was.

I asked the mother if the patient had a history of trauma in the region. There had been an a bicycle accident when the boy was 6. He had lost his left central and lateral incisors as the result of it. She remembered that small spot being there for several years but couldn't recall exactly when it had appeared.

12-year-old boy with foreign body tattoo

This was called a foreign body tattoo. The most likely conclusion is that some kind of foreign material got incorporated at the site at the time of the accident. However, a pencil injury (graphite tattoo) or some other incident cannot be completely ruled out. No treatment is usually required for this condition unless the patient has esthetic concerns. In those cases, a simple surgical excision is sufficient.