Oral malignant melanomas are extremely rare lesions and occur commonly in the maxillary gingiva more frequently on the palate with fewer incidences in the mandibular gingiva. Though these lesions are biologically aggressive, they often go unnoticed since they are clinically asymptomatic in the early stages and usually present merely as a hyperpigmented patch on the gingival surface. These lesions if diagnosed at an early in situ stage are potentially curable and definitely have a better prognosis, but unfortunately as they are clinically asymptomatic, it results in delayed diagnosis thus making the prognosis extremely poor. This paper presents the case of a patient who visited our department with the complaint of darkened patches on the gums and his concern was purely aesthetic. There were no symptoms associated with the hyperpigmented lesions and hence the patient did not approach us earlier. When the lesions grew larger and were unsightly, the patient has seeked dental advice. Histopathologic investigation confirmed the diagnosis as ‘Oral Malignant Melanoma’. Though aggressive therapy was instilled immediately, unfortunately, the patient succumbed to death within a few months after diagnosis as the lesion was highly invasive. Due to the biologically aggressive but clinically silent nature of progression of the lesion, the importance of maintaining a high index of suspicion and early detection and diagnosis for any pigmented gingival lesions cannot be overemphasised. Diagnosis must be based on thorough detailed history and valid histologic evidence.

Squamous cell carcinomas of the gingiva make up a significant percentage of oral squamous cell carcinomas and are one of the most common causes of death worldwide. Cancers of the gingiva often escape early detection, and hence an early intervention, since their initial signs and symptoms resemble common dental and periodontal infections. This article presents a case of a 29-year-old female patient who presented with a non-healing wound for about 1.5 months post-extraction. The wound was associated with pain and suppuration. A provisional diagnosis of alveolar osteitis was derived at with a differential diagnosis of osteomyelitis and carcinoma of the alveolus. The patient was advised a complete hemogram, orthopantomograph, and intra-oral periapical radiograph of the extraction socket. An incisional biopsy was carried out. Radiographs revealed extensive bone loss, and the biopsy report confirmed the diagnosis of well-differentiated squamous cell carcinoma of the alveolus. Carcinoma of the gingiva often mimics inflammatory lesions and hence is often misdiagnosed. Therefore, any oral lesion should strike a chord of suspicion, and practitioners should base their diagnosis on careful examination, and valid evidence.