Oral pigmented lesions: a pragmatic approach to diagnosis and management Faculty Dental Journal 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 Kiss and Tell: Variations of Normal and Pathology of the Lips Today's RDH Clinical Challenge: Dark Lesion on Lower Lip MPR