ulcerations with a rim of erythema on the buccal mucosa, lips, and lateral aspect of the tongue Patients are usually afebrile Spontaneous resolution occurs in to 10 days, and recurrence is common Less commonly, aphthous stomatitis may occur with a constellation of symptoms seen in the syndrome of PFAPA (p eriodic f ever, a phthous stomatitis, p haryngitis, and cervical a denitis) Children with PFAPA are usually between and years of age, and experience episodes of or days of high fevers along with aphthous stomatitis, pharyngitis, and cervical adenitis, recurring every to weeks Etiology is unknown, and there are no long-term effects Erythema migrans, also known as benign migratory glossitis or geographic tongue, is a benign inflammatory disorder causing migratory, smooth, annular patches on the tongue Patients are typically asymptomatic, but may complain of pain No treatment is required Traumatic tooth brushing or other habits leading to friction on the oral mucosa may cause white or gray lesions that may be smooth or rough, termed frictional keratosis Lesions are most commonly found on the buccal mucosa and resolve with removal of the irritant Gingival hyperplasia seen in patients receiving long-term anticonvulsant therapy with phenytoin is irreversible However, gingival overgrowth occurring with cyclosporine or nifedipine use is reversible with discontinuation of the drug Poor dental hygiene appears to play a role in the cause The gingivae undergo fibrous enlargement but are not inflamed or painful Gingival fibromatosis is an inherited form of gingival hyperplasia Painless, leathery, white patches or plaques termed leukoplakia may develop in areas of long-term smokeless tobacco exposure This is typically found on the mucosa of the buccal sulcus, and may result in dysplasia or carcinoma Linea alba is a sharply demarcated white line on the buccal mucosa opposite the plane of dental occlusion It is a benign finding present in up to 5% of adolescents Areas of brown or black hyperpigmentation may be physiologic in patients with darker skin The bronzing of adrenal insufficiency (Addison disease) may be present on intraoral mucosa, as well as over the external skin Flat, blue-gray lesions known as amalgam tattoos may be found in soft tissue adjacent to amalgam dental fillings due to inadvertent misplacement of filling material Graphite exposure from trauma may result in similar lesions Localized brown, blue, gray, or black macules or papules, most commonly on the hard palate, may represent melanotic nevi These are often treated with excisional biopsy to rule out mucosal melanoma The finding of multiple intraoral and perioral