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melanotic macule gingiva have had for years Pigmented on the mandibular (a, case 1), affecting the Clinically Unusual Pigmented Lesion of
Description
This happens when your body is in a fluid deficit, and can occur because you're either not consuming enough fluid or you're losing too much (via NHS Inform)

(5) A control group should be included for comparison with the ALD group

Cancer 94 , 455459 (2006)
Eri RD, Adams RJ, Tran TV, Tong H, Das I, Roche DK, et al

Two thirds of the depressed patients had pain