A 28-year-old African-American woman visited an urgent care dental school clinic for evaluation of a painful right mandibular molar. Her medical history was unremarkable. The remainder of her intraoral and extraoral examination findings were within normal limits except for the presence of multiple small asymptomatic lesions on the right buccal mucosa, of which the patient was unaware (Figure 1). The lesions could not be “wiped off.” Further questioning of the patient did not reveal any parafunctional habits, allergies, history of trauma, medication use or medical conditions that seemed relevant to the source of the lesions. The attending dentist (M.J.K.) referred the patient to the Department of Oral and Maxillofacial Surgery, University of Maryland Dental School, Baltimore, for removal of the molar and a biopsy of the mucosal lesions.