Bismuth intoxication is manifested as:

 # Bismuth intoxication is manifested as: 
a. Pigmentation in areas of inflammation 
b. Burtonian line 
c. Gingiva 
d. Blackish line in the mucosa 

The correct answer is D. Blackish line in the mucosa.

Oral Manifestations: Bismuth pigmentation of the oral mucosa, particularly of the gingiva and buccal mucosa, is the most common oral feature of bismuth therapy and is reported to occur in a high proportion of patients receiving preparations containing the metal.

The pigmentation appears as a ‘bismuth line’, a thin blue-black line in the marginal gingiva which is sometimes confined to the gingival papilla. There may also be the same type of pigmentation of the buccal mucosa, the lips, the ventral surface of the tongue, or in any localized area of inflammation such as around partially erupted third molars or around the periphery of an ulcer as an anachoretic phenomenon.

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