Sir, we would like to share a very unusual case. We recently extracted these two severe intrinsically discoloured (greyish-black) upper and lower left third molars in a mildly asthmatic lady in her mid-30s (Fig. 1). These teeth were mildly impacted, vital, non-carious and were associated with severe pericorontis and cheek biting. Radiographic appearance was normal. All other teeth in the oral cavity including the contralateral third molars were normal in appearance. The patient is a non-smoker and an occasional drinker. There was no history of severe childhood illness or tetracycline antibiotic therapy.

Figure 1
figure 1

The extracted upper and lower left third molars

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A crude vertical section of one of these teeth (Fig. 2) revealed the discolouration confined to enamel only suggesting disturbances during amelogenesis. The initial calcification of third molars occurs between the ages of 7-10. Other differentials would include porphyria or metallic discolouration.

Figure 2
figure 2

Vertical section of one of the extracted teeth

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However, this ipsilateral involvement is quite perplexing as some degree of disturbance in enamel formation is also expected on the contralateral third molars during this period.

A search of the literature for a tooth of similar description revealed no results.

It would be interesting to know if anyone else has come across such a finding before.