Burton's line

Burton's line
Differential diagnosis	Chronic lead poisoning

Burton's line, also known as the Burton line or Burtonian line, is a clinical sign found in patients with chronic lead poisoning. It is a very thin, black-blue line visible along the margin of the gums, at the base of the teeth.[1][2] It is caused by the reaction between circulating lead and sulphur ions produced by oral bacteria, forming deposits of lead sulfide in the gums.[3]

The sign was described in 1840 by Henry Burton:[4]

The edges of the gums attached to the necks of two or more teeth of either jaw, were distinctly bordered by a narrow leaden-blue line, about the one-twentieth part of an inch in width, whilst the substance of the gum apparently retained its ordinary colour and condition.

A similar line, the "bismuth line", occurs in people who have ingested bismuth compounds; bismuth, however, is of relatively low toxicity.

References

1. Pearce JM (2007). "Burton's line in lead poisoning". Eur. Neurol. 57 (2): 118–9. doi:10.1159/000098100. PMID 17179719. Retrieved 2009-03-21.
2. Helmich, Friederike; Lock, Guntram (2018-11-08). "Burton's Line from Chronic Lead Intoxication". New England Journal of Medicine. 379 (19): e35. doi:10.1056/NEJMicm1801693. ISSN 0028-4793. PMID 30403939. S2CID 205088502.
3. Rao JV, Vengamma B, Naveen T, Naveen V (April 2014). "Lead encephalopathy in adults". J Neurosci Rural Pract. 5 (2): 161–3. doi:10.4103/0976-3147.131665. PMC 4064184. PMID 24966557.
4. Burton, Henry (1840-01-14). "On a remarkable effect on the human gums, produced by the absorption of lead" (PDF). Medico-Chirurgical Transactions. 23: 63–79. doi:10.1177/095952874002300106. PMC 2116895. PMID 20895719.