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Case Presentation A 25 years old male was referred form the Division of Diagnostic specialty clinics to the Division of Periodontics specialty clinics at King Khalid University College of Dentistry, Abha, Saudi Arabia, presenting with oral malodor and unaesthetic appearance due to unique heavy dark brown stains on lower lip vermillion border and mucosa, labial surfaces of lower anterior teeth with localized gingival recession and areas of fenestrations at attached gingiva of lower central incisors (Figure3,Figure 4)

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LGBTQ+ People living below the poverty level Uninsured/Medicaid Users 25-64+ Men People in the south/Midwest Adults with mental health or substance use disorder A closer look into Missouri