The painless black spots inside the cheeks in a smoker are commonly caused by smoking-related pigmentation of the oral mucosa, but it is important to understand that any oral mucosal changes in a person who smokes must be properly examined by a doctor or dentist to rule out early precancerous changes â this is not something to ignore or delay. The cuts on the tongue and burning sensation are likely oral ulcers, which are frequently caused by
Vitamin B12 or B-complex deficiency, both of which are common in smokers. The constipation adds to the picture of possible nutritional deficiency and gut imbalance.
Next Steps
Please see a dentist or oral physician soon for a proper examination of the black spots â they can determine whether further investigation or biopsy is needed. Get
Vitamin B12 and B-complex levels tested. Reducing or stopping smoking is strongly advisable as continued smoking significantly worsens oral mucosal changes. Please consult me directly on Practo for a detailed evaluation.