The dentist is in a strategic position to evaluate early color changes of the head and neck. Certain oral and perioral changes of pigmentation are amenable to early diagnosis. Systemically acquired generalized melanoses and nonmelanotic color changes should be periodically reviewed by all examining physicians and dentists. The multiple forms of acanthosis nigricans are described, and the triad of Albright's syndrome is compared with the findings of Peutz-Jegher's syndrome, multiple basal cell nevi, neurofibromatosis, and Addison's disease. The spectrums of changes seen in abnormal nonmelanotic pigmentation are reviewed, and the importance of recognition of drug-induced pigmentation is emphasized.