Lead toxicity is a major global health concern, affecting both children and adults through environmental, occupational, and consumer product exposure. Despite regulatory efforts to minimize risk, lead continues to pose significant hazards, particularly in developing regions and among vulnerable populations. One of the classical, though now rare, clinical signs of chronic lead poisoning is the Burtonian line—a bluish-black pigmentation along the gingival margin caused by the reaction between circulating lead and hydrogen sulfide produced by oral bacteria. This review explores the historical background, sources of exposure, pathophysiological mechanisms, and systemic manifestations of lead toxicity. It emphasizes the diagnostic significance of Burtonian lines in identifying chronic lead exposure. The article also discusses current diagnostic approaches including blood lead level testing, hematological findings, and radiographic imaging. Treatment strategies focus on exposure elimination, chelation therapy, and supportive care. While Burtonian lines are infrequently observed today due to improved public health measures, they remain an important clinical clue in diagnosing lead poisoning, especially in individuals with poor oral hygiene. Early recognition and intervention are vital to preventing the irreversible effects of lead on multiple organ systems.
Keywords: Lead poisoning, Blood lead levels, Burtonian line.
