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Other oxidative stress triggers include a poor diet, low physical activity, prolonged stress, and intrinsic factors, such as mitochondrial dysfunction leading to reduced adenosine 5-triphosphate (ATP) production, inflammation, and hypoxia (106, 117)

Increase in antioxidant activity was accomplished during KD by an increase of glutathione and glutathione peroxidase activity (111, 112)

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The most common location for smokers melanosis is the anterior labial mandibular gingiva, however, buccal mucosa, lip, hard palate, and tongue can also be affected [1, 2, 36, 45]