Salt and pepper effect in IOPA is seen in:
Sjogren syndrome
Thalassemia
Sickle cell anemia
Condensing osteitis
Intraoral radiographs in some cases reveal a peculiar trabecular pattern of the maxilla and mandible, characterized by an apparent coarsening of some trabeculae and the blurring and disappearance of others, resulting in a salt and pepper effect. In general, thinning of the lamina dura and circular radiolucencies in the alveolar bone are also found.
Shafer's Oral pathology, 7th ed, pg 768