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Definition

What is black hairy tongue?

Black hairy tongue is a temporary, harmless oral condition that gives the tongue a dark, furry appearance. The distinct look usually results from a buildup of dead skin cells on the many tiny projections (papillae) on the surface of the tongue that contain taste buds. These papillae, which are longer than normal, can easily trap and be stained by bacteria, yeast, tobacco, food or other substances.

Although black hairy tongue may look alarming, typically it doesn’t cause any health problems, and it’s usually painless. Black hairy tongue usually resolves by eliminating possible causes or contributing factors and practicing good oral hygiene.

How common is black hairy tongue?

Black hairy tongue is more common in men, people who use intravenous drugs, and those who are HIV-positive. Please discuss with your doctor for further information.

Symptoms

What are the symptoms of black hairy tongue?

The common symptoms of black hairy tongue are:

  • Black discoloration of the tongue, although the color may be brown, tan, green, yellow or white
  • A hairy or furry appearance of the tongue
  • Altered taste or metallic taste in your mouth
  • Bad breath (halitosis)
  • Gagging or tickling sensation, if the overgrowth of the papillae is excessive

There may be some symptoms not listed above. If you have any concerns about a symptom, please consult your doctor.

When should I see my doctor?

You should contact your doctor if you have any of the following:

  • You’re concerned about the appearance of your tongue

Black hairy tongue persists despite brushing your teeth and tongue twice daily

Causes

What causes black hairy tongue?

A black hairy tongue is caused by too much bacteria or yeast growth in the mouth. The bacteria build up on tiny rounded projections called papillae. These lie along the surface of the tongue. Instead of shedding as they normally do, the papillae start to grow and lengthen, creating hair-like projections. They can grow to 15 times their normal length.

Normally, the papillae are pinkish-white. But as they grow, pigments from food, drinks, and possibly the bacteria or yeast themselves get caught in the papillae, dyeing the tongue a color. Most often that color is black, hence the name. But the tongue can also turn brown, yellow, green, or a variety of other colors.

Risk factors

What increases my risk for black hairy tongue?

There are many risk factors for black hairy tongue, such as:

  • Poor oral hygiene
  • Smoking tobacco
  • Drinking a lot of coffee or tea
  • Using antibiotics (which may disrupt the normal balance of bacteria in the mouth)
  • Being dehydrated
  • Taking medications that contain the chemical bismuth (such as pepto-bismol for upset stomach)
  • Not producing enough saliva
  • Regularly using mouthwash that contains peroxide, witch hazel, or menthol
  • Getting radiation therapy to the head and neck

Diagnosis & treatment

The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.

How is black hairy tongue diagnosed?

Diagnosis of black hairy tongue is based on appearance and possible causes or contributing factors. It also includes eliminating other conditions that may cause a similar appearance to the tongue, such as:

  • Normal variations in tongue color (pigment)
  • Foods or medications that have stained the tongue
  • Fungal or viral infections
  • Oral lesions that occur on the tongue, such as oral hairy leukoplakia
  • Blackened tongue (pseudo-black hairy tongue) from using products containing bismuth, such as Pepto-Bismol

How is black hairy tongue treated?

Practicing good oral hygiene is the best way to treat black hairy tongue. Gently brush your teeth twice a day with a soft toothbrush. Also, brush your tongue. You can use a tongue scraper to make sure you’re thoroughly cleaning the area. Drink plenty of water throughout the day to help keep your mouth clean.

Other tips include:

  • If you smoke, quit.
  • Add more roughage to your diet. Soft foods won’t clean off the tongue effectively.

Call your doctor or dentist if the problem doesn’t get better on its own. Your doctor may prescribe antibiotics or an antifungal drug to get rid of the bacteria or yeast. Topical medications, such as tretinoin (Retin-A), are also sometimes prescribed. As a last resort, if the problem doesn’t improve, the papillae can be surgically clipped off with a laser or electrosurgery.

Lifestyle changes & home remedies

What are some lifestyle changes or home remedies that can help me manage black hairy tongue?

The following lifestyles and home remedies might help you cope with black hairy tongue:

  • Brush your tongue. Give your tongue a gentle brushing whenever you brush your teeth to remove dead cells, bacteria and food debris. Use a soft-bristled toothbrush or a flexible tongue scraper.
  • Brush after eating. Brush your teeth at least twice a day and ideally after every meal, using fluoride toothpaste.
  • Floss at least once a day. Proper flossing removes food particles and plaque from between your teeth.
  • Visit your dentist regularly. Get professional teeth cleanings and regular oral exams, which can help your dentist prevent problems or spot them early. Your dentist can recommend a schedule for you.
  • Maintain good nutrition. Drink plenty of water and eat a balanced diet that contains fresh fruits and vegetables.

If you have any questions, please consult with your doctor to better understand the best solution for you.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Sources

Review Date: September 13, 2017 | Last Modified: September 13, 2017

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