Black Hairy Tongue

Black hairy tongue is a generally harmless, mostly cosmetic, condition presenting the following symptoms ...

• unusual dark appearance -- usually black, but could also be shades of brown, white, green, or pink - often affected by secondary factors such as mouthwashes, breath mints; and / or

• the surface of the tongue may have a rough appearance and / or hairy appearance; and/or

• bad breath and/or a bad taste in the mouth

Potential Causes:

The "hairy" appearance is a result of a taller-than-normal forest of papillae on the surface of the tongue, which can grow to 15 times their normal length. The extra height comes from an accumulation of keratin (the chief protein found in hair and skin). In people suffering from a black hairy tongue not enough keratin is shed or maybe too much keratin is being produced at the surface of the tongue. 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 most often black - but the tongue can also turn brown, yellow, green or a variety of other colors.

This condition is most commonly seen in:

• the elderly
• those missing teeth and are on a soft diet as soft foods don't exfoliate the tongue as rough foods would naturally
• tobacco smokers and/or
• those undergoing chronic of extensive antibiotic treatment (overuse)
• poor oral hygiene
• radiation treatments to the head and neck

Patients with hairy tongue often may develop a secondary infection of candida.

Note:

• Pepto-Bismol, or other drugs that have bismuth as an ingredient, can cause a black discoloration or staining on your tongue for a few days. It is harmless and goes away a few days after you stop taking the medication.
• The tongue may also turn dark after eating or drinking certain things such as beetroot or red wine.

Possible Treatments

• Eliminate possible causal factors; for example:
  • stop smoking
  • strong mouthwashes that contain peroxide, witch hazel or menthol can cause this condition; therefore switching to a different mouthwash may help
  • antacids can also cause black hairy tongues
  • heavy coffee / tea consumption
  • address any dry mouth problems
  • if antibiotic treatments led to the condition, then the condition may resolve on its own after the antibiotic course is completed.

• Good oral hygiene, including:
  • scraping the surface of the tongue along with brushing the tongue with baking soda several times a day

• Since nutritional deficiencies may contribute to this problem, eat a well balanced diet along with taking vitamin and mineral supplements


• Antibiotics may be warranted if there is a suspicion of candida infection.

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