Diagnosis of Black Tongue

Black tongue is also known as hairy black tongue. While it may sound like an ominous disease, bad comic book character, or a dangerous pirate name, it is a harmless oral health condition. Black tongue varies in cause and severity from individual to individual and usually clears up without any type of medical intervention.

Facts

• Black tongue occurs when the tiny finger-like protuberances on the tongue, the papillae, fail to shed properly. They become elongated and result in the tongue looking fuzzy, or hairy. The papillea trap bacteria and microscopic bits of debris in the mouth causing the tongue to appear black, brown, or yellow. Black tongue typically occurs on the frontal area of the tongue.

Symptoms

• The most noticeable symptom of black tongue is the fuzzy, black appearance. The individual may also experience an altered sense of taste. Food and beverages may taste metallic or stale. They will have bad breath despite repeatedly brushing their teeth or an unpleasant taste that lingers. A stronger than normal gag reflex may also occur.

Causes

• Hairy black tongue has a number of causes including poor oral hygiene practices. Black tongue can be the result of a change in the normal levels of bacteria and yeast contained in the mouth due to the use of antibiotic, anti-psychotic, anti-depressant and anti-cholinergic medications. Dehydration, breathing through the mouth, illness, radiation therapy and medications with bismuth as an ingredient also lead to hairy black tongue. Not eating a proper diet and heavy tobacco usage also have the potential to lead to black tongue. Mouthwash containing oxidizing agents like peroxide or astringent agents also contribute to the development of black tongue.

Treatment

• Black tongue caused by prescription medications requires a change in dosage or a change in medication to resolve the condition. The individual should discuss this with their doctor. Properly and thoroughly brushing the teeth and tongue and flossing on a daily basis helps to clear the black tongue up. Anti-fungal medications may be prescribed for advanced cases of hairy black tongue that prove to be stubborn. Medical treatment of black tongue is usually not necessary.

Considerations

• Black tongue is a preventable oral health issue. Maintaining proper oral hygiene, not using tobacco products and maintaining a healthy diet will go far in helping to avoid this embarrassing oral health issue. Concerns regarding radiation therapy and medications can be addressed with the individual's doctor. Black tongue develops over a period of a few weeks and clears up on its own in a comparable amount of time.